Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic Coronavirus (COVID-19), go here. These expert reports are free of charge and can be saved and shared.
__________________________________
There is so much chatter going around about whether or not the COVID-19 vaccines are safe if you’re pregnant or breastfeeding. There are a lot of great blog posts about the vaccines during pregnancy on The Pulse already. Check out this one about the Moderna and Pfizer vaccines, the only two vaccines that as of January 2021 have been given and emergency use authorization by the United States Food and Drug Administration. This post about the Johnson & Johnson vaccine and This primer about mRNA vaccines are also great reads.
The question of whether or not to get a COVID-19 vaccine if you’re pregnant or lactating is fraught because pregnant and lactating people were not included in the initial clinical trials for either of the vaccines that are currently available. Today, we’ll talk about what the experts have to say about pregnant and lactating people and the COVID-19 vaccine options.
World Health Organization
The World Health Organization (WHO) initially recommended against offering COVID-19 vaccines to pregnant people, based on the unknown risks. In information released on January 26, 2021, however, they recommended that “pregnant women at high risk of exposure to SARS-CoV-2 (e.g. health workers) or who have comorbidities which add to their risk of severe disease, may be vaccinated in consultation with their health care provider.” They changed their advice because based on what is known about mRNA vaccines, there is not a reason to believe that the risks of vaccination outweigh the benefits.
American College of Nurse-Midwives
This group, representing certified midwives and certified nurse-midwives in the United States joined with other organizations—notably the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine—to release a statement explaining some of the science behind the currently available vaccines. These vaccines are, they wrote, “mRNA vaccines, which help the body create antibodies to fight future infection. The vaccines do not contain live COVID-19 virus. Data suggest that mRNA is rapidly degraded in the body by normal cellular processes in about 10 to 20 days.” They add that approved vaccines are available for pregnant and lactating people.
American College of Obstetricians and Gynecologists
This group of obstetricians and gynecologists, also known as ACOG, recommends that COVID-19 vaccines not be withheld from pregnant individuals who meet criteria for vaccination based on their membership in groups that are being given vaccine priority, such as healthcare workers. In a practice advisory updated on January 27, 2021, they recommend that people considering the vaccine balance considerations such as the level of outbreak in their geographic area and the risks contracting COVID-19 to both the pregnant person and the fetus, which can be severe.
Society for Maternal-Fetal Medicine
In a statement issued on December 1, 2020 about vaccination in pregnant people, representatives of this organization that is composed of maternal-fetal medicine specialists, who largely focus on treating people with complex pregnancies, wrote, “SMFM strongly recommends that pregnant women have access to COVID-19 vaccines in all phases of future vaccine campaigns, and that she and her healthcare professional engage in shared decision-making regarding her receipt of the vaccine.” They added that counseling between patients and their physician “should balance available data on vaccine safety, risks to pregnant women from SARS-CoV-2 infection, and a woman’s individual risk for infection and severe disease.”
The Society of Obstetricians and Gynaecologists of Canada
In a statement on December 18 that was reaffirmed January 28, the SOGC said, “Women who are pregnant or breastfeeding should be offered vaccination at anytime if they are eligible and no contraindications exist.” They continued to say that the decision to receive the vaccine or not should be based on an individual’s personal values and an understanding that the risk of infection, short and long-term effects, or death from COVID-19 outweighs the undescribed risk of being vaccinated during pregnancy or while breastfeeding. “Women should not be precluded from vaccination based on pregnancy status or breastfeeding,” they added.
Experts in the United Kingdom
The Royal College of Obstetricians and Gynaecologists, Royal College of Midwives, and British Maternal and Fetal Medicine Society released a joint statement on December 30, 2020, indicating that the the Joint Committee on Vaccination and Immunisation in the UK does not recommend routine use of either the Oxford University/AstraZeneca or the Pfizer vaccine—the two COVID-19 vaccine options that have been approved for emergency use in the UK—in pregnant people, based on the lack of research about these vaccines’ effectiveness in pregnancy. They do however recommend that pregnant people who are especially vulnerable—due to preexisting conditions or their status as frontline health or social care workers—then they should be offered the vaccine.
Final Thoughts
After reading all of the perspectives of the experts included here, you may still have questions about whether it makes sense for you to get a COVID-19 vaccine. While it’s ultimately up to you, it might help to discuss your questions with your doctor or midwife, trusted family, and friends.
