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10 Things You Should Know About
COVID-19 Vaccination in Pregnancy

By Dr. Kristina AdamsWaldorf, Carly Baxter, Dr. Sylvia LaCourse, Isabelle Crary and Sara Rutz

Having a baby can be anxiety-provoking even without the additional stress of a worldwide pandemic. When you’re pregnant, you want to make sure that what you put into your body is safe for you and your new family member. The COVID-19 pandemic has heightened these concerns and many wonder: what are the best ways to keep myself and my baby healthy? Below are several key takeaways about COVID-19 vaccine and pregnancy, grounded in the latest medical research.

1. COVID-19 vaccination is safe for you and your baby.​​
Numerous studies with thousands of pregnant and breastfeeding individuals have shown that COVID-19 vaccinations are safe and effective. Nearly 200,000 pregnant individuals in the US have already received at least one of the COVID-19 vaccines.The mRNA COVID-19 vaccines do not contain a “live virus” or any harmful ingredients and therefore do not pose a risk to the developing baby. When the vaccine is administered, the ingredients remain in the muscle of the arm for just a few days, where they induce a beneficial immune response.  What we do know from many studies on COVID-19 vaccinations in pregnancy, is that the healthy antibodies produced from the pregnant person’s immune system can be transferred to the baby and provide at least partial protection once the baby is born.

2. The COVID-19 vaccine doesn’t cause miscarriage or stillbirth.
It is estimated that 11% to 22% of all pregnancies end in miscarriage. In a study following 2,456 pregnant people who received the COVID-19 vaccine, a miscarriage occurred in 12.8%. This is what we would normally expect. We have seen no increased rates of stillbirths associated with COVID-19 vaccination in pregnancy. However, there is some evidence suggesting that contracting COVID-19 during pregnancy could increase the risk of adverse outcomes like stillbirth.

3. You can still get COVID-19 if you are vaccinated.
The COVID-19 vaccine does not guarantee that you will never become infected with COVID-19. However, getting the COVID-19 vaccine does significantly reduce your risk of getting infected while pregnant. Studies have also shown that pregnant individuals who are vaccinated and contract COVID-19 are less likely to be hospitalized than those who are not vaccinated.

4. Catching COVID-19 can be extremely dangerous for pregnant people and their babies.
Several factors, such as altered immune systems and bodily stress, cause the pregnant population to be more susceptible to severe COVID-19 disease. Studies have shown that pregnant or recently pregnant individuals catching COVID-19 disease have a much higher risk of dying, being hospitalized, needing a breathing tube, and having a preterm birth or stillbirth delivery. Overall, pregnant individuals with COVID-19 are 22 times more likely to die in pregnancy compared to uninfected pregnant people. Obesity and other underlying conditions, such as diabetes, further increase these risks. When pregnant individuals become ill with COVID-19 and need a ventilator, one way to improve their breathing is by delivering the baby via an emergency C-section. Delivering the baby prematurely (weeks or months earlier than due) could help the pregnant person survive, but at the risk of the baby’s health. Preterm birth is harmful for your baby and can lead to serious complications including developmental and physical disabilities, long NICU stays, and even fetal death. Unvaccinated pregnant individuals with COVID-19 have a 59% higher rate of preterm birth compared to those without COVID-19.

5. You can get the COVID-19 vaccine in any trimester.
The sooner, the better. It is safe for you and your baby to receive the COVID-19 vaccine at any stage in pregnancy. There is no increased rate of miscarriage after receiving the vaccine. Given the risks of COVID-19 infection in pregnancy and complications for your health and your baby’s health, the sooner you get vaccinated, the more protected you both will be.

6. The COVID-19 vaccine is NOT linked to birth defects.
Three to five percent of babies in the United States are born with a birth defect. Among 1,612 women receiving the COVID-19 vaccine while pregnant, 45 had birth defects for a rate of 2.7%. This is what we would normally expect and does not indicate any relationship to the COVID-19 vaccine.

7. You should still get the vaccine even if you already had COVID-19.
Compared to natural infection, the vaccine triggers the body to make powerful protective antibodies, which are successfully transferred to the baby during pregnancy. And many people have become sick with COVID-19 more than once, which is likely the case due to the weaker immune response that comes from natural infections. Just because you had COVID-19 before, doesn’t mean it’s safe to remain unvaccinated.

8. The vaccine protects your baby when you are breastfeeding.
Breast milk offers much more than nutrition. It’s long been known to carry protective antibodies from mother to infant, shielding them from infection. Many studies have shown that breast milk from individuals vaccinated against flu while pregnant contains protective antibodies that can be passed to the infant. Recent studies have shown that similar protective antibodies against COVID-19 transfer in breast milk following vaccination. This is an excellent way to protect your baby from infection with COVID-19 once they’re born.

9. COVID-19 vaccines do cause some short term side effects.Commonly reported side effects associated with the COVID-19 vaccines are identical for pregnant and non-pregnant individuals, and include fevers, fatigue, headaches, and body aches. Interestingly, a study of nearly 8,000 pregnant women found that there were fewer reports of side effects, like fever and muscle pain, compared to non-pregnant women.

10. You don’t need health insurance to get the COVID-19 vaccine.
COVID-19 vaccines are free to everyone in the US regardless of health insurance or immigration status. They were paid for by taxpayers and are given to all people in the country.
If you have more questions, please visit our homepage, www.OneVaxTwoLives.com

Meet the Authors

Kristina Adams Waldorf, MD

Kristina Adams Waldorf, MD is a Professor of Obstetrics and Gynecology and Adjunct Professor of Global Health at the University of Washington School of Medicine. She is an internationally recognized expert in how infections impact pregnancy and how vaccines and therapeutics protect the mother and fetus. She is Chair of the National Institutes of Health Obstetrics and Maternal-Fetal Biology Study Section. She is a member of the Center for Reproductive Sciences and the Center for Innate Immunity and Immune Diseases. Her grant support has come from the National Institutes of Health, the March of Dimes, Burroughs-Wellcome Fund, the Canadian Institute for Health Research and the Australian National Medical Research Council.

Sara Rutz

Sara Rutz graduated from the University of Alaska, Anchorage with a Bachelor of Science degree in Natural Sciences and a minor in Psychology. She is now a third year medical student at the University of Washington School of Medicine. Prior to medical school, she worked with diverse & underserved populations in patient care settings and as an insurance specialist for 5 years. She has been involved in research on improving outcomes for infants with Neonatal Opioid Withdrawal Syndrome, quality improvement in obstetric care, and providing up to date information as a volunteer for the COVID-19 Literature Surveillance Team. She is passionate about reproductive medicine and improving access to care for rural and underserved populations.

Carly Baxter

Carly Baxter graduated from the University of Puget Sound with a Bachelor of Science degree in Biology and a minor in French studies. She is now a 2nd year medical student at the University of Washington School of Medicine. She has worked with the MaMHA (Maternal Mental Health Access) group coordinated by the University of Washington and WA Department of Health in an effort to reduce maternal mortality rates in WA state. She is passionate about reproductive justice, equitable health care access and volunteering within her community at local health fairs.

Isabelle Crary

Isabelle Crary graduated from Stanford University with a Bachelors of Arts in Human Biology. She is now a second year medical student at the University of Washington. She has been involved in research on anemia in pregnancy, breast cancer prevention and treatment, and adolescent nutrition. She is passionate about healthcare for individuals who are pregnant, reproductive justice and nutrition education.