Keeping up with the never-ending stream of information about the new COVID-19 vaccines can be stressful enough for anyone, but being pregnant can add an extra layer of stress. Just in the past few days, the WHO has flip-flopped between not recommending pregnant people get the vaccine to fully supporting them in receiving the inoculation. Luckily, for a number of reasons, doctors and public health experts say it’s actually quite safe for most pregnant folks to be vaccinated, and the rewards outrank the risks.
“Just being pregnant you have a higher risk of developing severe disease, higher risk of ICU care, needing a breathing tube, and a smaller increased risk of dying,” says Yalda Afshar, an assistant professor of Obstetrics and Gynecology at UCLA. “Being pregnant puts you in a different category, and that’s a reason in and of itself to get vaccinated.”
If you’re pregnant, especially if you also regularly come into contact with COVID-19 patients or other risky scenarios, you’re more likely to have serious COVID-19 symptoms that may even lead to preterm birth. So, if you’re faced with the opportunity to get a vaccine, Afshar recommends going ahead and getting vaccinated. This is largely because the major vaccines being approved right now are mRNA vaccines (Moderna’s and Pfizer’s) and a new viral vector vaccine (Johnson & Johnson’s).
One reason some public health organizations, such as the WHO might take pause in outwardly recommending the COVID-19 vaccines to pregnant people is that the clinical trials that allowed the vaccines to gain FDA emergency use authorization were not tested in pregnant people. But this is not uncommon. Most vaccines (and all drugs, really) are tested first in clinical trials with healthy, generally young people before they are tested in other populations, such as children, those with chronic conditions, as well as pregnant people. But that doesn’t necessarily mean the drug isn’t safe for those groups of people who were included in the initial testing. In fact, the vaccines approved for COVID-19 might be particularly safe given how they were made and designed.
The mRNA vaccines work by teaching your body how to build up an immune response against a virus without actually putting you at risk of infection. “There’s truly no biologic plausibility that an mRNA vaccine can cause harm to a pregnant person or their baby,” Afshar says.
Similarly, viral vector vaccines prep your body’s immune response by bringing in a harmless virus that carries the genetic sequence for the spike protein on SAR-CoV-2. Essentially, you get the boosted immune response without ever having to come in contact with a live virus.
Some vaccines for other diseases, such as chickenpox, shingles, or measles vaccines, do contain the live virus, which is why it’s best to stay away from them during the course of your pregnancy since they could theoretically pass the disease on to a fetus. But for COVID-19, the vaccine is likely going to keep you much safer than you would be without.
As for people breastfeeding or hoping to get pregnant, Afshar says it’s totally okay to get the vaccine whenever it becomes available, and there’s no reason to wait to start trying to conceive or begin fertility treatments.
Update: In the original post, Afshar was misquoted as saying “possibility that an mRNA vaccine can cause harm.” The post has been updated with her accurate quote.