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Is the COVID-19 Vaccine Safe for Pregnant People?

pregnant woman standing in a park holding her belly

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Key Takeaways

  • People who are pregnant may choose to be vaccinated. Although speaking with one's healthcare provider beforehand is recommended, it isn't required to get a vaccine.
  • There currently aren't enough data on how the vaccine would affect pregnant women because they have yet to be included in clinical trials.
  • Two recent studies on the safety of mRNA vaccines for pregnant women show that the Moderna and Pfizer vaccines do not appear to have any serious risks for that population.
  • The CDC and WHO don't agree on guidelines for pregnant women not in the recommended priority groups.
  • Moderna and Pfizer-BioNTech are monitoring people in the clinical trials who became pregnant, and the CDC is also funding research at Duke University on pregnant women who choose to receive the COVID-19 vaccine.

According to the latest recommendations from the American College of Obstetricians and Gynecologists (ACOG), pregnant or lactating individuals should be able to receive the COVID-19 vaccine. The College recommends the use of Pfizer and Moderna vaccines. It also supports use of the Janssen vaccine, although ACOG cautions that the Janssen vaccine does pose a small risk of thrombosis with thrombocytopenia syndrome.

A study published in the New England Journal of Medicine reviewed data from the CDC's V-safe smartphone-based surveillance system and Vaccine Adverse Event Reporting System (VAERS). Preliminary findings based on data from 35,691 pregnant people, ages 16 to 54, showed that mRNA vaccines, including Moderna and Pfizer, do not appear to have any serious risks for that population. There are still no data on outcomes for pregnant women who were vaccinated during the first trimester of pregnancy.

Another recent study, published in the journal Obstetrics & Gynecology, found no evidence of placental damage in women who received either the Pfizer or Moderna vaccine 22 to 70 days (average 46 days) before pregnancy.

There haven't been any clinical trials among pregnant women, including those from Pfizer-BioNTech, Moderna, Janssen, AstraZeneca, and Novavax, but those are planned for the near future, says Yvonne Maldonado, MD, professor of pediatrics and health research and policy at Stanford University School of Medicine. Those clinical trials will establish whether the vaccine is safe for pregnant women and also whether it induces the same immune response that protects nonpregnant people. 

Perhaps not surprising, these limited data have resulted in conflicting advice from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) for pregnant women not in the ACIP-recommended priority groups.

  • CDC: Recommends pregnant women consult with their doctor and weigh the risk and benefits together prior to getting a COVID-19 vaccine.
  • WHO: Recommends pregnant women not receive the vaccine, unless they are at high risk of COVID because of work exposure or a chronic condition.

Weighing the Risks and Benefits

In the meantime, if you are pregnant, you have the option to receive the COVID-19 vaccine. It is important to assess the potential benefits as well as the potential risks—for both the mother and the developing baby.

"That means we have to think about the risks that coronavirus infection may pose to the mother and baby if they remain unprotected or if they are unable to access a highly effective vaccine,” says Carleigh Krubiner, PhD, one of the leaders of the Pregnancy Research Ethics for Vaccines, Epidemics, and New Technologies (PREVENT) project at Johns Hopkins University. 

At the same time, it’s crucial to examine any safety signals or concerns. “We can start by looking at what we know from the safety studies in non-pregnant adults, to see if there are any adverse effects that maternal-fetal medicine experts would find particularly concerning during various stages of pregnancy,” Dr. Krubiner explains.  

Yvonne Maldonado, MD

We believe that pregnant women, who make up a large share of the healthcare workforce and the general population, should be protected against infection with SARs-CoV-2 with a vaccine that has been shown to be safe and effective among pregnant women.

— Yvonne Maldonado, MD

"We can also learn from experiences where women receive vaccines before they know they are pregnant, which may be the only way to learn about the safety of vaccines in early pregnancy," she adds. "Understanding the safety profile of different COVID-19 vaccines in pregnancy will necessarily be an ongoing process, collecting more and better evidence even after vaccines are made available to the general public."

Other Countries Are Doing Things Differently

The provisional guidance published by the Public Health England initially recommended pregnant people in the U.K. wait until they give birth before getting immunized. As of April 16, 2021, however, Public Health England has judged the benefits of vaccination to outweigh the risks of COVID-19 itself.

The guidance says Pfizer and Moderna are "the preferred vaccines for pregnant women of any age." Pregnant people should only take the Astra-Zeneca vaccine if they have already started an Astra-Zeneca dose schedule. However, new mothers who are breastfeeding are able to get any available vaccine.

While the guidance acknowledges that "there is no known risk" connected to pregnancy, "as with most pharmaceutical products, large clinical trials of COVID-19 vaccine in pregnancy have not been carried out."

Carleigh Krubiner, PhD

Experts will have to continue reviewing the best available evidence to determine which may be best suited for pregnancy, especially as more vaccine candidates demonstrate efficacy and move toward approval.

— Carleigh Krubiner, PhD

Some Vaccines May Be Safer Than Others in Pregnancy

It's possible that some vaccines will be more suitable for pregnant women than others. Dr. Krubiner says, "Right now, there are various committees with a mix of expertise and experience in infectious disease in pregnancy, obstetrics, pediatrics, and ethics who are assessing the available evidence to guide these decisions for particular vaccine products."

Dr. Krubiner believes that whenever experts determine that the prospect of benefit from being vaccinated outweighs the potential associated risks, pregnant women should be offered the opportunity to receive the vaccine. 

What This Means for You

Being pregnant during a pandemic is understandably stressful, and we know you want to take whatever measures necessary to protect your unborn child. Unfortunately, there isn't enough clinical evidence to support the safety of a COVID-19 vaccine for pregnant individuals, so the decision to get vaccinated falls largely on you and your provider. In the meantime, you should continue to be extra cautious about wearing a mask, social distancing, and following all COVID-19 public health protocols.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

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  1. Centers for Disease Control and Prevention. COVID-19 vaccines while pregnant or breastfeeding. Updated May 14, 2021.

  2. Craig AM, Hughes BL, Swamy GK. Coronavirus disease 2019 vaccines in pregnancy. AJOG MFM. 2021;3(2):100295. doi:10.1016/j.ajogmf.2020.100295

  3. American College of Obstetricians and Gynecologists. Vaccinating pregnant and lactating patients against COVID-19. Updated April 28, 2021.

  4. Shimabukuro TT, Kim SY, Myers TR, et al. Preliminary findings of mRNA COVID-19 vaccine safety in pregnant personsN Engl J Med. 2021. doi:10.1056/NEJMoa2104983

  5. Shanes ED, Otero S, Mithal LB, Mupanomunda CA, Miller E, Goldstein J. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in pregnancy: measures of immunity and placental histopathologyObstet Gynecol. 2021. doi:10.1097/AOG.0000000000004457

  6. World Health Organization. Interim recommendations for use of the Moderna mRNA-1273 vaccine against COVID-19. Published January 25, 2021.

  7. Department of Health. COVID-19 - SARS-CoV-2. In: Salisbury D, Ramsay M, eds. Green Book. London, UK: Department of Health; 2021.