Pregnancy

Because there are not currently enough COVID-19 vaccine doses to go around at this time, the ACIP recommends that healthcare personnel and those working and living in long-term care facilities be offered the first available doses of vaccine.

Pregnant and breastfeeding women, who are a part of a group that is recommended to get a COVID-19 vaccine, may choose to be vaccinated. 

Things to Consider When Getting Deciding Whether to Get a COVID-19 Vaccine (Advice from CDC and the Advisory Committee on Immunization Practices)

• Getting a COVID-19 vaccine is a personal choice for pregnant and breastfeeding women. While a conversation with a healthcare provider may be helpful, it is not required prior to vaccination. Key considerations pregnant and breastfeeding women can discuss with their healthcare provider include:
  • The likelihood of exposure to COVID-19
  • The risks of COVID-19 to them and potential risks to their fetuses/newborn baby
  • What is known about the vaccine: how well it works to develop protection in the body, known side effects of the vaccine, and lack of data during pregnancy and breastfeeding
• Pregnant women are at higher risk of severe illness from COVID-19, including illness that results in ICU admission, placement of a ventilator, and death. Additionally, pregnant women with COVID-19 might be at increased risk of adverse pregnancy outcomes, such as preterm birth.
• The mRNA COVID-19 vaccines (both Pfizer-BioNTech and Moderna COVID-19 vaccines are mRNA vaccines) are expected to have some side effects, especially after the second dose. Pregnant women who experience fever following vaccination may be counseled to take acetaminophen because fever has been associated with adverse pregnancy outcomes. Acetaminophen may be offered as an option for pregnant women experiencing other post-vaccination symptoms as well.
• There are limited data about the safety of COVID-19 vaccines in people who are pregnant. Animal developmental and reproductive toxicity (DART) studies are ongoing and studies in people who are pregnant are planned. CDC and the Food and Drug Administration (FDA) have safety monitoring systems in place to capture information about vaccination during pregnancy and will closely monitor reports. While studies have not yet been done, based on how mRNA vaccines work, experts believe they are unlikely to pose a risk for people who are pregnant. mRNA vaccines do not contain the live virus that causes COVID-19 and therefore cannot give someone COVID-19. Additionally, mRNA vaccines do not interact with genetic material DNA because the mRNA does not enter the nucleus of the cell. Cells break apart the mRNA quickly. However, the potential risks of mRNA vaccines to the pregnant person and her fetus are unknown because these vaccines have not been studied in pregnant women.
• Routine testing for pregnancy before COVID-19 vaccination is not recommended. Women who are trying to become pregnant do not need to avoid pregnancy after receiving an mRNA COVID-19 vaccine.
• There are no data on the safety of COVID-19 vaccines in breastfeeding women or on the effects of mRNA vaccines on infants who are breastfed or on milk production/excretion. mRNA vaccines are not thought to be a risk to breastfeeding infants.
• Pregnant and breastfeeding women who decide to get vaccinated should continue to follow the current guidelines to prevent the spread of COVID-19 after they are vaccinated:
  • Wear a mask over your nose and mouth
  • Stay at least six feet away from others (social distancing)
  • Avoid crowds
  • Wash your hands with soap and water for 20 seconds or using hand sanitizer with at least 60% alcohol
  • Follow CDC travel guidance
  • Follow quarantine guidance after being around someone sick with COVID-19

Read what the American College of Obstetricians and Gynecologists (ACOG) has to say about COVID-19 vaccination of pregnant and lactating women.

For more information about COVID-19 and the vaccines being created to prevent it, visit vaccinateyourfamily.org/covid19.

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Yes. According to the CDC, based on what is known at this time, pregnant people are at an increased risk for severe illness from COVID-19 compared to non-pregnant people. Additionally, pregnant people with COVID-19 might be at increased risk for other adverse outcomes, such as preterm birth.

How Can Pregnant Women Protect Themselves and Their Babies from COVID-19?

If you are pregnant, it is important to know how to be as safe as possible in order to help protect yourself and your baby.

