Should Pregnant Women Get the COVID-19 Vaccine?

Should pregnant women get the COVID-19 vaccine when eligible? We asked the experts what you need to know about the COVID vaccine and pregnancy.

There’s a lot to weigh when making the call. Data show that pregnant people who contract symptomatic COVID-19 are at higher risk of getting really sick, requiring ICU admission and intubation. Pregnant people also face a greater risk of dying from the disease compared with their nonpregnant peers. On top of that, pregnant women with COVID-19 may be at greater risk of poor pregnancy outcomes, including preterm birth, compared with pregnant women without COVID-19, according to the Centers for Disease Control and Prevention (CDC).

Getting vaccinated would, in theory, significantly reduce these risks. The caveat: Pregnant people were excluded from the Pfizer-BioNTech, Moderna, and newly FDA-approved Johnson & Johnson vaccine trials (which is currently common practice for first-round vaccine trials), so we don’t have as much data as we would like on how safe and effective these shots are in folks who are expecting.

So what do the official guidelines say? Guidance from the CDC reflects this murkiness; the organization says pregnant people may choose to get a COVID-19 shot but stops short of explicitly encouraging it. A practice advisory from the American College of Obstetricians and Gynecologists (ACOG) strikes a similar tone, stating that the COVID-19 vaccine “should not be withheld” from pregnant people. The American Society for Reproductive Medicine (ASRM) takes a more assertive stance by recommending pregnant people get vaccinated.

Still, given the scant information available on the COVID-19 shot and the lack of resounding endorsement from experts, how can those who are expecting make the best decision for themselves and their unborn babies? We posed this question to three doctors. Here’s what you need to know about the COVID vaccine and pregnancy.

Is it safe to get the coronavirus vaccine if you’re pregnant now?

The short answer is that we don’t have enough data yet to say that the COVID-19 vaccine is safe in pregnant women, says Jeanne S. Sheffield, M.D., director of the division of maternal-fetal medicine and professor of gynecology and obstetrics at Johns Hopkins. But the very limited information we do have is promising. Preliminary studies that tested the COVID-19 vaccines in pregnant animals were reassuring and did not reveal any safety concerns.

Anthony Fauci, M.D., the nation’s leading expert in infectious disease, said in a February 10 press conference that about 20,000 pregnant women in the U.S. had been vaccinated since the Food and Drug Administration authorized the two COVID-19 vaccines for emergency use in December. So far, Fauci said, there have been “no red flags” with these vaccinations.

A small group of women in the vaccine clinical trials became pregnant during the trials; 18 of those women were vaccinated, and two months later, none had miscarried. It’s too small a sample size to draw any meaningful conclusions, but so far there is no evidence to suggest the vaccine can cause miscarriage or birth defects.

More promising is that the “biologic plausibility” of the vaccine—meaning, what experts know about how the shot is designed and the way it works in the body—is “reassuring,” says Linda Eckert, M.D., professor of obstetrics and gynecology at the University of Washington and ACOG liaison to the Advisory Committee on Immunization Practices, the group that advises the CDC on vaccine recommendations. “We don’t see a reason to fear that this vaccine harms the fetus or the pregnant individual,” says Dr. Eckert, who helped develop ACOG’s advisory on pregnancy and COVID-19 vaccination.

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