COVID-19 Vaccines for Pregnant or Breastfeeding Women: What You Need to Know

A pregnant African American woman poses outside while holding her stomach tenderly.

Pregnancy and the first months after childbirth are stressful during normal times, but have become especially stressful during the COVID-19 pandemic.

COVID-19 has touched all aspects of the pregnancy and childbirth experience, from changes in birth plans to limitations on who can visit your little one after his or her arrival.

Additionally, studies have shown that COVID-19 can be more dangerous for pregnant women, which does little to decrease the anxiety felt by expecting moms.

Fortunately, the rollout of COVID-19 vaccines has begun across the globe, and there’s hope that we may finally be able to get the virus under control in the coming months.

However, the release of vaccines has become another source of stress for women who are pregnant, thinking about getting pregnant, or are breastfeeding, as they wonder: “Should I get the vaccine?”

Here are some answers to common questions about the COVID-19 vaccine for women of childbearing age.

How dangerous is COVID-19 for pregnant women?

While it seems like we’ve been in this pandemic for years, COVID-19 is still a relatively new illness. The medical community has made stunning progress in a year, but there’s still a lot that we don’t know.

One thing we do know, however, is that COVID-19 can be particularly dangerous for pregnant women.

Studies have shown that pregnant women who develop severe COVID-19 are more likely to end up in the ICU or on a ventilator than patients who aren’t pregnant.

Preterm birth may also be more common for pregnant women with severe COVID-19 infection.

Why is there hesitation about pregnant or breastfeeding women receiving the vaccine?

The COVID-19 vaccines currently approved for use in the United States were tested on tens of thousands of people who participated in clinical trials.

In those tens of thousands of trial vaccinations, no serious issues were reported.

These findings led the United States Food & Drug Administration (FDA) to issue Emergency Use Authorizations (EUA) for both the Pfizer-BioNTech and Moderna vaccines.

However, neither company tested its vaccine on pregnant or breastfeeding women during the clinical trial period.

It’s important to note that this has little to do with the Pfizer-BioNTech and Moderna vaccines themselves, and is instead a typical approach for clinical trials: many avoid including pregnant women to help protect them and their babies from research-related risks.  

As a result, there’s currently no data on whether the vaccine works as well in pregnant or breastfeeding women as it does in the rest of the population, nor is there data on whether there are unique side effects for pregnant women, breastfeeding women, and their babies.

This lack of data has led some women to hesitate to get vaccinated.

Does the COVID-19 vaccine cause infertility?

No.

Regardless of what you’ve seen on Facebook, there is no research-based evidence to suggest that the Pfizer-BioNTech or Moderna COVID-19 vaccines cause infertility.

The idea that either vaccine causes infertility isn’t backed by any kind of science or data — it’s a rumor, and nothing more.

Can the vaccine infect me or my baby with COVID-19?

No. The Pfizer-BioNTech and Moderna COVID-19 vaccines do not feature what are known as “live” viruses, which are weakened forms of a virus that are used to provoke an immune response.

Because the COVID-19 vaccines do not contain a live virus, there is no way for the vaccine to infect you or your baby with COVID-19.

Both vaccines use messenger RNA (mRNA) to imitate how a virus works in your body. The mRNA is like a recipe for a small part of the virus known as the spike protein. When this spike protein is released from cells, the body recognizes it as foreign and the immune system responds.

In most cases where patients report that a vaccine has made them sick, they’re actually just feeling their own body’s immune response — which means the vaccine is working as it should.

Will the vaccine pass the virus through breastmilk?

No. As mentioned above, the vaccine does not contain a live virus, so there is no way for the vaccine to pass the virus through breastmilk.

Additionally, because mRNA is fragile, it’s highly unlikely that any part of the vaccine will get into a breastfeeding mom’s milk.

Overall, the Society for Maternal-Fetal Medicine reports that there is no reason to believe that the vaccine affects the safety of breastmilk.

What do the experts say about getting the COVID-19 vaccine while pregnant or breastfeeding?

Because the vaccines are so new and data on how the vaccines affect pregnant women isn’t available, most organizations and professional groups have stayed away from issuing definitive guidance on whether or not pregnant or breastfeeding women should be vaccinated.

However, the Society of Maternal-Fetal Medicine (SMFM) strongly recommends that pregnant women have access to COVID-19 vaccines.

The American College of Obstetricians and Gynecologists (ACOG) also recommends that the COVID-19 vaccine not be withheld from pregnant women.

In both cases, SMFM and ACOG suggest that pregnant or breastfeeding women discuss the vaccination with their care provider in order to make an informed decision.


Overall, there are many different factors for pregnant and breastfeeding women to consider: COVID-19 seems to be more dangerous for pregnant women, but the risks of getting a COVID-19 vaccine aren’t entirely known (though the risk is thought to be low).

Moms should take their own situations into consideration as well. Ask yourself:

  • Is COVID-19 prevalent in my community right now?
  • Is my risk for COVID-19 exposure high?
  • Is anyone in my household at high risk for COVID-19 exposure?

 

Answering these questions will help you assess your own risk for contracting COVID-19, which you can then discuss with your doctor.

Ultimately, the decision to get the vaccine should be up to mom, and should be one that she’s comfortable with — after all, the last thing pregnancy or early motherhood needs is more stress.

 

Kim Dever, MD is Vice President of Medical Affairs at South Shore Health and Chair of the Department of Obstetrics and Gynecology at South Shore Hospital.

Learn more about Pregnancy & Childbirth at South Shore Health.