Editor’s note: This article originally ran June 14, 2021, and was updated January 26, 2023.
Part of living through a pandemic is the reality that doctors and researchers learn about the virus in real time. Recommendations change and knowledge evolves.
Thankfully for pregnant women, the answer to an earlier question has become clear: Should pregnant women get the COVID-19 vaccine and boosters?
Yes. The COVID-19 vaccine is safe and effective—and potentially lifesaving—for pregnant women. Obstetricians, women’s health medical associations and the Centers for Disease Control and Prevention agree.
Even early in the pandemic, it was clear that COVID-19 itself posed a much greater risk to the health of pregnant women than the vaccine, says Brian Brimmage, MD, an OB-GYN who delivers babies at UNC Rex Hospital. So doctors recommended the shot while acknowledging that research was ongoing.
That research has been validating. “Paper after paper has proven not only its safety and efficacy for pregnant women, but also that it provides some degree of protection to infants after delivery, before they can get a vaccine themselves,” Dr. Brimmage says. “The evidence is overwhelming, and I wholeheartedly and unequivocally recommend to my pregnant patients that they get the vaccine or the booster as soon as possible.”
The Risk of COVID-19 During Pregnancy
The overall risk of COVID-19 to pregnant women is low, but pregnant and recently pregnant women face a higher risk of severe illness and complications than others with their same age and health status.
Pregnant women with COVID-19 are at higher risk of being hospitalized in intensive care, needing a ventilator and death. COVID-19 increases the risk of preterm birth and, some studies suggest, stillbirth. Babies whose mothers had COVID-19 are at higher risk of needing care in a neonatal intensive care unit (NICU). COVID-19 may even pose risk to the brain development of a fetus.
All that said: Most pregnant women with COVID-19 will do just fine, as will their babies. Getting vaccinated is the best way to prevent severe illness and complications, so you don’t need to worry nearly as much if you do get infected, Dr. Brimmage says.
Dr. Brimmage compares it to wearing a seat belt: “A seat belt doesn’t guarantee that you won’t get in a car accident, but if you do, it drastically reduces the chances of serious injury or death. The same holds for any vaccine, COVID included: The vaccine can decrease your chances of catching the virus, but no vaccine can prevent illness 100 percent of the time.”
Still, he adds: “The data is absolutely clear that your chances of serious illness are dramatically reduced if you have gotten your COVID vaccine and your boosters. This is especially true for pregnant women.”
Research on Pregnancy and the COVID-19 Vaccines
When the Pfizer and Moderna vaccines became available in December 2020, there was no data on safety or efficacy in pregnancy because the vaccines had not been tested on pregnant women, which is standard procedure for clinical trials.
Since then, research has provided much more information:
- Studies of more than 80,000 pregnant people found that COVID-19 vaccination did not have negative effects on the baby and was associated with a decreased risk of fetal death in utero, NICU admission and maternal COVID-19 infection.
- Despite online misinformation, researchers have found no evidence that COVID-19 vaccines affect fertility in women or men.
- Vaccinated mothers pass protective antibodies to their babies in utero through cord blood and after birth via breastfeeding, which is critical in a baby’s early months before they are eligible for the vaccine.
“We suspected early on that after maternal vaccination against COVID, antibodies would cross the placenta to the baby and provide some degree of protection in the first few months of life, but we have now seen an abundance of data to prove it,” Dr. Brimmage says, adding that a similar process occurs when expecting mothers get the Tdap vaccine to protect against whooping cough.
Advice for Pregnant Women
If you’re pregnant, Dr. Brimmage advises talking to your doctor about the COVID-19 vaccines and any questions or concerns you have. He advises his patients to be up to date on their COVID-19 vaccines, including boosters, to best protect themselves and their babies.
Women who are considering a pregnancy in the near future or who think they might be pregnant also should get vaccinated and boosted, Dr. Brimmage says.
“There is already such a long list of things to worry about during pregnancy,” he says. “Getting the COVID vaccine and booster can make that list a little shorter. Do it for you, and for your baby.”
Have questions about a vaccine? Talk to your doctor. If you need a doctor, find one near you.