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Pregnancy and the COVID-19 Vaccine

January 20, 2021

Pregnant or Family Planning?

Day Kimball Healthcare’s women’s health team understands you may be wondering if it’s safe to get the COVID-19 mRNA vaccine.

Here’s what you need to know about the COVID-19 mRNA vaccine related to conception, pregnancy and breastfeeding. More Q&A below.

What is an mRNA vaccine?

Instead of using a live virus, or a piece of dead virus like other vaccines, mRNA vaccines present your cells with a “recipe” (mRNA) to create just one protein from the virus. Your own cells start to produce this protein, and your immune system creates antibodies to it. When the virus enters your body, those antibodies attack the same protein on the virus, killing the virus.
The mRNA is quickly dissolved in your body after your cells create the protein, so no mRNA stays in your system. The mRNA vaccines is ~95% effective in preventing symptomatic COVID-19 infection and can reduce your risk of passing COVID-19 to someone you love.
The most common side effects from the vaccine are sore arm, fatigue, headache, fever, muscle pain, joint pain, chills.

Does the vaccine cause infertility or miscarriage?

There were no pregnant patients enrolled in the vaccine studies, but there were patients that became pregnant during the study period. The patients who received the vaccine did not have any higher rates of miscarriage or infertility than those that didn’t.

You can develop a fever as a side effect of the vaccine. Because a very high fever can cause miscarriage, it is advised if you are trying to get pregnant or are in the first trimester when you get the vaccine, you should take 4g of folic acid daily starting before your first dose and continuing until a few days after your second dose. You can also take Tylenol to reduce your fever, even if you are pregnant.

Some patients who are trying to get pregnant may choose to delay conception until after their second dose. Patients who are already pregnant, may choose to delay their vaccine until they are out of the first trimester when the risk of fever to the pregnancy is reduced. If you become pregnant after your first dose, but before you receive the second dose, you do not have to delay getting the second dose.

Can I get the COVID-19 vaccine if I am pregnant?

Yes. Although there were no pregnant patients enrolled in the original vaccine studies, because this vaccine does not contain live virus, it is considered likely safe in pregnancy. The protein to which we are creating an immune response is not similar enough to any components of a pregnancy to cause our antibodies to “attack” the pregnancy.

Can I breastfeed and get the vaccine?

The American Academy of Breastfeeding Medicine states that there is no reason to believe that the vaccine would affect the safety of breast milk. There is no live virus in the vaccine, so you cannot infect your baby through your breast milk if you get the vaccine. The mRNA from the vaccine quickly breaks down in our bodies, therefore it is unlikely to get into the breast milk. However, the antibodies you create may pass to your baby through your breastmilk, which might help prevent infection in baby.

Should I get the vaccine?

COVID-19 is more dangerous for pregnant women than to the average person. Pregnant patients are 5 times more likely to end up in the ICU or on a ventilator, preterm birth is more common in patients who have COVID-19, and pregnant patients are more likely to die from COVID-19 than non-pregnant patients of the same age. Because infection with COVID-19 is so dangerous for pregnant patients, this needs to be balanced with the small but unknown risks associated with the vaccine.

Pregnant patients who have other risk factors are even more at risk for poor outcomes: patients > 35 years old, overweight, diabetes, high blood pressure, heart disease, smoking, racial or ethnic minorities. Patient who live in areas with high rates of virus in the community or who are themselves healthcare workers are also considered at higher risk for getting infected.

The American College of Obstetrics and Gynecology (ACOG), Society for Maternal Fetal Medicine (SMFM) and American Society for Reproductive Medicine (ASRM) all advise that patients who are pregnant or trying to conceive should not be denied the vaccine. Ultimately it is your choice as a patient whether or not to take the vaccine, and this decision can be further discussed with your provider.

Q&A: Pregnancy and the COVID-19 Vaccine


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Youlan Tang, MD

Youlan Tang, MD


Dr. Youlan Tang is board-certified in family medicine and has authored several publications and presentations. She was a former research scholar at both Columbia and Duke University. Dr. Tang is a...more »
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