The currently available COVID-19 vaccines weren’t specifically tested on women who are pregnant or breastfeeding, so how do expecting and nursing mothers know the vaccines are safe to take? Tara Gellasch, MD, OBGYN and Chief Medical Officer at United Memorial Medical Center updates us on how the COVID-19 vaccines can impact pregnant and breastfeeding women and whether she's recommending her patients get vaccinated.

Should pregnant or breastfeeding mothers get the vaccines?

The American College of Obstetrics and Gynecology recommends that both the Pfizer/BioNTech and Moderna COVID-19 vaccines should not be withheld from pregnant or breastfeeding individuals who meet the criteria for vaccination.

"While the vaccines were not studied specifically on pregnant women or breastfeeding women, the vaccines do not enter the nuclei of cells nor are they altering human DNA," explained Dr. Tara Gellasch, Rochester Regional Health OBGYN. "The vaccines are created to prepare your body to fight against the virus that causes COVID-19 and keep you protected, so they are believed to be safe for pregnant and breastfeeding women." 

Pregnant and breastfeeding women should speak with their OBGYN or primary care provider to determine the best option for them.

Side effects and mild symptoms

Side effects are the body’s normal reaction to the vaccine and the body’s normal reaction to developing antibodies against COVID-19. We expect mild side effects to be similar in women who are pregnant and not pregnant. Reported side effects from the vaccines are pain at the injection site, headache, tiredness, muscle pain, and more. 

Is the vaccine as effective on pregnant women?

There’s no evidence to suggest any difference in the effectiveness of the vaccines between pregnant women and the general population.

"We expect to see that 95% efficacy rate to remain with pregnant women, which is very encouraging," said Dr. Gellasch.

Research on mRNA COVID-19 vaccines in pregnant women 

In April 2021, preliminary findings from new research that studied the safety of the mRNA COVID-19 vaccines in pregnant women found that there are "no obvious safety signals with respect to pregnancy or neonatal outcomes associated with Covid-19 vaccination in the third trimester of pregnancy."

Researchers monitored symptoms and reactions of 35,691 pregnant persons from age 16 to 54 from December 14, 2020, to February 28, 2021. Each participant received both doses of either the Pfizer/BioNTech or Moderna COVID-19 vaccine. 

The research demonstrated that injection-site pain was reported more frequently among those pregnant, but symptoms like headache, myalgia, chills, and fever were reported less. Current findings reveal that adverse pregnancy and neonatal outcomes in those vaccinated against COVID-19 are similar to results reported in studies before the coronavirus pandemic--meaning the likelihood of adverse outcomes does not appear to increase after COVID-19 vaccination.

"Experts will continue to monitor participants to further study the effect of the mRNA COVID-19 vaccines on maternal, pregnancy, neonatal, and childhood outcomes. Meanwhile, the current data can help pregnant patients make a more informed decision about COVID-19 vaccination," said Dr. Gellasch.

Can side effects be passed on to baby through breast milk?

There is currently no evidence to suggest there’s any negative side effect of the vaccine to breastfeeding women. We would not expect any impact on their ability to breastfeed or negative impact on the baby from their breastmilk.

As research and guidance evolves, the ROC Baby Cafe offers free education, support, and up-to-date information to pregnant women or breastfeeding mothers in the community, at all stages of the breastfeeding journey.

 What about couples planning on becoming pregnant?

We continue to recommend that women receive the vaccine as soon as it becomes available to them. The vaccine will help protect all people who get the vaccine from getting COVID-19.

Pregnant women who get COVID-19 are at a greater risk for more serious outcomes, as well as at a higher risk for preterm delivery and potentially stillbirth. 

"If a pregnant woman does contract COVID-19, she is at a higher risk of getting a severe version of the illness and at a higher risk of hospitalization or even ICU admission," said Dr. Gellasch. "We see that with other viral illnesses like the flu. Pregnant women who get a viral illness often have a worse course compared to their non-pregnant counterparts. This is why it’s important for pregnant women to do what they can to stay protected and consider getting the vaccine when it is available to them."