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When Will a COVID-19 Vaccine Be Safe for Pregnant Women?

pregnant woman standing in a park holding her belly

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Key Takeaways

  • Women who are pregnant and part of certain groups recommended to receive the COVID-19 vaccine (healthcare workers, frontline essential workers) may choose to be vaccinated.
  • There currently isn't enough data on how the vaccine would affect pregnant women because they have yet to be included in clinical trials.
  • Moderna and Pfizer-BioNTech are monitoring people in the clinical trials who became pregnant, and the 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 Obstetrics and Gynecologists (ACOG), pregnant women who fall into the Advisory Committee on Immunization Practices (ACIP) priority groups should be able to receive the COVID-19 vaccine.

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 non-pregnant people. 

Weighing the Risks and Benefits

In the meantime, if you are pregnant, you have the option to receive the COVID-19 vaccine, but 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

On November 27, Public Health England published provisional guidance for health care workers, which said pregnant women in the U.K. will have to wait until they give birth before they can be immunized against COVID-19.

The guidance makes it clear that even when the vaccine is widely available to the general public in the U.K., there are some groups that will not be offered it immediately, including pregnant women. They will be told to wait until after giving birth before they get the vaccination.

While the guidance acknowledges that "there is no known risk" connected to pregnancy, "as with most pharmaceutical products, specific clinical trials of COVID-19 vaccine in pregnant women 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

The Public Health England guidance states, "Although the available data do not indicate any safety concern or harm to pregnancy, there is insufficient evidence to recommend routine use of COVID-19 vaccines during pregnancy. Vaccination should be postponed until the completion of pregnancy. If a woman finds out she is pregnant after she has started a course of vaccine, she should complete her pregnancy before finishing the recommended schedule."

However, new mothers who are breastfeeding will be able to get the vaccine, and Public Health England says pregnant women who are deemed high-risk due to other health factors (such as an underlying condition) should be vaccinated as soon as possible after giving birth.

Some Vaccines May Be Safer Than Others in Pregnancy

It's possible that some vaccines will be more suitable for pregnant women than others. "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," 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. Dr. Maldonado agrees. "We believe that pregnant women, who make up a large share of the health care 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 for them."

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.

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Article Sources
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  1. Centers for Disease Control and Prevention. Vaccination Considerations for People who are Pregnant or Breastfeeding. Updated December 28, 2020.

  2. Duke University School of Medicine. Duke Ob/Gyn team publishes "COVID-19 Vaccines in Pregnancy" in AJOG-MFM. Updated December 7, 2020.

  3. ACOG. Vaccinating pregnant and lactating patients against COVID-19. Updated December 2020.

  4. Public Health England. COVID-19 Green Book Chapter 14a. November 2020.