The CDC recommends that you (and people you live with) take the following steps:

• Limit interactions with people who might have been exposed to or infected with COVID-19, including people within your household, as much as possible.
• When going out or interacting with others outside your immediate household,
  • Wear a mask, especially when other social distancing measures are difficult to maintain. (Wearing a mask is not a substitute for other preventive actions like washing hands frequently and avoiding close contact with other people.)
  • Avoid others who are not wearing masks or ask others around you to wear a mask, if possible.
  • Stay at least 6 feet away from others outside your household (both indoors and outdoors).
  • Wash your hands with soap and water for at least 20 seconds. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
• Avoid activities where taking protective measures and social distancing may be difficult.
• Don’t skip your healthcare appointments.
• Get recommended vaccines and a 30-day supply of your medicines.

Visit ACOG’s website for more information and advice for pregnant women related to COVID-19.

Even breastfed babies need to be protected with vaccines at the recommended ages.

While breast milk provides your baby with important protection from some infections, such as colds, ear infections and diarrhea, breast milk will not protect them against all diseases.

Your baby needs the long-term protection  that can only come from making sure they get all their vaccinations according to the CDC’s recommended immunization schedule, before they are exposed to dangerous infectious diseases.

Yes. The flu shot is safe, during any trimester, for both you and your  baby. The flu shot has been safely given to millions of pregnant women over many years. You can not get the flu from the flu vaccine.

Multiple studies have shown that women who have gotten flu shots during pregnancy have not had a higher risk for miscarriage. One of the largest and strongest studies was conducted in CDC’s Vaccine Safety Datalink (VSD) project. The study looked at three flu seasons to see if there was any increased risk for miscarriage among pregnant women who had received a flu vaccine during their pregnancy. The study found NO increased risk for miscarriage after flu vaccination during pregnancy

It is also safe for women to get the flu vaccine while breastfeeding. In fact, breastfeeding also helps to protect babies because breast milk passes your antibodies to your baby, and these antibodies help your baby fight off flu.

Following is a list of studies that show that the flu vaccine is safe during pregnancy. Click on the studies below to read the research.

• Review of reports to the Vaccine Adverse Reporting System (VAERS) (Moro et al, 2011, Moro et al, 2011 Moro et al, 2017) – A review of the reports to VAERS found no evidence to suggest a link between pregnancy complications or adverse fetal outcomes among pregnant women and flu shots.
• Case-Control Study of Inactivated Influenza Vaccine and Spontaneous Abortion in the Vaccine Safety Datalink, 2012-13, 2013-14, and 2014-15 – During the February 2019 meeting of the Advisory Committee on Immunization Practices (ACIP), the results of a recent study of flu vaccination of pregnant women were presented by James Donahue PhD, DVM, senior epidemiologist with the Marshfield Clinic Research Institute. The study, which specifically looked at flu vaccine and miscarriage, was a matched case-control study of women ages 18-44 in the 2012-’13, 2013-’14 and 2014-’15 flu seasons. The study’s findings showed no link between flu vaccine during pregnancy and spontaneous abortion within 28 days, and supports the safety of flu vaccine in early pregnancy.

• Adverse events in pregnant women following administration of trivalent inactivated influenza vaccine and live attenuated influenza vaccine in the Vaccine Adverse Event Reporting System, 1990-2009 – American Journal of Obstetrics and Gynecology, February 2011 – This article is a review of reports to the Vaccine Adverse Reporting System (VAERS), which found no unusual or unexpected patterns of reporting for pregnancy complications or adverse fetal outcomes among pregnant women and flu shots.
• Trivalent inactivated influenza vaccine and spontaneous abortion – Obstetrics & Gynecology, January 2013 – A study using Vaccine Safety Datalink (VSD) data found no increased risk of miscarriage among pregnant women who received flu vaccines in the 2005-06 or 2006-07 flu seasons.
• Inactivated Influenza Vaccine During Pregnancy and Risks for Adverse Obstetric Events – Obstetrics & Gynecology, September 2013 – A large study using VSD data found no increased risk for adverse obstetric events (like chorioamnionitis, pre-eclampsia, or gestational hypertension) for pregnant women who received the flu vaccine from 2002 to 2009 when compared to pregnant woman who were not vaccinated.
• Maternal Influenza Vaccine and Risks for Preterm or Small for Gestational Age Birth – Pediatrics, May 2014 – A study using VSD data compared pregnant women who received the flu shot with an equal number of pregnant women who did not receive the flu shot during the 2004-05 and 2008-09 flu seasons. The study found no differences between the two groups in the rates of premature delivery or small for gestational age infants.
• First Trimester Influenza Vaccination and Risks for Major Structural Birth Defects in Offspring – Pediatrics, August 2017 – A large study using VSD data found that the babies of women who received the flu shot during their first trimester had no increased risk of having children with major birth defects.

