Important update: Healthcare facilities
CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more
UPDATE
Given new evidence on the B.1.617.2 (Delta) variant, CDC has updated the guidance for fully vaccinated people. CDC recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Children should return to full-time in-person learning in the fall with layered prevention strategies in place.
UPDATE
The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. More information is available here.
UPDATE
Travel requirements to enter the United States are changing, starting November 8, 2021. More information is available here.

COVID-19 Vaccines While Pregnant or Breastfeeding

COVID-19 Vaccines While Pregnant or Breastfeeding
Updated July 14, 2022
What You Need to Know
  • COVID-19 vaccination is recommended for all people 6 months and older. This includes people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future. CDC also recommends COVID-19 vaccines for infants 6 months and older who’s mother was vaccinated or had a COVID infection before or while pregnant.
    • If you are pregnant or were recently pregnant, you are more likely to get very sick from COVID-19 compared to people who are not pregnant. Additionally, if you have COVID-19 during pregnancy, you are at increased risk of complications that can affect your pregnancy and developing baby.
    • Getting a COVID-19 vaccine can help protect you from getting very sick from COVID-19.
    • People who are pregnant should stay up to date with their COVID-19 vaccines, including getting a COVID-19 booster shot when it’s time to get one.
  • Evidence continues to build showing that:
    • COVID-19 vaccination during pregnancy is safe and effective.
    • There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men.

People who are Pregnant

pregnant woman holding belly

Although the overall risks are low, if you are pregnant or were recently pregnant, you are:

  • More likely to get very sick from COVID-19 compared to people who are not pregnant.
  • People who get very sick from COVID-19 may require hospitalization, admission to an intensive care unit (ICU), or use of a ventilator or special equipment to breathe. Severe COVID-19 illness can also lead to death.
  • Additionally, if you have COVID-19 during pregnancy, you are at increased risk of complications that can affect your pregnancy and developing baby. For example, COVID-19 during pregnancy increases the risk of delivering a preterm or stillborn infant.

Getting a COVID-19 vaccine can protect you from getting very sick from COVID-19, and keeping you as healthy as possible during pregnancy is important for the health of your baby.

CDC recommends COVID-19 vaccines for everyone ages 6 months and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future and getting boosters, if eligible.

CDC recommendations align with those from professional medical organizations serving people who are pregnant, including the:

Safety and Effectiveness of COVID-19 Vaccination during Pregnancy

Pregnant person with pink bandage on left arm.

Evidence continues to build showing that COVID-19 vaccination before and during pregnancy is safe, effective, and beneficial to both mother and baby. The benefits of receiving a COVID-19 vaccine outweigh any potential risks of vaccination during pregnancy. Below is a brief summary of the growing evidence:

