What pregnant, breastfeeding, and prospective parents should know about the COVID-19 vaccines

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For people who are pregnant or who might become pregnant soon, one question is top of mind: Is it okay for me to get the COVID-19 vaccine? After all, pregnant people weren’t included in the trials that demonstrated the Pfizer and Moderna vaccines are safe and effective.

It’s not only safe, but important, to get the COVID-19 vaccine if you are pregnant, breastfeeding, or you may become pregnant, say experts.

Pregnant people should get vaccinated

“I would be more worried, if I were pregnant, about having COVID while pregnant than I would about receiving a vaccine,” says David Schwartz, a pathologist at Augusta University in Georgia who also studies pregnancy and infectious diseases.

We have every reason to think that getting vaccinated is not only safe for pregnant people or people who may become pregnant, he says, but even more important for them than for people who are otherwise healthy and don’t have underlying conditions.

That’s because COVID-19 is extra-risky when mixed with pregnancy. Pregnant people who get COVID-19 face an increased risk of pregnancy-related issues compared to people who are pregnant who don’t get the disease.  As the CDC notes, statistics show that pregnant people are more likely to have severe COVID-19 symptoms, have an increased mortality risk, and have an increased risk for preterm birth or miscarriage.

Although the vaccine trials set out to exclude pregnant people, as is usual during all clinical trials for new drugs, some people who didn’t yet know they were pregnant or who became pregnant during the trials slipped through. “They appear to have no untoward outcomes,” says Schwartz, and are part of the population of pregnant people who have been vaccinated and are now being studied.

“Thousands of healthcare workers and others have already received COVID-19 vaccines during pregnancy,” says Sonja Rasmussen, a University of Florida pediatrician and epidemiologist who studies the links between birth defects and disease. Studies are being done now to understand more about the use of COVID-19 vaccines during pregnancy, she says, and by the time vaccines are available to the general population much more will be known. But what’s important now is to recognize the vaccine is safe and can help prevent harms to you and your tiny passenger.

Schwartz’s own research, published in late December of 2020, shows that in some cases COVID-19 can travel from a pregnant person to their fetus via the placenta, with the potential ability to do significant damage to the placenta in the process. Most diseases can’t be spread this way, he notes, and the fact that SARS-CoV-2, the virus that causes COVID-19, can pass through the placenta, is cause for big concern. Although it’s not yet known how common this is, “it makes it even more important for a pregnant [person] to receive the vaccine,” he says.

[Related: Read about what we know about the safety of COVID-19 vaccines for pregnant people]

There’s no reason to delay pregnancy or the vaccine

For people who might become pregnant in the future, there’s absolutely no reason not to get vaccinated. Doing so won’t hurt you or your chances of having children down the road, Sonja Rasmussen, a University of Florida pediatrician and epidemiologist who studies the links between birth defects and disease, told Popular Science by email.

A widely-spread piece of false information about the vaccine suggests that being vaccinated against COVID-19 can result in infertility. “There is no evidence for that,” Rasmussen emphasizes.

There’s also no medical reason to delay a planned pregnancy, Schwartz says. He spent several years on the front lines of studying the Zika virus, which can cause birth defects, and says that in high-transmission areas he might have recommended delaying pregnancy. COVID-19 is “just a very different clinical scenario,” he says.

But your social risk—for instance, whether you can effectively distance from people and have the supports you would need to be pregnant during this time—might tip the scales. The CDC has published a comprehensive guide to pregnancy and caring for a baby at this time that might be worth consulting if you’re planning a pregnancy.

What we still don’t know

There are some unknowns when it comes to pregnancy, COVID-19, and vaccinations. For instance, it’s still unclear if the COVID-19 immunity imparted by a vaccine can be passed to an infant from a parent’s breastmilk, although this and many other questions about breast milk and COVID-19 are being studied.

But reputable sources of information are in agreement: getting vaccinated, whether you’re pregnant, might become pregnant, or breastfeeding, is safer than getting COVID-19.

“Based on what we know about how the vaccines currently available in the US work and about the safety of other vaccines during pregnancy,” says Rasmussen, “pregnant people can get the vaccine.”