Now that COVID-19 vaccines are being rolled out, pregnant and breastfeeding women are asking many questions about the risks and benefits. Initially, many of those who get vaccines in the United States will be healthcare workers, although the circles of vaccine eligibility are widening.
the Centers for Disaster Control and Prevention (CDC), American College of Obstetrics and Gynecology (ACOG) and the Society of Maternal and Fetal Medicine agree that new COVID-19 mRNA vaccines should be offered to pregnant and lactating women who are eligible for vaccination.
Here are the answers to some basic questions you might ask yourself about the COVID-19 vaccine if you’re pregnant or breastfeeding – or planning to become pregnant. Keep in mind that information changes quickly. Your obstetrics provider or medical team can advise you more fully, depending on your personal health risks, your exposure to the virus that causes COVID-19, and your preferences.
What do we know about how COVID-19 affects pregnant women?
COVID-19 is potentially dangerous for all people. Although the actual risk of serious illness and death in pregnant women is very low, it is higher compared to non-pregnant people of the same age group. Pregnant women are at greater risk of being hospitalized in an intensive care unit and require a high level of care, including machine-assisted breathing, and are at greater risk of dying if this occurs.
If you are pregnant, you may also wonder about the risks to the fetus if you contract COVID-19. Research suggests that COVID-19 could increase the risk of premature birth, especially for people with serious illness. So far, studies have not identified any birth defects associated with COVID-19. And while transmission of the virus from mother to baby during pregnancy is possible, it seems to be a rare event. You can read more about pregnancy and COVID-19 here.
What do we know about the safety of new COVID-19 mRNA vaccines in pregnant women?
The mRNA vaccine trials have not deliberately included pregnant or breastfeeding women, so our direct knowledge is currently limited. Some participants in vaccine trials inadvertently became pregnant; 18 of these people received the vaccine. More information may become available in the coming months.
When studied in animal testing, the MRNA vaccines did not affect fertility or cause pregnancy problems. In humans, we know that other types of vaccines are generally safe during pregnancy – in fact, many are. advised.
It is also important to know that
- MRNA vaccines do not contain virus particles.
- Within hours or days, our bodies eliminate the mRNA particles used in the vaccine, so these particles are unlikely to reach or cross the placenta.
- The immunity that a pregnant person generates from the vaccination can cross the placenta and can help keep the baby safe after birth.
What about side effects of vaccines? A possible short-term side effect of mRNA vaccine trials (occurring within one to two days of vaccination) is fever. About 1% to 3% of people have had a fever after the first dose of mRNA vaccine, and about 15% to 17% after the second dose. These fevers are usually low and can be managed with acetaminophen, which is safe during pregnancy. Rarely, high and prolonged fevers during pregnancy can lead to birth defects.
For more information on common side effects of the COVID vaccine, click here.
What to consider about COVID-19 vaccines if you are pregnant
Eligibility for COVID vaccines varies from state to state. Health workers in direct contact with patients are usually in the first phase of vaccines, followed by others at high risk of contracting COVID, such as first responders, essential workers, residents of nursing homes. , people over 75 and people with certain health problems.
Assuming the mRNA vaccine is available during your pregnancy, you have several options to discuss with your healthcare provider.
- Get vaccinated as soon as the vaccine is available. You may decide to do this if you have additional risk factors for serious complications from COVID-19 (such as high blood pressure or obesity) and / or multiple potential exposures to COVID-19 from your job, your family or your community.
- Wait after giving birth to get the vaccine. You may choose to do this if pregnancy is your only risk factor for serious illness and you are able to control your exposures by limiting interactions with people outside your household and using protective measures (wearing a mask hand washing and physical distancing).
- Consider ways to modify your COVID-19 exposures and possibly delay the vaccine. Most people have risk factors and uncontrolled exposures. If this describes you, you still have options. You may decide to change your exposures if possible and postpone vaccination until the second trimester, when the natural risk of miscarriage is lower. Or you can choose to delay the vaccination until the baby is born.
- Wait for a traditional vaccine similar to the influenza vaccine or Tdap vaccines. These vaccines are under development but have not yet been approved in the United States. Experts know a lot more about the use of these types of vaccines in pregnant women. However, depending on your exposure to COVID-19 and your risk of becoming seriously ill if you are infected, it may be wiser to have an mRNA vaccine.
If you plan to postpone the vaccine, ask if the vaccination will be available to you at a later date. The answer may vary depending on the COVID vaccine supply and the vaccination programs where you live.
What to consider about COVID-19 vaccines if you are breastfeeding
Experts think it is very likely that you will get a COVID-19 mRNA vaccine if you are breastfeeding. Although breastfeeding people have not been included in vaccine trials, the mechanism of mRNA vaccines and experience with other vaccines suggests that this is true.
It is important to know:
- There is no virus in mRNA vaccines. You cannot get COVID or give COVID to your baby by getting the vaccine. The components of the vaccine are not known to harm breast-fed infants.
- When you receive the vaccine, the small particles of the mRNA vaccine are used up by your muscle cells at the injection site and are therefore unlikely to enter breast milk. Any small mRNA particles that reach breast milk would likely be digested.
- When a person is vaccinated while breastfeeding, their immune system develops antibodies that protect against COVID-19. These antibodies can be passed through breast milk to the baby. Newborns of vaccinated mothers who are breastfeeding may benefit from these antibodies against COVID-19.
What to consider if you are planning to become pregnant soon or in the future
If you’re planning to become pregnant soon, accepting the COVID-19 vaccine as soon as it’s available to you is a great way to make sure you – and your pregnancy – are protected.
COVID-19 vaccination is not believed to affect future fertility.
The bottom line
COVID-19 vaccination for pregnant or breastfeeding women has potential benefits and raises unanswered questions. It helps to be as informed as possible when making your decision, but be aware that information can change quickly. We will learn more about the safety of the COVID vaccine during pregnancy and breastfeeding through ongoing animal studies and human studies that are recruiting participants.
In the meantime, you can stay informed by checking out trusted health websites, such as the ones listed above, and talking to your health care providers. Together, you can balance the latest data on the risks of COVID-19 during pregnancy, the safety of available vaccines, your individual risk factors and exposures, and most importantly, your values and preferences.
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