Pregnancy

If you’re pregnant you may choose to be vaccinated. While a conversation with a healthcare provider may be helpful, it is not required prior to vaccination.

Things for Pregnant People to Consider When Deciding Whether to Get a COVID-19 Vaccine

• Your risk of being exposed to the virus that causes COVID-19.
• People who are pregnant are at higher risk of severe illness from COVID-19, including COVID illness that results in intensive care unit (ICU) admission; placement on a ventilator to help with breathing; and death.
• Other health conditions, such as obesity and gestational diabetes, may also increase a person’s risks of experiencing severe COVID-19 illness.
• Some studies suggest getting COVID-19 during pregnancy may increase risks of preterm birth and stillbirth.
• A COVID vaccine can help protect you from severe illness from COVID-19, which could help both you and your baby.
  • Recent reports have shown that people who have received COVID-19 mRNA vaccines during pregnancy (mostly during their third trimester) have passed protective antibodies to their babies, which could help protect them after birth.
• Although there are limited data about the safety of COVID-19 vaccines in people who are pregnant, what is known so far is reassuring. Based on what is known about how COVID vaccines are made and the early data collected through the U.S. vaccine monitoring systems, experts believe they are likely to be safe during pregnancy.
  • COVID vaccines do not contain the live coronavirus that causes COVID-19 and therefore cannot give you COVID-19.
  • COVID vaccines do not change or interact with your DNA.
  • The vaccinations being given are being monitored closely by public health officials through safety monitoring systems, including a new pregnancy registry in V-Safe to monitor pregnancy and birth outcomes.
• Vaccine side effects, like a sore/red arm, tiredness, chills, joint aches, and muscle aches are possible, and are a normal part of the body’s reaction to the vaccine and developing antibodies (immunity) to protect against COVID-19.
  • Pregnant individuals who experience fever after getting a COVID-19 vaccine may be counseled to take acetaminophen (e.g., Tylenol) because fever has been associated with adverse pregnancy outcomes. Acetaminophen may be suggested as an option during pregnancy to manage other expected side effects as well.

Click here to see what experts at the American College of Obstetricians and Gynecologists (ACOG) has to say about COVID-19 vaccination of pregnant and breastfeeding women.

New Data on COVID-19 Vaccines During Pregnancy

A study published in March 2021 found that pregnant people who were vaccinated against COVID-19:

• Had a stronger immune response than pregnant people who were naturally infected with the COVID-19 virus
• Passed protective antibodies (immunity) to their babies. (Flu and whooping cough vaccinations during pregnancy also protect both mom and baby from dangerous illness.)
• Passed antibodies to their babies in their breast milk.
• Getting vaccinated during pregnancy didn’t result in more or worse side effects for participants in the study.

COVID-19 Vaccine Should Be Available to Pregnant Individuals

VYF joined the Maternal Immunization Task Force and other partners to put out the following statement:

All pregnant individuals who choose to receive the COVID-19 vaccine must be allowed to do so in alignment with their state and local vaccination allocation plan. This includes the estimated 330,000 health care workers who are pregnant and should be allowed to receive the vaccine as part of the first phase of vaccine distribution plans. Reports of pregnant individuals being refused vaccination are concerning. Pregnant individuals who otherwise meet the criteria for COVID-19 vaccines should not be denied the opportunity to be vaccinated, should they choose to do so. Although a conversation with a clinician may be helpful for patients to aid in their decision-making, it should not be required prior to vaccination.

Read the full joint statement here.

More Information

For more information about COVID-19 and the vaccines being created to prevent it, see other questions on this Q&A page or visit vaccinateyourfamily.org/covid19.

For more information about COVID-19 vaccines during pregnancy and breastfeeding, click the video below to watch this recent Q&A video with OB-GYN and Infectious Disease Expert Dr. Laura Riley.

If  you would like to speak to someone about COVID-19 vaccination during pregnancy, the CDC recommends that you contact MotherToBaby. MotherToBaby experts are available to answer questions in English or Spanish by phone or chat. The free and confidential service is available Monday–Friday 8am–5pm (local time).

To reach MotherToBaby:

• • Call 1-866-626-6847
  • Chat live or send an email MotherToBaby

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 Individuals 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.

Pregnant individuals should take steps to stay healthy, including

• considering a COVID-19 vaccine
• keeping your prenatal care visits
• wearing a mask or cloth face covering in public and any other needed protection while at work
• limiting contact with other people as much as possible
• staying at least 6 feet away from other people and avoiding crowds if you need to go out
• avoiding contact with other people in places that do not offer fresh air from the outdoors (open windows and doors when possible)
• washing hands often with soap and water for at least 20 seconds
• cleaning hands with a hand sanitizer that contains at least 60 percent alcohol if you can’t wash them (rub until your hands feel dry)
• avoiding touching your eyes, nose, and mouth
• having a good stock of essential supplies, including at least 30 days of any medications (so you don’t have to go out as often)
• talking with an ob-gyn or other health care professional if you have any questions about your health or COVID-19
• calling 911 or going to the hospital right away if you need emergency healthcare

Visit the American College of Obstetricians and Gynecologists’ (ACOG’s) website for more information and advice for pregnant individuals related to COVID-19 and COVID-19 vaccination.

