Experts Weigh In on Whether Pregnant People Should Get the COVID-19 Booster Shot

Pregnancy comes with many hard decisions, and how to best manage your COVID-19 vaccination options may be on your list. But expert consensus is clear: The best way to protect yourself from the serious complications of COVID-19 is to get fully vaccinated, and to get a booster shot too.

In fact, the Center for Disease Control and Prevention (CDC) has recommended "urgent action" to increase COVID-19 vaccination during pregnancy. Data collected in the fall of 2021 revealed that only 31% of pregnant people were vaccinated, even though the risk for severe complications from COVID-19 is higher during pregnancy.

Between January 2020 and July 2022, 34,693 people were hospitalized while pregnant with COVID-19, and 306 pregnant people died from the disease.

Should I Get a COVID-19 Booster During Pregnancy?

COVID-19 variants continue to spread worldwide, even causing breakthrough infections in fully vaccinated people. The CDC recommends booster shots for all individuals ages 5 and older, including those who are pregnant (as well as for younger children, depending on when they complete their primary series and what vaccine they receive).

Pfizer-BioNTech and Moderna offer updated (bivalent) booster doses, which protect against the original strain of COVID-19 as well as the Omicron variant, which is dominant in the U.S.

Getting fully vaccinated against COVID-19 is especially important during pregnancy. For reasons scientists are still working to understand, people are more likely to have severe symptoms of COVID-19 when they are pregnant.

Being pregnant when catching COVID-19 increases your risk for hospitalization, intensive care, need for a ventilator, and severe illness that results in death. Additionally, people who have COVID-19 during pregnancy are at increased risk of preterm birth and stillbirth, and might be at increased risk of other pregnancy complications.

Getting vaccinated is a key step to keeping yourself and your unborn baby healthy. With the highly contagious Omicron variant circulating, it's important to get a booster dose to stay protected through pregnancy and just after. You are at high risk for COVID-19 complications for at least 42 days following the end of pregnancy, according to the CDC.

“We know that the threat of variants is real but the risk is greatly minimized in those that have been vaccinated and have had a booster," says Betsy Greenleaf, DO, the medical advisor for pH-D Feminine Health in Howell, NJ.

Will a COVID-19 Booster Harm My Baby?

Pregnant people are encouraged to check ingredients in their beauty products, medicines, and foods, since some may harm a developing fetus. It is natural to wonder how the booster shot may impact your growing baby during pregnancy.

The COVID-19 vaccines have been shown to be safe for babies in all trimesters of pregnancy. The CDC has verified that there aren’t any increased risks of miscarriage in those studied groups who received the vaccine, nor is there any increase in birth anomalies.

Heather Masters, MD, an assistant professor of obstetrics and gynecology at the University of Cincinnati College of Medicine, wants pregnant people to know that it is not the booster they should worry about in regard to their baby’s health, but rather the danger of not getting it.

This decision to avoid vaccine exposure puts you at higher risk for an even riskier exposure: COVID-19. Dr. Masters says, "Women with COVID-19 during pregnancy have an increased risk of their baby being preterm, admitted to the NICU, and even dying. The risk is not only for you but for your child too. The decision to get vaccinated is for both your health and your child's health."

Cindy Duke, MD, a board-certified OB/GYN, a reproductive endocrinology and infertility specialist, virologist, and the medical and laboratory director at the Nevada Fertility Institute, adds that the benefits of the booster shot include decreasing the risk of stillbirth, pregnancy loss, and prematurity that is often caused by COVID-19.

COVID-19 vaccines and boosters during pregnancy can even protect your baby after they are born by supplying them with protective antibodies that may shield them from infection during the newborn period. “A new study has shown that women who have been vaccinated may pass on immunity to their infants, yet another reason to get vaccinated and boosted," Dr. Greenleaf says.

Dr. Masters explains the process. “When getting vaccinated, women make an increased number of antibodies, even more antibodies than getting the virus itself," she says. "Some of these antibodies are passed to the baby. When testing the blood of babies of vaccinated mothers, the babies have an increased number of antibodies, suggesting an increased duration of immunity for the babies."

When Is the Best Time to Get a COVID-19 Booster Shot While Pregnant?

Some people wonder about the best time to receive the bivalent booster, which protects against the Omicron variant, while they are pregnant. The most important requirement is that it comes at least two months after your last dose, whether that was a primary-series shot or a previous booster.

There aren’t any official recommendations that one trimester would be better than another to be vaccinated and boosted against COVID-19. The CDC recommends that anyone who is pregnant or trying to get pregnant start and complete their vaccination series as soon as possible.

Some parents are opting to wait to vaccinate until after first trimester, when the miscarriage rate decreases. According to the American College of Obstetricians (ACOG), research shows no increased risk for miscarriage following a COVID-19 shot.

However, the longer a pregnant person waits to get fully vaccinated, the higher their chance is of contracting COVID-19. This can place them at increased risk of preterm birth as well as other potential complications.

Should Breastfeeding Parents Get a COVID-19 Booster Shot?

If you are breastfeeding, it’s recommended that you get the bivalent booster as long as it’s been two months since your last shot (booster or primary series).

It’s been proven that COVID-19 antibodies produced in your body during initial vaccine shots can transfer to your newborn through breast milk. "A booster in a lactating person would theoretically increase available antibodies in the milk, too," says Dr. Duke.

Getting fully vaccinated and boosted while pregnant or breastfeeding may be one of the best ways you can protect your young baby who can’t get vaccinated themselves. All children aged 6 months and older are eligible to receive a COVID-19 vaccine.