  • COVID-19 vaccines do not cause COVID-19, including in people who are pregnant or their babies. None of the COVID-19 vaccines contain live virus. They cannot make anyone sick with COVID-19, including people who are pregnant or their babies. Learn more about how vaccines work.
  • Data on the safety of receiving an mRNA COVID-19 vaccine, Moderna or Pfizer-BioNTech (Comirnaty), before and during pregnancy are reassuring.
    • Data from vaccine safety monitoring systems have not found any safety concerns for people who received an mRNA COVID-19 vaccine late in pregnancy or for their babies.1-5
    • Scientists have not found an increased risk for miscarriage among pregnant people who received an mRNA COVID-19 vaccine just before or during early pregnancy (before 20 weeks of pregnancy).2-4,6
    • Data from American, European and Canadian studies showed that vaccination with an mRNA COVID-19 vaccine during pregnancy was not associated with an increased risk for pregnancy complications, including preterm birth, stillbirth, bacterial infection of the placenta, and excessive maternal blood loss after birth.4,6,7
    • A Chicago study has shown that vaccination of pregnant people with a COVID-19 vaccine prior to and during the first trimester was not associated with an increased risk of birth defects detectable on prenatal ultrasound.8
    • The monitoring of COVID-19 vaccination during pregnancy is ongoing. CDC will continue to follow people vaccinated during all trimesters of pregnancy to better understand effects on pregnancy and babies.
  • Data show that receiving an mRNA COVID-19 vaccine during pregnancy reduces the risk of severe illness from COVID-19 for people who are pregnant. Recent studies compared people who were pregnant and received an mRNA COVID-19 vaccine with people who did not. Scientists found that COVID-19 vaccination was effective at reducing the risk of getting very sick from COVID-19.9-13
  • Vaccination during pregnancy builds antibodies that can help protect the baby. When people receive an mRNA COVID-19 vaccine during pregnancy, their bodies build antibodies against COVID-19, similar to people who are not pregnant. Antibodies made after a pregnant person received an mRNA COVID-19 vaccine have been found in their baby’s umbilical cord blood. This means COVID-19 vaccination during pregnancy can help protect babies against COVID-19. More data are needed to determine how these antibodies, similar to those produced with other vaccines, may provide protection to the baby.14-16
    • A recent small study found that at 6 months old, the majority (57%) of infants born to pregnant people who were vaccinated during pregnancy had detectable antibodies against COVID-19, compared to 8% of infants born to pregnant people who had COVID-19 during pregnancy.17
  • New data show that completing a two-dose primary mRNA COVID-19 vaccine series during pregnancy can help protect babies younger than 6 months old from hospitalization due to COVID-19. In this report, the majority (84%) of babies hospitalized with COVID-19 were born to pregnant people who were not vaccinated during pregnancy.18
  • No adverse pregnancy-related outcomes occurred in previous clinical trials that used the same vaccine platform as the J&J/Janssen COVID-19 vaccine. Vaccines that use the same viral vector as the J&J/Janssen COVID-19 vaccine have been given to people in all trimesters of pregnancy, including in a large-scale Ebola vaccination trial. No adverse pregnancy-related outcomes, including adverse outcomes affecting the baby, were associated with vaccination in these trials. Learn more about how viral vector vaccines work.
  • No safety concerns were found in animal studies. Studies in animals receiving a Moderna, Pfizer-BioNTech, or Johnson & Johnson’s Janssen (J&J/Janssen) COVID-19 vaccine before or during pregnancy found no safety concerns in pregnant animals or their babies.

More clinical trials on the safety of COVID-19 vaccines and how well they work in people who are pregnant are underway or planned. Vaccine manufacturers are also collecting and reviewing data from people in the completed clinical trials who received a vaccine and became pregnant during the trial.

V-safe provides quick and confidential health check-ins via text messages and web surveys so you can quickly and easily share with CDC how you or your dependent feel after getting a COVID-19 vaccine.

Talk to Your Healthcare Provider

If you are pregnant, talk to your healthcare provider about COVID-19 vaccination. While such a conversation might be helpful, it is not required before vaccination. You can receive a COVID-19 vaccine, including a booster shot, without any additional documentation from your healthcare professional.

Common Questions about Vaccination during Pregnancy

If you are pregnant and have questions about COVID-19 vaccine

If you would like to speak to someone about COVID-19 vaccination during pregnancy, you can contact MotherToBaby whose experts are available to answer questions in English or Spanish by phone or chat. The free and confidential service is available Monday–Friday, 8am–5pm (local time). To reach MotherToBaby:

  • Call 1-866-626-6847
  • Chat live or send an email MotherToBaby

People who are Breastfeeding

CDC recommends that people who are breastfeeding get vaccinated and stay up to date with their COVID-19 vaccines, including getting a COVID-19 booster shot when it’s time to get one.

Clinical trials for the COVID-19 vaccines currently used in the United States did not include people who were breastfeeding. Therefore, there are limited data available on the

  • Safety of COVID-19 vaccines in people who are breastfeeding
  • Effects of vaccination on the breastfed baby
  • Effects on milk production or excretion

COVID-19 vaccines cannot cause COVID-19 in anyone, including the mother or the baby. None of the COVID-19 vaccines contain live virus. Vaccines are effective at preventing COVID-19 in people who are breastfeeding. Recent reports have shown that breastfeeding people who have received mRNA COVID-19 vaccines have antibodies in their breastmilk, which could help protect their babies. More data are needed to determine what level of protection these antibodies might provide to the baby.16, 19-23

People Who Would Like to Have a Baby

CDC recommends that people who are trying to get pregnant now or might become pregnant in the future, as well as their partners, get vaccinated and stay up to date with their COVID-19 vaccines, including getting a COVID-19 booster shot when it’s time to get one.

