Pregnancy and a COVID vaccine: the info you need

Can COVID-19 vaccine affect pregnancy and autism risk?

Questions on pregnancy and a COVID vaccine–or pregnancy after a COVID vaccine? When it comes to health and medical decisions, you should always work with your healthcare team to make a choice that’s right for you and based on your history. But doing your research is a good thing. Our contributors teamed up to talk pregnancy and vaccines.

First, what happens if I get a COVID infection while pregnant?

Pregnancy with COVID- woman holding baby shoes

Part of deciding whether or not you should get a COVID vaccine while pregnant has to do with weighing the risks of infection with your provider versus benefits and risks of a vaccine. There’s so much we still have to learn about COVID and its effects on people, including women who are pregnant and babies. Your response to COVID is highly individual, whether you’re pregnant or not. Some women who are pregnant with COVID have no symptoms. Others do.

What we do know: as a whole, having COVID while pregnant puts you at higher risk for complications. Pregnant women with COVID have about a 3% higher likelihood of being placed in intensive care. Though the data is still young, women with symptomatic COVID infections are more likely to go into preterm labor. That said, the overall risk of complex issues is still low.

If I am pregnant and get COVID, will it hurt my unborn baby?

COVID- Woman holding ultrasound

Getting COVID while you’re pregnant brings up all types of feelings: fear, anxiety, and worry. The data collected so far shows that passing COVID along to your unborn baby is pretty rare. No birth defects or abnormalities have been associated with or linked back to a COVID infection, whether the mother was infected or it was passed in utero.

Can the COVID-19 vaccine actually give me COVID? How does the vaccine work?

Healthcare worker holding a vaccine vial

The COVID-19 vaccine cannot cause a viral infection because it’s not a live vaccine. Nicole Lewis, ND, adds, “When creating an inactive form of a vaccine, scientists take the virus and kill it. Once delivered [in a vaccine], it can trigger an immune response.”

But the COVID vaccines from Moderna and Pfizer aren’t traditional. They actually don’t have any virus particles at all. “The COVID-19 vaccine on the market right now is an mRNA vaccine. It has to be stored at a very low temperature because it is unstable,” Dr. Lewis says. “The RNA tells the cell to produce an antigen to the spike protein [of coronavirus]. This antigen then moves to the surface of the cell, where the immune system can detect the protein and produce antibodies,” she explains. “Currently, the idea is that the antibodies will allow your immune system to respond more quickly if you contract the virus, keeping you from having more severe symptoms.” 

Is pregnancy and a COVID-19 vaccine–or pregnancy after a COVID vaccine–safe?

Woman on couch considering pregnancy and a COVID vaccine or pregnancy after a COVID vaccine

Women who were pregnant weren’t intentionally included in COVID vaccine trials. As a whole, there isn’t a robust amount of data on vaccines during pregnancy, and that’s especially true for mRNA vaccines, which are new. However, research shows our bodies eliminate the mRNA from our systems pretty quickly and efficiently. This makes it highly unlikely that the vaccine will cross over to your baby through the placenta.

History tells us vaccines are overwhelmingly safe for the majority of pregnant women. (Pregnant women shouldn’t receive live vaccines, though.) Most women already get some vaccines while pregnant–but which ones depend on your age and medical history. In most cases, your physician might recommend an inactivated flu (influenza) shot and a Tdap vaccine.

What’s extra important for women who are pregnant or trying to conceive is to look at vaccination as an individual decision. Jennifer Abdul-Rahman, BSN, RN, IBCLC, says “The risk and benefit of getting the vaccine should be weighed against your individual risk for getting COVID-19 as well as how well you are expected to tolerate the disease. Every person’s situation is different and therefore each situation deserves individualized care and respect.”

Women who are pregnant and considering a COVID vaccine should also know that the CDC recommends having your COVID vaccine separate from any others. You’ll want to space out COVID vaccine so that it’s two weeks before and/or two weeks after any other vaccines you may get.

