COVID-19 Vaccines While Pregnant or Breastfeeding

People Who Are Pregnant

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, intensive care, or the use of a ventilator or special equipment to breathe. Severe COVID-19 illness can also lead to death.
• 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.

Vaccination remains the best protection against COVID-19-related hospitalization and death. Getting the updated COVID-19 vaccine can protect you and others and is important to keep you and your developing baby as healthy as possible during pregnancy.

CDC recommends everyone ages 6 months and older get the updated COVID-19 vaccine. This includes people who are pregnant, breastfeeding, trying to get pregnant now, or those who might become pregnant in the future.

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

• American College of Obstetricians and Gynecologists,
• Society for Maternal Fetal Medicine, and
• American Society for Reproductive Medicine

Safety and Effectiveness of COVID-19 Vaccination during Pregnancy

Studies including hundreds of thousands of people around the world show that COVID-19 vaccination before and during pregnancy is safe, effective, and beneficial to both the pregnant person and the baby. The benefits of receiving a COVID-19 vaccine outweigh any potential risks of vaccination during pregnancy. Below is a brief summary of the 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), before and during pregnancy are reassuring. Studies show no increased risk for complications like miscarriage, preterm delivery, stillbirth, or birth defects.^1,2
  • The monitoring of the safety of COVID-19 vaccination during pregnancy is ongoing. CDC will continue to follow people vaccinated during all trimesters of pregnancy to better understand any effects of the vaccine on pregnancies and babies.
• Data show that mRNA COVID-19 vaccines during pregnancy are effective. They reduce the risk of severe illness and other health effects from COVID-19 for people who are pregnant. COVID-19 vaccination might also help prevent stillbirths and preterm delivery.^1-4
• COVID-19 vaccination during pregnancy builds antibodies that can help protect the baby.  Much like people who are not pregnant, when people who are pregnant receive an mRNA COVID-19 vaccine, their bodies build antibodies against COVID-19.^4,5
• Receiving mRNA COVID-19 vaccines during pregnancy can help protect babies younger than age 6 months from hospitalization due to COVID-19. In these reports, the majority of babies hospitalized with COVID-19 were born to pregnant people who were not vaccinated during pregnancy.

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 without any additional documentation from your healthcare provider.

Common Questions about Vaccination during Pregnancy

People Who Are Breastfeeding

CDC recommends that people who are breastfeeding stay up to date with COVID-19 vaccination and get the updated COVID-19 vaccine.

Although breastfeeding people were not included in clinical trials for the COVID-19 vaccines currently used in the United States, studies suggest that COVID-19 vaccines are safe for people who are breastfeeding and their babies.

Available data on the safety of COVID-19 vaccination while breastfeeding indicate no severe reactions after the first or second dose, neither in the breastfeeding person nor the breastfed child.⁹ There has been no evidence to suggest that COVID-19 vaccines are harmful to either people who have received a vaccine and are breastfeeding or to their babies.¹⁰

COVID-19 vaccines cannot cause COVID-19 in anyone, including breastfeeding people and their babies. 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 breast milk, which could help protect their babies. More data are needed to determine what level of protection these antibodies might provide to the baby.^9,10

CDC also recommends COVID-19 vaccines for children aged 6 months and older.

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, stay up to date and get the updated COVID-19 vaccine. COVID-19 vaccines are not associated with fertility problems in women or men.¹¹

Vaccine Side Effects

Side effects after getting a COVID-19 vaccine can vary from person to person. Some people experience a little discomfort and can continue to go about their day.

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). ^1,2

• Fever during pregnancy, 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. Fleming-Dutra KE, Zauche LH, Roper LE, Ellington SR, Olson CK, Sharma AJ, Woodworth KR, Tepper N, Havers F, Oliver SE, Twentyman E, Jatlaoui TC. Safety and Effectiveness of Maternal COVID-19 Vaccines Among Pregnant People and Infants. Obstet Gynecol Clin North Am. 2023 Jun;50(2):279-297. https://www.doi.org/10.1016/j.ogc.2023.02.003
2. Prasad, S., Kalafat, E., Blakeway, H. et al. Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy. Nat Commun 13, 2414 (2022). https://doi.org/10.1038/s41467-022-30052-w
3. Schrag SJ, Verani JR, Dixon BE, et al. Estimation of COVID-19 mRNA Vaccine Effectiveness Against Medically Attended COVID-19 in Pregnancy During Periods of Delta and Omicron Variant Predominance in the United States. JAMA Netw Open. 2022;5(9):e2233273. doi:10.1001/jamanetworkopen.2022.33273
4. Piekos SN, Price ND, Hood L, Hadlock JJ. The impact of maternal SARS-CoV-2 infection and COVID-19 vaccination on maternal-fetal outcomes. Reprod Toxicol. 2022;114:33-43. doi:10.1016/j.reprotox.2022.10.003
5. 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
6. Halasa NB, Olson SM, Staat MA, et al. Maternal Vaccination and Risk of Hospitalization for Covid-19 among Infants. N Engl J Med. 2022;387(2):109-119. doi:10.1056/NEJMoa2204399
7. Hamid S, Woodworth K, Pham H, et al. COVID-19–Associated Hospitalizations Among U.S. Infants Aged <6 Months — COVID-NET, 13 States, June 2021–August 2022. MMWR Morb Mortal Wkly Rep 2022;71:1442–1448. DOI: http://dx.doi.org/10.15585/mmwr.mm7145a3
8. – Simeone RM, Zambrano LD, Halasa NB, et al. Effectiveness of Maternal mRNA COVID-19 Vaccination During Pregnancy Against COVID-19–Associated Hospitalizations in Infants Aged <6 Months During SARS-CoV-2 Omicron Predominance — 20 States, March 9, 2022–May 31, 2023. MMWR Morb Mortal Wkly Rep 2023;72:1057–1064. DOI: http://dx.doi.org/10.15585/mmwr.mm7239a3
9. Muyldermans J, De Weerdt L, De Brabandere L, Maertens K, Tommelein E. The Effects of COVID-19 Vaccination on Lactating Women: A Systematic Review of the Literature. Front Immunol. 2022;13:852928. Published 2022 Apr 8. doi:10.3389/fimmu.2022.852928
10. Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. COVID-19 Vaccines. [Updated 2022 Sep 19]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK565969/
11. Zaçe D, La Gatta E, Petrella L, Di Pietro ML. The impact of COVID-19 vaccines on fertility-A systematic review and meta-analysis. Vaccine. 2022;40(42):6023-6034. Doi:10.1016/j.vaccine.2022.09.019