Vaccine Side Effects

Side effects can occur after receiving any of the available COVID-19 vaccines, especially after the second dose for vaccines that require two doses or a booster.

People who are pregnant have not reported different side effects from people who are not pregnant after vaccination with mRNA COVID-19 vaccines (Moderna and Pfizer-BioNTech vaccines). 1

  • Fever, for any reason, has been associated with adverse pregnancy outcomes.
  • Fever in pregnancy may be treated with acetaminophen as needed, in moderation, and in consultation with a healthcare provider.
  • Learn more at Possible Side Effects After Getting a COVID-19 Vaccine.

Although rare, some people have had severe allergic reactions after receiving a COVID-19 vaccine. Talk with your healthcare provider if you have a history of allergic reaction to any other vaccine or injectable therapy (intramuscular, intravenous, or subcutaneous).

Key considerations you can discuss with your healthcare provider include:

  • The benefits of vaccination
  • The unknown risks of developing a severe allergic reaction
  • If you have an allergic reaction after receiving a COVID-19 vaccine during pregnancy, you can receive treatment for it.

References

  1. Shimabukuro TT, Kim SY, Myers TR, et al. Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons. N Engl J Med 2021; 384:2273-2282. DOI: https://doi.org/10.1056/NEJMoa2104983.
  2. Zauche LH, Wallace B, Smoots AN, et al. Receipt of mRNA COVID-19 vaccines and risk of spontaneous abortions. New Engl J Med Published online September 8, 2021; DOI: https://doi.org/10.1056/NEJMc2113891
  3. Kharbanda EO, Haapata J, DeSilva M, et al. Spontaneous Abortion Following COVID-19 Vaccination During Pregnancy. JAMA. Published online September 8, 2021. DOI: https://doi.org/10.1001/jama.2021.15494
  4. Lipkind HS, Vazquez-Benitez G, DeSilva M, et al. Receipt of COVID-19 Vaccine During Pregnancy and Preterm or Small-for-Gestational-Age at Birth — Eight Integrated Health Care Organizations, United States, December 15, 2020–July 22, 2021. MMWR Morb Mortal Wkly Rep 2022;71:26–30. DOI: https://dx.doi.org/10.15585/mmwr.mm7101e1
  5. Morro PL, Olson CK, Clark E, et al. Post-authorization surveillance of adverse events following COVID-19 vaccines in pregnant persons in the vaccine adverse event reporting system (VAERS), December 2020 – October 2021. Vaccine. Published online April 12, 2022. DOI: https://doi.org/10.1016/j.vaccine.2022.04.031
  6. Magnus MC, Gjessing HK, Eide HN, et al. Covid-19 Vaccination during Pregnancy and First-Trimester Miscarriage. New Engl J Med 2021; 385:2008-2010. DOI: https://doi.org/10.1056/NEJMc2114466
  7. Fell DB, Dhinsa T, Alton GD, et al. Association of COVID-19 Vaccination in Pregnancy With Adverse Peripartum Outcomes. JAMA. 2022;327(15):1478-1487. DOI: https://doi.org/10.1001/jama.2022.4255
  8. Ruderman RS, Mormol J, Trawick E, et al. Association of COVID-19 Vaccination During Early Pregnancy With Risk of Congenital Fetal Anomalies. JAMA Pediatr. Published online April 4, 2022. DOI: https://doi.org/10.1016/j.vaccine.2022.04.031
  9. Goldshtein I, Nevo D, Steinberg DM, et al. Association Between BNT162b2 Vaccination and Incidence of SARS-CoV-2 Infection in Pregnant Women. JAMA. Published online July 12, 2021. DOI: https://doi.org/10.1001/jama.2021.11035
