Pregnancy is a really exciting time, to be sure. But let’s be real: It can also be stressful — especially during this era of COVID-19.

What you need to know now if you’re pregnant

If you’re looking for the short and sweet version of this article, look no further. Here’s what you need to know about the COVID-19 vaccine and pregnancy:

  • You are more likely to get very sick from COVID-19 if you are pregnant.
  • Getting COVID-19 increases the risk of pregnancy complications.
  • COVID-19 vaccines and boosters are recommended for all people who are pregnant, breastfeeding, or planning to become pregnant.
  • The COVID-19 vaccine is both safe and effective during pregnancy for you and your baby.
  • There’s currently no scientific evidence that the COVID-19 vaccine leads to miscarriage, pregnancy and delivery complications, or decreased fertility.
  • Antibodies from getting the COVID-19 vaccine during pregnancy can help protect your baby after they’re born.
Was this helpful?

Pregnant people are one of several groups at a higher risk of becoming very ill from COVID-19. COVID-19 can also lead to serious pregnancy complications as well.

The good news is that the COVID-19 vaccine can protect against severe illness and complications. The Centers for Disease Control and Prevention (CDC) recommends that anyone who is pregnant, breastfeeding, or plans to become pregnant get a COVID-19 vaccine and booster.

Getting vaccinated during pregnancy may feel intimidating, but we’re here to help. Keep reading as we go over eight facts about the COVID-19 vaccine that are backed by research.

Language Matters

You’ll notice we use the term “women” in this article. While we realize this term may not match your gender experience, it’s the term used by the researchers whose data was cited. We try to be as specific as possible when reporting on research participants and clinical findings.

Unfortunately, the studies and surveys referenced in this article didn’t report data for or may not have had participants who are transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

Was this helpful?

According to the CDC, if you’re pregnant, you have a higher risk of serious illness from COVID-19. This can include things like:

That’s not all, though: COVID-19 can also have serious consequences for your pregnancy. That’s because if you get COVID-19 while pregnant, you have a higher risk of pregnancy complications.

A March 2022 review of research notes that various studies have found that getting COVID-19 while pregnant is associated with an increased risk of:

Vaccination can go a long way in helping prevent these complications.

Let’s get a big concern out of the way next: COVID-19 vaccines are indeed safe and effective during pregnancy.

Since the COVID-19 vaccines have been available, many studies have supported this. We’re not going to cover each one of them here (that would take all day), but let’s explore what some of them say.

Researchers in a 2021 study looked at the effectiveness of the Pfizer-BioNTech COVID-19 vaccine in pregnant women. They compared 7,530 vaccinated pregnant women and 7,530 unvaccinated pregnant women.

Overall, researchers found vaccinated women had a significantly lower risk of contracting the coronavirus that causes COVID-19 than their unvaccinated counterparts.

Further, none of the vaccinated women reported serious side effects from vaccination. The most common side effects were similar to those seen in the general population and included:

Vaccines work by introducing your immune system to a germ. Your immune system crafts a response, which includes antibodies, to the vaccine. Your immune system can then call upon this response to protect you from the actual germ in the future.

Another bit of good news is that pregnant people appear to make the same immune response to COVID-19 vaccination as nonpregnant people.

In a 2021 study, researchers compared immune responses in 131 pregnant, lactating, or nonpregnant women. They found the levels of antibodies made in response to vaccination were similar between all three groups. Side effects were also similar in all groups.

And there’s more: Antibody levels made in response to vaccination during pregnancy were higher than the antibodies made from infection during pregnancy.

Despite the safety and effectiveness of the COVID-19 vaccine during pregnancy, vaccination in this group is still low compared with the general population.

For example, a January 2022 study in Scotland found that in October 2021, only 32.3% of women giving birth had received two doses of a COVID-19 vaccine, compared with 77.4% of the total female population.

A 2021 study found that out of a group of 1,328 pregnant women, less than one-third got the COVID-19 vaccine when it was offered to them. Vaccinated women still had similar pregnancy outcomes to those who were not vaccinated.

Raising vaccine coverage is vital for preventing severe illness and complications during pregnancy. However, concerns about the vaccine and its potential effects have made people hesitant. Let’s explore some of these concerns next.

One concern about the COVID-19 vaccine is whether it increases the risk of miscarriage. Research says this isn’t the case.

A 2021 research letter outlines a study on this topic. For the study, researchers used the Vaccine Safety Datalink database to analyze COVID-19 vaccines and miscarriage rates. Data from about 3% of the U.S. population is included in this database.

Researchers found 105,446 unique pregnancies, 92,286 of which were ongoing and 13,160 of which resulted in miscarriage. All three COVID-19 vaccines used in the United States were represented within this large group.

Researchers wanted to see whether COVID-19 vaccines were linked with miscarriage. They were specifically looking to see whether people who had a miscarriage were more likely to have received a COVID-19 vaccine in the past 28 days.

This isn’t what they found. Instead, researchers saw that, compared with those with ongoing pregnancies, women who had a miscarriage were not more likely to have received a COVID-19 vaccine in the previous 28 days.

COVID-19 vaccination is also not associated with birth and delivery complications.

Researchers in a March 2022 study reviewed data from a population-based survey. Among a group of 97,590 pregnant people, 22,660 (23%) had gotten at least one dose of a COVID-19 vaccine during their pregnancy.

Researchers compared people who were vaccinated during their pregnancy to those who got vaccinated after their pregnancy. They found that vaccination during pregnancy did not lead to a significantly increased risk of:

Another large March 2022 study also supports these findings. This study used data from 157,521 deliveries of single babies (no twins, triplets, etc.) in Sweden and Norway.

