COVID-19 vaccines and pregnancy: what you should know
Should you get a COVID-19 vaccine if you’re pregnant, breast-feeding or planning to become pregnant?
At present, there’s no cut-and-dry answer, only guidelines from health experts to help individuals decide what’s best for them. The Centers for Disease Control and Prevention, American College of Obstetricians and Gynecologists (ACOG) and Society for Maternal-Fetal Medicine all agree that the COVID-19 vaccines should be offered to or “not withheld from” people who are pregnant and who are eligible for vaccination.
We spoke with Loren Molina, MD, MultiCare’s Chair of Women’s Health Services for Tacoma General and Allenmore Hospitals, to better understand current guidelines. Dr. Molina is a board-certified obstetrician/gynecologist specializing in maternal-fetal medicine, focusing on patients with high-risk pregnancies. As of March 17, 2021, anyone 16 and older who is pregnant is now eligible for COVID-19 vaccination in the state of Washington.
“Whether or not to get the vaccine is an extremely personal decision,” said Dr. Molina. “Patients should make their own decision after weighing the benefits and risks and having the conversation with their health care provider.”
Data on COVID-19 vaccine safety is still being collected because people who were pregnant were not included in the clinical trials for any of the three vaccines currently approved for emergency use (from Pfizer, Moderna and Johnson & Johnson) in the United States.
“Pregnant women are typically not included in these types of clinical trials, so the data we have on vaccine safety is strictly observational,” said Dr. Molina. “The Centers for Disease Control is monitoring self-reported data from women who were pregnant when they got the vaccine. There have been no adverse effects in the small sample reported so far and more data is coming in all the time.”
While longer-term studies are underway, there have been no trends showing increased pregnancy complications, such as miscarriages, stillbirth, growth restriction or preterm births, in women who have been vaccinated compared to those who have not, according to the CDC. In general, pregnant people can expect to have the same vaccine side effects as the overall population and these are not considered harmful.
COVID-19 vaccines are also believed to be safe for those who are breast feeding, as well as their babies.
Vaccinating pregnant patients against disease is not a new practice. For example, it’s routine to give vaccines that prevent flu and Tdap (tetanus, diphtheria, pertussis) to pregnant patients.
“Flu and Tdap vaccines are 100 percent recommended because we’ve accumulated enough data over many years to know they’re safe,” said Dr. Molina. “Studies looking specifically at pregnant women and the COVID-19 vaccine are now underway and we look forward to getting more information specific to pregnancy in future.”
In deciding whether to get a COVID-19 vaccine, Dr. Molina advises pregnant patients to analyze their specific situation.
“Have a conversation with your physician that discusses your personal health risk and what your life is like on a daily basis,” she said. “If you’re in a high-risk situation because of your job, your health or your personal life, the benefits of getting vaccinated likely outweigh the potential risks.”
As with the general population, pregnant patients with certain existing conditions such as diabetes, obesity and tobacco use are at higher risk for becoming severely ill if they contract COVID-19, Dr. Molina noted. Even without these conditions, developing symptomatic COVID-19 while pregnant can create a higher overall risk of getting very sick from the virus.
For people who may want to become pregnant in future, Dr. Molina cited a recent statement from the American College of Obstetricians and Gynecologists which dispels the notion that COVID-19 vaccines cause infertility. ACOG stated that “unfounded claims linking COVID-19 vaccines to infertility have been scientifically disproven.”
As the vaccines have become available, many of Dr. Molina’s pregnant patients, especially front-line health care workers, have been eager to get vaccinated. “Others are choosing not to get vaccinated based on the limited safety data currently available,” she said.
No matter what patients decide, Dr. Molina advises them to continue practicing preventive measures, including hand washing, physical distancing and wearing a mask.
“It’s also important to stay informed as we’re learning more all the time,” said Dr. Molina.
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