Your Questions About the COVID-19 Vaccine and Pregnancy, Answered

Published on: Nov 5, 2021fb-roundtwitter-roundemail-round
covid vaccine and pregnancyDesign: theSkimm | Photo: iStock
The Story

Only about 35% of pregnant people have been fully vaccinated for COVID-19. That’s despite the fact that they have a higher risk of serious illness or death after getting infected, compared to everyone else. Not to mention complications that can arise for the baby (like a higher chance of a rare stillbirth).

Is getting the COVID-19 vaccine recommended if you’re pregnant?

Louder for the people in the back: yes. That’s according to health societies including the CDC, The American College of Obstetricians and Gynecologists (ACOG), the Society for Maternal-Fetal Medicine (AMFM), and the American Society for Reproductive Medicine (ASRM). Although pregnant people weren’t in the first rounds of vaccine trials (as is the current practice for some clinical trials), more and more evidence suggests that the benefits of getting vaccinated outweigh the risks for parent and baby. 

But in case you need more convincing, we talked to reproductive endocrinologist and infertility specialist Dr. Temeka Zore about pregnancy and the COVID-19 vaccine. In her words, "To date, there is no evidence that the vaccine causes serious adverse side effects in pregnancy. The vaccine does not cross the placenta and the vaccine has not been shown to cause infertility.” And she has personal experience with this topic: Dr. Zore, who is Black, says she was vaccinated for COVID-19 while pregnant this year and is now breastfeeding her healthy baby girl, Mackenzie. She talked to us right after she got her booster. The following has been edited for length and clarity.

Only about 35% of pregnant people are vaccinated (and just 20% of Black pregnant people). Why is that?

There are a few factors. First, the rampant misinformation that spread regarding the vaccine and fertility. Second, the fact that early vaccine trials didn’t include pregnant people slowed down our ability to get data. In regard to people of color, feelings of mistrust toward the medical community date back decades, from the Tuskegee study to Henrietta Lacks. But we have no data to suggest vaccine side effects are worse in different racial groups. What we do know is that COVID infection, hospitalization, and death can be up to 3.5x higher in the BIPOC community. So there needs to be a constant, consistent effort by the medical community to promote the science behind the vaccine and answer patient questions.

What ultimately convinced you to get vaccinated?

I was diagnosed with COVID-19 in my first trimester. I had three to four days of fevers and my heart rate, which was normally in the 60s at rest, would spike to the 130s if I tried getting off the couch. I never wanted to feel that way again. Obviously, I wanted to know the safety data on the vaccine. However, as I mentioned, pregnant people were not included in the clinical trials, so I studied the data available and how the vaccine worked. After weighing risks and benefits, and knowing that as a health care worker I had a high risk of exposure, I felt that the vaccine was the safest choice. I received the Pfizer vaccine a month after I had COVID, and I didn't have any side effects besides a sore arm.

There have been false claims that the COVID-19 vaccine causes infertility. What’s the truth?

This was started when a researcher falsely claimed a protein associated with the COVID vaccine (the spike protein) shared a sequence similar to a protein that’s important in the development of the placenta. That claim was scary because it led people to believe that antibodies meant to fight COVID-19 might also attack the placenta and lead to infertility. I can't say this loudly enough: This is a myth. We have absolutely no data to support this claim both in clinical trials and with real world data. 

How might a pregnant person’s reaction to a virus like COVID-19 be different from someone else’s?

During pregnancy, certain parts of the immune system are enhanced while others are suppressed with the objective to protect the mother and the fetus. Pregnant people are at higher risk of viral infections during pregnancy and thus are more susceptible to COVID-19 infection. Pregnant people also experience reduced lung capacity (due to the increasing uterine size and the diaphragm shifting upward), an increased blood volume (to support the placenta) as well as having a higher chance of getting blood clots (which likely protect the mother during delivery by reducing blood loss). Because COVID infection impacts the respiratory system and can increase the risk of blood clots, pregnancy can exacerbate COVID-19 symptoms and increase the risk of severe disease, hospitalization, and intubation.

Does it matter which trimester you’re in, or where in a fertility cycle you are, when it comes to getting a COVID-19 vaccine or booster? 

The vaccine and booster are currently recommended in any trimester of pregnancy, according to the CDC and ACOG. You don’t need to delay trying to conceive to get vaccinated, nor do you need to postpone fertility treatment to get the vaccine or the booster. Booster shots are recommended for anyone 18 to 64 at high risk for severe disease (which pregnant people are). Therefore, ACOG recommends a booster shot for pregnant and lactating people at least six months after your last vaccine dose.

Can a COVID-19 vaccine give antibodies to a pregnant or lactating person’s baby?

Yes, and that’s the benefit of being vaccinated while pregnant or breastfeeding. The immune response that’s generated after vaccination produces antibodies to COVID-19, which can cross the placenta and give antibodies to the fetus during pregnancy or through breast milk.

theSkimm

Pregnant people’s immune systems can work differently. So being both pregnant and hesitant about getting a new vaccine is completely understandable. But data on pregnant people (and a number of medical groups) supports getting vaxxed for COVID-19 as the safest choice for most — at any trimester. Reach out to your health care provider if you have questions about how to best protect yourself from COVID-19.

This content is for informational and educational purposes only. It does not constitute a medical opinion, medical advice, or diagnosis or treatment of any particular condition. 

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Skimm'd by Carly Mallenbaum, Becky Murray, and Anthony Rivas


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