The CDC, the American Academy of Family Physicians (AAFP), the American College of Nurse-Midwives (ACNM), the American College of Obstetricians and Gynecologists(ACOG), and Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) all strongly recommend that pregnant women get a flu shot for the best protection – for them and their babies – against serious flu illness and flu-related complications.

Flu shots have been safely given to millions of pregnant women over many years.

The CDC monitors flu vaccine safety in pregnant women during each flu season using the Vaccine Adverse Event Reporting System (VAERS) – a U.S. system that monitors health concerns following vaccination. In addition, vaccine safety research is done through the Vaccine Safety Datalink (VSD). which is a collaboration between CDC and nine healthcare organizations.

View the large number of vaccine safety studies on flu vaccination during pregnancy.

The CDC, the American Academy of Family Physicians (AAFP), the American College of Nurse-Midwives (ACNM), the American College of Obstetricians and Gynecologists(ACOG), and Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) all strongly recommend that pregnant women get a flu shot for the best protection – for them and their babies – against serious flu illness and flu-related complications.

Yes. Tdap vaccinations during pregnancy have been studied for both safety and effectiveness. Medical and public health experts agree that the benefits of Tdap vaccination during pregnancy outweighs any potential risks to moms and babies. See the research that has been done to make sure the Tdap vaccine during pregnancy is safe and effective for women and their babies.

The CDC, the American Academy of Family Physicians, the American College of Nurse-Midwives, the American College of Obstetricians and Gynecologists; and Association of Women’s Health, Obstetric and Neonatal Nurses all strongly recommend that women get a Tdap vaccination during the third trimester of every pregnancy to protect them and their babies against whooping cough.

The most common side effects from flu shots are soreness, redness, tenderness or swelling where the shot was given.  Some people also report having a low fever, headache and muscle aches. If these reactions occur, they usually begin soon after getting the shot and last 1-2 days.

Besides side effects, there are several reasons why someone might get flu symptoms, even after they have been vaccinated against flu.

• Some people can become ill from other respiratory viruses besides flu such as rhinoviruses, which are associated with the common cold, cause symptoms similar to flu, and also spread and cause illness during the flu season. The flu vaccine only protects you from the flu, not other illnesses.
• It is possible to be exposed to influenza viruses, which cause the flu, shortly before getting vaccinated or during the two-week period after vaccination that it takes the body to develop immune protection. This may result in a person becoming ill with flu before protection from the vaccine takes effect.
• Some people may experience flu like symptoms even after getting vaccinated because they were exposed to a flu virus that is very different from the viruses the vaccine is designed to protect against. The ability of a flu vaccine to protect a person depends largely on the “match” between the viruses selected to make the flu vaccine that season and those spreading and causing illness. There are many different flu viruses that spread and cause illness among people.
• The flu vaccine can vary in how well it works season to season, and sometimes people who get vaccinated may still get sick. However, the flu vaccine still offers important benefits. It will:

• • Reduce the severity of your illness if you got vaccinated, but still get sick from flu.
  • Reduce the risk of children dying from flu.
  • Reduce the risk of flu-associated hospitalization for children and adults.
  • Help protect people around you, including those who are more vulnerable to serious flu illness due to age and/or certain chronic health conditions.
  • Help protect people with certain chronic conditions from serious health complications.
  • Help protect women during and after pregnancy.

Yes. Studies shown that getting the Tdap (whooping cough) vaccine while you are pregnant is very safe for you and your baby. Severe side effects are extremely rare. You cannot get whooping cough from the Tdap vaccine.

OB-GYNs, nurse midwives, family physicians and other medical experts, who specialize in caring for pregnant women, agree that the Tdap vaccine is both important and safe for women (and their babies) during their third trimester of every pregnancy.

Getting the vaccine during pregnancy will not put you at increased risk for any pregnancy complications, and will help your baby be born with some protection against whooping cough. This is especially important since babies don’t start their own whooping cough vaccination series (DTaP) until they are 2 months old.