Within this group, 28,506 pregnancies (18%) included COVID-19 vaccination at some point during pregnancy. Compared with pregnancies in which no COVID-19 vaccine was given, researchers found that among the pregnancies with vaccination, there was no increased risk of:

  • preterm birth
  • stillbirth
  • low birth weight
  • admission to the NICU
  • low Apgar score

If you’re not yet pregnant but plan to be in the near future, you may wonder whether the COVID-19 vaccine could affect your fertility. According to the CDC, there’s currently no evidence that COVID-19 vaccines cause fertility issues.

Research supports this statement. A January 2022 study included 2,126 self-identified female participants ages 21 through 45 who were trying to get pregnant. Participants completed surveys every 8 weeks about:

  • COVID-19 vaccination or infection details
  • sociodemographic info
  • medical and lifestyle details
  • information on their partner

After analyzing the data, researchers concluded that COVID-19 vaccination was not associated with long-term decreased fertility in either females or males.

But researchers did find that getting COVID-19 itself was associated with a potential temporary decline in male fertility for about 60 days.

Now that we’ve debunked the main concerns about COVID-19 vaccination during pregnancy, let’s take a look at some of the benefits that vaccination may give your baby.

Antibodies that your body makes after vaccination can be passed to your baby through the placenta. These antibodies can go on to protect them when they’re particularly vulnerable to germs in the months after birth.

A June 2022 study included 21,643 babies, 9,739 (45%) of whom were born to mothers who had gotten their second or third dose of a COVID-19 vaccine during pregnancy.

Researchers found these babies had a lower risk of having a positive COVID-19 test within 4 months of birth. This finding persisted during both the Delta and Omicron coronavirus variant waves, although protection was stronger against Delta.

A February 2022 study included 379 hospitalized babies; 176 of them had COVID-19 and the other 203 babies were hospitalized for other reasons.

Researchers wanted to see how effective maternal vaccination was at preventing COVID-19 hospitalization of a baby within their first 6 months of life. Using this parameter, researchers found that vaccine effectiveness was:

  • 61% overall
  • lower (32%) in infants of mothers who had completed their vaccine series within the first 20 weeks of their pregnancy
  • higher (80%) in infants of mothers who had completed their vaccine series 21 weeks or later into their pregnancy

How long does this protection last, though? Researchers aimed to find this out.

According to a February 2022 research letter, experts compared antibody levels in babies whose mothers had either been vaccinated against COVID-19 during pregnancy or who had actually had COVID-19 during pregnancy.

Overall, researchers found that antibody levels in babies whose mothers had been vaccinated against COVID-19 while pregnant stuck around for longer.

Six months after birth, 57% of babies born to vaccinated mothers still had detectable antibodies. Only 8% of babies whose mothers had COVID-19 during pregnancy had detectable antibodies.

It’s known that breastfeeding parents pass antibodies to their babies through breast milk. These antibodies can help protect a baby from various germs.

Antibodies made in response to COVID-19 vaccination have been detected in breast milk. Let’s look at a research letter about a 2021 study that discussed this.

The study included 84 breastfeeding mothers who provided 504 breast milk samples over the course of the study. After getting the first dose of the Pfizer-BioNTech vaccine, participants were followed up weekly for 6 weeks.

Researchers looked for two types of antibodies to COVID-19 called IgA and IgG. IgA is found earlier in the immune response. IgG appears later.

They found the amount of breast milk samples with IgA rose early after vaccination. They peaked at week 4 (1 week after the second dose) before beginning to drop at week 6.

Few breast milk samples contained IgG after the first vaccine dose. However, by weeks 4 and 6, more than 90% of breast milk samples had detectable IgG.

This all sounds great, right? There are some caveats: The number of participants was small, and it’s unknown how long these antibodies last or the strength of protection they provide to a baby. More research will help find these things out, though.

COVID-19 vaccine recommendations during pregnancy

We’ve done all this talking about COVID-19 vaccines and pregnancy, but what exactly are the COVID-19 vaccine recommendations, anyway?

As of writing, the CDC recommends the following for adults:

  • All adults should receive a primary vaccine series of one of the following:
    • two doses of the Pfizer-BioNTech mRNA vaccine, spaced 3 to 8 weeks apart
    • two doses of the Moderna mRNA vaccine, spaced 4 to 8 weeks apart
    • one dose of the Johnson & Johnson (J&J) adenovirus vector vaccine
  • When eligible, adults can also get a booster shot. You’re eligible for a booster:
    • 5 months after your primary mRNA vaccine series
    • 2 months after the J&J vaccine
  • MRNA vaccines are preferred over the J&J vaccine for both the primary series and the booster.
  • Immunocompromised people have a different schedule for their primary vaccine series and boosters.
Was this helpful?

The COVID-19 vaccine is safe and effective during pregnancy. It’s vital for preventing serious illness and pregnancy complications from COVID-19.

The COVID-19 vaccine has not been associated with an increased risk of infertility, miscarriage, or other pregnancy and delivery complications.

In fact, vaccinated pregnant people can pass antibodies to their baby both through the placenta and breast milk. These antibodies can continue to protect babies after they’re born.

The COVID-19 vaccine is recommended for all people who are pregnant, breastfeeding, or plan to get pregnant. If you ever have questions or concerns about getting the COVID-19 vaccine, be sure to raise them with your doctor or another healthcare professional.