  10. Dagan N, Barda N, Biron-Shental T, et al. Effectiveness of the BNT162b2 mRNA COVID-19 vaccine in pregnancy. Nat Med. Published online September 7, 2021. DOI: https://doi.org/10.1038/s41591-021-01490-8
  11. Theiler RN, Wick M, Mehta R, et al. Pregnancy and birth outcomes after SARS-CoV-2 vaccination in pregnancy. Am J Obstet Gynecol MFM. 2021 Nov; 3(6): 100467
  12. Morgan JA, Biggio JR, Martin JK, et al. Maternal Outcomes After Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Vaccinated Compared With Unvaccinated Pregnant Patients. Obstetrics & Gynecology: January 2022 – Volume 139 – Issue 1 – p 107-109. DOI: https://doi.org/10.1097/AOG.0000000000004621
  13. Stock SJ, Carruthers J, Calvert C, et al. SARS-CoV-2 infection and COVID-19 vaccination rates in pregnant women in Scotland. Nat Med (2022). DOI: https://doi.org/10.1038/s41591-021-01666-2
  14. Yang YJ, Murphy EA, Singh S, et al. Association of Gestational Age at Coronavirus Disease 2019 (COVID-19) Vaccination, History of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection, and a Vaccine Booster Dose With Maternal and Umbilical Cord Antibody Levels at Delivery. Obstetrics & Gynecology: 2021. DOI: https://doi.org/10.1097/AOG.0000000000004693
  15. Nir O, Schwartz A, Toussia-Cohen S, et al. Maternal-neonatal transfer of SARS-CoV-2 immunoglobulin G antibodies among parturient women treated with BNT162b2 messenger RNA vaccine during pregnancy. Am J Obstet Gynecol MFM. 2022; 4(1): https://doi.org/10.1016/j.ajogmf.2021.100492
  16. Gray KJ, Bordt EA, Atyeo C, et al. Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study. Am J Obstet Gynecol. Published online March 25, 2021. DOI: https://doi.org/10.1016/j.ajog.2021.03.023
  17. Shook LL, Atyeo CG, Yonker LM, et al. Durability of Anti-Spike Antibodies in Infants After Maternal COVID-19 Vaccination or Natural Infection. JAMA. Published online February 07, 2022. DOI: https://doi.org/10.1001/jama.2022.1206
  18. Halasa NB, Olson SM, Staat MA, et al. Vaccine Effectiveness Against COVID-19 Hospitalization in Infants <6 Months of Age from Maternal mRNA COVID-19 Vaccination — United States, July 2021– January 2022 MMWR Morb Mortal Wkly Rep 2022;71: 264–270. DOI: https://dx.doi.org/10.15585/mmwr.mm7107e3
  19. Perl SH, Uzan-Yulzari A, Klainer H, et al. SARS-CoV-2–Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women. 2021;325(19):2013–2014. DOI: https://doi.org/10.1001/jama.2021.5782
  20. Kelly JC, Carter EB, Raghuraman N, et al. Anti–severe acute respiratory syndrome coronavirus 2 antibodies induced in breast milk after Pfizer-BioNTech/BNT162b2 vaccination. Am J Obstet Gynecol. 2021;225(1):101-103. DOI: https://doi.org/10.1016/j.ajog.2021.03.031
  21. Jakuszko K, Kościelska-Kasprzak K, Żabińska M, et al. Immune Response to Vaccination against COVID-19 in Breastfeeding Health Workers. Vaccines. 2021; 9(6):663. DOI: https://doi.org/10.3390/vaccines9060663
  22. Baird JK, Jensen SM, Urba WJ, et al. SARS-CoV-2 Antibodies Detected in Mother’s Milk Post-Vaccination. Journal of Human Lactation. 2021;37(3):492-498. DOI: https://doi.org/10.1177/08903344211030168
  23. Charepe N, Goncalves J, Juliano M, et al. COVID-19 mRNA vaccine and antibody response in lactating women: a prospective cohort study. BMC Pregnancy Childbirth 2021;(21): 632. DOI: https://doi.org/10.1186/s12884-021-04051-6