If you would like to speak to someone about COVID-19 vaccination during pregnancy, the CDC recommends that you contact MotherToBaby. MotherToBaby experts are available to answer questions in English or Spanish by phone or chat. The free and confidential service is available Monday–Friday 8am–5pm (local time).

To reach MotherToBaby:

• Call 1-866-626-6847
• Chat live or send an email MotherToBaby

The CDC and the FDA have safety monitoring systems in place to capture information about vaccination during pregnancy and will closely monitor that information.

Early data from these systems did not identify any safety concerns for pregnant people who were vaccinated or for their babies. Most of the pregnancies reported in these systems are ongoing, so more follow-up data are needed for people vaccinated just before or early in pregnancy.

CDC and FDA will continue to follow people vaccinated during all trimesters of pregnancy to understand effects on pregnancy and babies.

• Vaccine Adverse Event Reporting System (VAERS)— The national system to which healthcare professionals, vaccine manufacturers, and the public can report possible side effects or health problems that happen after vaccination. Scientists investigate reports of events that are unexpected, appear to happen more often than expected, or have unusual patterns. The VAERS system has a question to identify pregnant people (question 8). CDC clinicians review all pregnancy reports related to COVID-19 vaccinations.
• V-safe COVID-19 Vaccine Pregnancy Registry  — V-safe is a new smartphone-based, after-vaccination health checker for people who receive COVID-19 vaccines. The v-safe COVID-19 Vaccine Pregnancy Registry is a registry to collect additional health information from v-safe participants who report being pregnant at the time of vaccination or a positive pregnancy test after vaccination. This information helps CDC monitor the safety of COVID-19 vaccines in people who are pregnant.
• Vaccine Safety Datalink (VSD) — A network of nine integrated healthcare organizations across the United States that monitor and evaluate the safety of vaccines. The system is also used to help determine whether possible side effects identified using VAERS are actually related to vaccination. Through VSD, CDC will study:
  • Weekly counts and rates of COVID-19 vaccination in pregnant people
  • Miscarriage and stillbirth that occurs among people who received COVID-19 vaccine during pregnancy
  • Adverse outcomes in pregnancy following COVID-19 vaccination, including:
    • Pregnancy complications
    • Birth outcomes
    • Infant outcomes for the first year of life (includes infant death, birth defects, and developmental disorders)
• Clinical Immunization Safety Assessment (CISA) Project — A collaboration between CDC and seven medical research centers to provide expert consultation on individual cases of adverse events after vaccination and conduct clinical research studies about vaccine safety. CISA will implement a clinical research study on COVID-19 vaccine safety among pregnant people at three sites. The study will:
  • Enroll pregnant people who plan to receive COVID-19 vaccination. COVID-19 vaccines will be given as part of the study
  • Collect baseline maternal health information, including if they previously had COVID-19
  • Follow people during pregnancy and for three months after delivery
  • Follow babies through their first three months of life
• Birth Defects Study to Evaluate Pregnancy Exposures (BD-STEPS) — This ongoing study collects information, including COVID-19 vaccination information, from people who have recently been pregnant to understand the potential causes of birth defects and how to prevent them.

Getting a COVID-19 vaccine is a personal choice for those who are breastfeeding. While a conversation with a healthcare provider may be helpful in helping you make a decision, it is not required prior to vaccination.

Things for Breastfeeding Women to Consider When Deciding Whether or Not to Get a COVID-19 Vaccine

• Your risk of being exposed to the virus that causes COVID-19.
• Clinical trials for the COVID-19 vaccines authorized in the U.S. did not include people who are breastfeeding. However, based on how COVID vaccines work in the body, they are thought not to be a risk to breastfeeding women or their babies.
• Recent studies have shown that breastfeeding women who have received COVID-19 mRNA vaccines have antibodies in their breastmilk, which could help protect their babies from COVID. The CDC says that more data is needed to determine what protection these antibodies may provide to the baby.
• Some side effects, like a sore/red arm, tiredness, chills, joint aches, and muscle aches are possible. They are a normal part of the body’s reaction to the vaccine and developing antibodies (immunity) to protect against COVID-19
• The American College of Obstetricians and Gynecologists (ACOG) recommends that breastfeeding women get a COVID-19 vaccine. Click here to read more from the experts at ACOG and check out My Vaccine Choice: I’m a Breastfeeding Ob-Gyn. Here’s Why I Got a COVID-19 Vaccine.

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

Find a COVID-19 vaccine near you.

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. 

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.