To read some of the research on Tdap vaccination of women during pregnancy, click on the links to the studies below. Find more research on the CDC website.

• Effectiveness of Vaccination During Pregnancy to Prevent Infant Pertussis – Pediatrics, May 2017
• Impact of the US Maternal Tetanus, Diphtheria, and Acellular Pertussis Vaccination Program on Preventing Pertussis in Infants 2 Months of Age: A Case-Control Evaluation – Clinical Infectious Disease, November 2017
• Infant hospitalizations and mortality after maternal vaccination – Pediatrics, February 2018
• Study: Maternal vaccination during pregnancy safe for infants – AAP News, February 2018
• Maternal Tdap vaccination and risk of infant morbidity – Vaccine, June 2017
• Safety of pertussis vaccination in pregnant women in UK: observational study – BMJ, July 2014

Getting a Tdap shot during every pregnancy – as opposed to before or after – allows your body to pass on some protective antibodies against whooping cough (immunity) to your baby. This is especially important since babies don’t start their own whooping cough vaccination series (DTaP) until they are 2 months old.

Getting vaccinated with Tdap during pregnancy also protects you during delivery and will make you less likely to pass whooping cough to your newborn.

A study published in Pediatrics in May 2017 looked to see how effective the Tdap vaccine was at preventing whooping cough in babies whose mothers got the vaccine while pregnant or in the hospital after giving birth. The study found that getting Tdap between the 27th through 36th weeks of pregnancy is 85% more effective at preventing whooping cough in babies younger than 2 months old.

Additionally, authors of the study, Sources of Infant Pertussis Infection in the United States published in October 2015 in Pediatrics, state that vaccinating pregnant women with Tdap increases protection of their babies.

Yes. You can safely get the flu and the Tdap (whooping cough) vaccines at the same time.

• Safety of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis and Influenza Vaccinations in Pregnancy –Obstet Gynecol, November 2015

Yes. Pregnant women can safely get the Tdap vaccine even if they recently got a tetanus-containing vaccine (Td or Tdap).

It does not matter when you got your last tetanus shot (Tdap or Td vaccine), you still need the Tdap vaccine during the 3rd trimester of each pregnancy to protect yourself and your newborn from whooping cough.

The protection (antibodies) that you pass on to your baby before birth is very important and will give them some early protection against flu and whooping cough. This is important because 

However, these antibodies will only give your baby short-term protection. That’s why it is also very important for your baby to get vaccinated according to the CDC’s recommended childhood immunization schedule, so he can start building his own protection against these dangerous diseases.

You may have heard that vaccines contain all types of crazy ingredients that sound as though they don’t belong in a medical product. The truth is that a very small group of very vocal, but misinformed, individuals have made false claims regarding the safety of vaccines and their ingredients. In most instances these claims are just wrong. In other cases, the claims are from information taken out of context or are trying to purposely mislead people.

The main ingredients in vaccines are antigens, which are small amounts of the bacteria or virus against which the person is being vaccinated. Antigens are the parts of the vaccine that encourage your immune system to create antibodies to fight against future infections. To make sure that the vaccines cannot cause the disease you are trying to protect against, the antigens are altered or weakened. Learn more about how vaccines are made and how they work.

Like many of the foods we eat and beverages we drink, vaccines also contain a small amount of additional ingredients, and each has a specific, necessary function. These ingredients may be added to the vaccine to make it more effective, sterile and/or safe. These additional ingredients have been studied and are safe for humans in the amount used in vaccines.

In fact, the amount of these additional ingredients in vaccines is much less than children encounter in their environment, food and water. As the saying goes, “the dose makes the poison.” In other words, any chemical – even water or oxygen – can be toxic or even deadly in large enough quantities.

Sometimes a child may be sensitive to one of the components of a vaccine, and an allergic reaction may result. For this reason, you should discuss any allergies your child may have with their healthcare provider. Click here and see below to learn about the ingredients that may be found in certain vaccines and their purpose.

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Visit VYF’s Questions about Vaccines section for answers to your questions about vaccine safety, vaccine ingredients, vaccine schedules, COVID-19 vaccines and much more.

You can find more information on flu and Tdap vaccines during pregnancy here.

You can find more information on vaccines for babies and children here.