Vaccination Considerations for People who are Pregnant or Breastfeeding

COVID-19 Vaccination Considerations for People Who Are Pregnant

CDC and the independent Advisory Committee on Immunization Practices (ACIP) have provided information to assist pregnant people with their decision to receive the COVID-19 vaccine. At this time, ACIP recommends that healthcare personnel be offered vaccination in the initial phase of the COVID-19 vaccination program. Healthcare personnel who are pregnant may choose to be vaccinated. If they have questions around getting vaccinated, a discussion with a healthcare provider might help them make an informed decision.

There are limited data about the safety of COVID-19 vaccines for people who are pregnant

Currently, there are limited data available on the safety of COVID-19 vaccines for people who are pregnant. Animal developmental and reproductive toxicity (DART) studies are ongoing and studies in people who are pregnant are planned. CDC and the Food and Drug Administration (FDA) have safety monitoring systems in place to capture information about vaccination during pregnancy and will closely monitor reports.

While studies have not yet been done, based on how mRNA vaccines work, experts believe they are unlikely to pose a risk for people who are pregnant. mRNA vaccines do not contain the live virus that causes COVID-19 and therefore cannot give someone COVID-19. Additionally, mRNA vaccines do not interact with genetic material DNA because the mRNA does not enter the nucleus of the cell. Cells break apart the mRNA quickly. However, the potential risks of mRNA vaccines to the pregnant person and her fetus are unknown because these vaccines have not been studied in pregnant women.

Pregnant people are at increased risk for severe illness from COVID-19

Observational data demonstrate that, while the chances for these severe health effects are infrequent, pregnant people with COVID-19 have an increased risk of severe illness, including illness that results in ICU admission, mechanical ventilation, and death. Additionally, pregnant people with COVID-19 might be at increased risk of adverse pregnancy outcomes, such as preterm births.

Because supplies are currently limited, CDC recommends certain groups receive the first supply of COVID-19 vaccines

At this time, healthcare personnel are recommended to be among the first to receive the vaccine because they are at increased risk of exposure to the virus that causes COVID-19.

Learn more about how CDC is making COVID-19 vaccination recommendations, including recommendations while there is a limited supply.

Getting vaccinated is a personal choice for people who are pregnant

People who are pregnant and part of a group recommended to receive the COVID-19 vaccine, such as healthcare personnel, may choose to be vaccinated. A conversation between pregnant patients and their clinicians may help them decide whether to get vaccinated with a vaccine that has been authorized for use under Emergency Use Authorization (EUA). While a conversation with a clinician may be helpful, it is not required prior to vaccination.

Key considerations pregnant patients can discuss with their healthcare provider include:

• The likelihood of exposure to SARS-CoV-2, the virus that causes COVID-19
• Risks of COVID-19 to them and potential risks to their fetuses
• What is known about the vaccine: how well it works to develop protection in the body, known side effects of the vaccine, and lack of data during pregnancy

Pregnant patients who decide to get vaccinated should continue to follow the current guidelines to prevent the spread of COVID-19 after they are vaccinated. That means:

• Wearing a mask
• Staying at least six feet away from others
• Avoiding crowds

• Washing hands with soap and water for 20 seconds or using hand sanitizer with at least 60% alcohol
• Following CDC travel guidance
• Following quarantine guidance after exposure to COIV-19
• Following any applicable workplace guidance

Vaccine side effects

These mRNA COVID-19 vaccines are expected to produce some side effects after vaccination, especially after the second dose. Pregnant women who experience fever following vaccination may be counseled to take acetaminophen because fever has been associated with adverse pregnancy outcomes. Acetaminophen may be offered as an option for pregnant women experiencing other post-vaccination symptoms as well.

Routine testing and pregnancy

Routine testing for pregnancy before COVID-19 vaccination is not recommended. Women who are trying to become pregnant do not need to avoid pregnancy after receiving an mRNA COVID-19 vaccine.

COVID-19 vaccination considerations for people who are breastfeeding

There are no data on the safety of COVID-19 vaccines in lactating women or on the effects of mRNA vaccines on the breastfed infant or on milk production/excretion. mRNA vaccines are not thought to be a risk to the breastfeeding infant. People who are breastfeeding and are part of a group recommended to receive a COVID-19 vaccine, such as healthcare personnel, may choose to be vaccinated.