Pregnant or trying to conceive? What to know about the COVID-19 vaccine and fertility

If you’re pregnant, trying to conceive or breastfeeding, you likely have questions about the COVID-19 vaccine — Is it safe for you? Are there any risks to your baby? Can the vaccine impact fertility for women of childbearing age?

As an OB/GYN and maternal fetal medicine specialist, I hear you. These are important questions to ask. As with any medical decision, it’s imperative that you feel confident making the right decision for your and your family’s health. 

With that in mind, let’s address some common myths and fears around the COVID-19 vaccine and pregnancy.

Is the COVID-19 vaccine safe for pregnant women?

The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine recommend that COVID-19 vaccines should not be withheld from pregnant women who meet eligibility criteria for vaccination.

While pregnant women were not officially included in the COVID-19 vaccine trials to date, some of the women who participated in the trials happened to be (or became) pregnant. This means we do have some data on how pregnant women have responded to the vaccine. Among these women, there have been no reports of any problems during pregnancy, and they are continuing to be monitored. 

However, because there are no studies specifically studying pregnant women yet, there are no clear official recommendations. It’s important to keep in mind that this is standard for a new drug and is not due to any particular concern with this vaccine. 

No serious side effects were reported in the vaccine trials and for those who were pregnant, there did not appear to be any impact on pregnancy. In fact, the only miscarriages reported occurred among the group of women who received the placebo, not the vaccine.

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However, many people do experience mild side effects, such as soreness at the injection site, fatigue, headache, chills or fever within three days after getting the COVID-19 vaccine. To help manage these side effects for pregnant women, the Centers for Disease Control and Prevention (CDC) recommends taking acetaminophen, as this medication is safe to use during pregnancy and does not affect how the vaccine works.

Related: When will you get the COVID-19 vaccine?

Why should pregnant women get the COVID-19 vaccine?

Getting a vaccine during pregnancy is not a new concept — and in fact, many vaccines are routinely and safely given in pregnancy for the health of both mom and baby. For years, vaccines for illnesses like the flu, tetanus and diphtheria have been highly recommended for pregnant women. The antibodies from the vaccine can also pass to your baby, providing your little one with protection against the virus after they are born.

For the COVID-19 vaccine, it’s important to consider your own risk level. COVID-19 can be dangerous for anyone but is certainly more dangerous for pregnant women. COVID-19 patients who are pregnant are more likely to require intensive care and ventilation. The COVID-19 virus has also been linked to an increased risk of preterm birth.

However, the COVID-19 vaccine has proven 94-95% effective at preventing the virus — which means it is very effective. Getting COVID-19 during pregnancy can be life-threatening for you and your baby, but getting the vaccine is a proven way to protect you both with very few risks.

If you’ve already had COVID-19, the CDC recommends you still consider getting the vaccine since we don’t have long term data on the length of immunity following infection.

Related: What to do if you’re pregnant and get COVID-19

Is the COVID-19 vaccine safe while breastfeeding?

According to the Academy of Breastfeeding Medicinethere is no reason to believe that the COVID-19 vaccine affects the safety of breastmilk. Here, it’s important to remind ourselves of how vaccines work.

It is a common misunderstanding that the COVID-19 vaccine (and other vaccines like the flu vaccine) contain the live virus and can therefore potentially cause you to develop COVID-19. However, this is a myth. 

The vaccine does not contain the virus itself. It works by causing your body to make antibodies to fight off the infection. These antibodies formed from vaccines given during pregnancy do pass into your breastmilk and then to your baby, helping prevent future infections. This is one of many benefits of breastfeeding for both mom and baby.

Can the vaccine impact fertility?

Maybe you’re not pregnant but you’re trying or planning to become pregnant in the next few years. Another common misconception is that the COVID-19 vaccine can cause infertility. 

However, there is no reason to think that getting the vaccine will lead to fertility problems or interfere with treatments like IVF. In fact, the American Society for Reproductive Medicine recommends women who are planning to conceive or undergoing fertility treatment should be offered the vaccine based on state and CDC eligibility criteria. Again, should you become pregnant, you will face an increased risk of complications with COVID-19. In most cases, it is better to get the vaccine sooner rather than later.

Should you get the COVID-19 vaccine?

Although nothing is one-size-fits-all when it comes to pregnancy, it is recommended for most women to get the COVID-19 vaccine. Getting the vaccine provides you with an effective form of protection against the virus during pregnancy and beyond.

When making the decision about whether or not to get the COVID-19 vaccine, consider your personal risk factors. You are at an increased risk of severe illness with COVID-19 if you:

  • Work in healthcare
  • Live in an area with a high rate of COVID-19 infections
  • Have contact with people outside of your household who do not wear masks
  • Are 35 years or older
  • Are overweight
  • Have other medical conditions such as diabetes, high blood pressure or heart disease
  • Smoke
  • Are a racial or ethnic minority

On the other hand, if you don’t have these risk factors, you do not work in healthcare or another high-risk setting, you are able to stay home, you and the other members of your household can physically distance from others during your pregnancy, and you do not live in an area with high or increasing COVID-19 cases, it may make sense for you to wait until after you deliver if you have any concerns about the vaccine. If you have had a severe allergic reaction to a vaccine the past, you may also want to consider waiting for more information.

Ultimately, getting the vaccine is your choice. I urge you to consider your risk factors and consult your OB/GYN for guidance.

About the author

Jessica Ehrig, MD

Jessica Ehrig, MD, is a maternal fetal medicine specialist and maternal medical director on the medical staff at Baylor Scott & White Medical Center – Temple. 

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Pregnant or trying to conceive? What to know about the COVID-19 vaccine and fertility