If I get a COVID vaccine, will it give my baby immunity?

Researchers don’t think the vaccine itself will cross the placenta. But, once your body creates an immune response to the COVID vaccine, that immune response could help temporarily offer some protection to your baby after birth. The antibodies your body makes will pass through the placenta, just like the antibodies you make to other pathogens. If you choose to breastfeed, COVID antibodies could be passed along to your baby then, too.

What are the side effects of a COVID vaccine?

Pregnancy and a COVID vaccine- side effects

Whether or not you have side effects and which ones from a COVID vaccine is highly individual and hard to predict. “Adjuvants [certain ingredients] can be added to these vaccines to increase the immune response,” Dr. Lewis explains. “You can’t get sick with an infection from the virus in this type of vaccine, but it is possible to experience other reactions.”

The most common side effects are muscle soreness and/or redness at the injection site. Physical therapist Sara Smith, DPT, RYT-200, CHC, says, “Site injection soreness usually occurs within several hours and usually subsides after 24 to 72 hours.” 

Some people also experience fever, fatigue, and/or weakness after a COVID vaccine. These usually pop up one to two days after your shot. With COVID vaccines, side effects like fever are more likely after the second dose. About 15% to 17% of people report experiencing a fever after their second COVID vaccine. Approximately 3% report it after the first dose.

What can I do if I have side effects from the COVID vaccine?

Water bottle- stay hydrated to reduce side effects of COVID vaccine

Low fevers (like what you might experience from a vaccine) are generally not a problem when pregnant. That said, if you get one, it doesn’t hurt to call and let your ob-gyn office know about it. Ask if you can treat it with Tylenol, if necessary. Tylenol is generally safe during pregnancy, unless your physician says otherwise.

You can also take steps to minimize muscle soreness and fatigue after a vaccine. Dr. Smith says, “Stress plays a role in furthering inflammatory responses. Sleep, and lack thereof, is one well documented type of stress. It increases inflammatory response and makes side effects feel worse. Add on pregnancy and young children, and so many of us are on the struggle bus with getting adequate rest.”

“To avoid systemic fatigue and overall muscle soreness from the vaccine, I first suggest that, prior to receiving the vaccine, you make small, manageable goals to increase rest or sleep time,” Dr. Smith says. She also recommends drinking plenty of water. Aim to eat a colorful array of fun foods, and fill your tank with laughs with friends, alone time, nature, meditation or anything that brings you moments of joy.

Should I wait to get pregnant after a COVID vaccine?

Woman receiving shot from physician

Deciding to try to conceive is a personal decision you should discuss with your provider. The Centers for Disease Control (CDC) says there’s no need to wait to get pregnant after a COVID vaccine. But honor your body, feelings, and stress levels. Pressing pause for a month or so feels best to some people.

Talk with your ob-gyn or other healthcare provider about pregnancy and a COVID vaccine (or after)

Talk about COVID vaccine benefits and risks with your provider. First, place a phone call and leave a detailed message. This gives your provider a chance to review your history and give you personalized advice. If it needs be discussed more or it’s been a while, either one of you may suggest a visit. Some questions to ask and discuss during a conversation:

  • Do I have any allergies that suggest a possible severe reaction to the COVID vaccine?
  • Is pregnancy my only high-risk factor for COVID?
  • I’m quarantining really strong, and so are the people I see. Can I wait to have the COVID vaccine until after I give birth?
  • Are there benefits to my baby if I have the vaccine?
  • When was my last vaccination? (The CDC recommends getting your COVID vaccine at least two weeks away from any other vaccine.)

Want more resources on COVID? Check out our post on breastfeeding with COVID or after a COVID vaccine, exercise or yoga after a COVID vaccine, or type COVID into our search bar.

Latest posts by With Nicole Lewis, ND, and Sara Smith, DPT, RYT-200, CHC (see all)