COVID & Pregnancy: Vaccinations & Latest Research Findings [Updated April 2021]

Updated April 9 2021

It’s been a year since COVID-19 upended our lives, and we’ve worked to bring you as many resources as possible, such as Becoming Pregnant In a Pandemic, Giving Birth During COVID-19, and addressing Why Fewer Babies Have Been Born Prematurely in the past year.

We’ve also touched on vaccinations and what that might mean if you’re pregnant or breastfeeding on our Instagram, and we know there is so much constant and conflicting information regarding what’s safe and what’s not. So we wanted to dedicate a post to the latest research findings and recommendations on COVID-19 and pregnancy. We’ll keep updating this post as new information comes out, so give this page a bookmark!

Key Takeaways: 

  1. When it comes to vaccine recommendations: if you’re pregnant or breastfeeding, you and your baby are more likely to suffer severe complications from COVID-19. Taking this into consideration, you should talk with your healthcare provider and weigh the risks and benefits of getting vaccinated. 
  2. New research on mRNA vaccines proves interesting. A small study of 131 women was recently published in the American Journal of Obstetrics and Gynecology that suggests both the Pfizer-BioNTech and Moderna vaccines appear to be safe and effective during pregnancy and breastfeeding. 
  3. No signs of safety concerns in animal studies. Research conducted on animals before and during pregnancy found no evidence suggesting concerns with vaccine safety of the Moderna, Pfizer-BioNTech, or Johnson & Johnson’s vaccine.

Current Status of the Vaccine Rollout

If you live in the US: Since the rollout in December, more than 171 million doses have been administered and over 2 million more are being administered each day! Moderna and Pfizer-BioNTech vaccines require two doses and the Johnson & Johnson vaccines require one. Currently, one-third of the U.S. population has been vaccinated with at least one shot already, and 19.4% are fully vaccinated with both doses. Researchers estimate about 70% to 80% of people in the country need to have immunity to stop the rapid spread. See individual state data here and find out where you can go to get the vaccine here.

If you live in the UK: Since December, over 31 million doses have been administered of the Pfizer-BioNTech, Oxford Uni-AstraZeneca, and Moderna vaccines, and currently, over half of the UK population has 1 dose, and about 1 in 10 adults have received both doses. England, Scotland, and Wales are now offering vaccines to people 50 and older, and Northern Ireland is offering them to people over 40. There has been some evidence linking the Oxford-AstraZeneca vaccine to very rare blood clots after the 1st dose. The World Health Organization said the link is “plausible” but more research is needed to confirm, as over 200 million people have received the vaccine worldwide and reported blood clots were very rare (which is a 4 in 1 million risk). Those under 30 years old are advised to be given the Pfizer-BioNTech or Moderna as an alternative. You can find information about eligibility and booking an appointment on the NHS website

If you live in Australia: Since late February, almost 1 million doses have been administered so far to healthcare workers, border enforcement, care homes workers, and care home residents. The government has secured over 150 million doses total from 4 agreements with Pfizer-BioNTech, Oxford-AstraZeneca, Novavax, and COVAX Facility, and vaccines in this initial rollout are from Pfizer/BioNTech and Oxford-AstraZeneca. The vaccine rollout is happening slowly at the moment compared to other countries as mass vaccination sites weren’t allowed in all states, but many have adopted this policy now and are working on fast-tracking vaccinations. If you’d like to check your vaccine eligibility and find out when you can receive it, use this helpful tool here.

To find out more vaccination rollout information specific to your country, you can read more here.

FAQs on the COVID-19 Vaccine While Pregnant and/or Breastfeeding

What do we currently know about the risks for pregnant and breastfeeding women?

Pregnant and breastfeeding women were excluded from initial clinical trials of the vaccine due to FDA protocol, so there’s currently limited evidence to work with — but it’s on the way! Researchers at Pfizer-BioNTech announced on February 18th that they will be testing the safety and efficacy of their vaccine in a large-scale clinical trial of about 4,000 pregnant women over 18 years old in their 2nd and 3rd trimesters of pregnancy. They’ll also be monitoring the babies for 6 months after birth to ensure it’s safe for our newborns. All other studies to date on pregnancy and the COVID vaccine have been conducted on animal populations. There were no signs of safety concerns in studies of animals that received the Moderna, Pfizer-BioNTech, or Johnson & Johnson’s vaccine before or during pregnancy. 

What do we know about general vaccine safety during pregnancy and breastfeeding?

Vaccines are widely considered to be safe, and since the 1960s, pregnant women have been encouraged to get vaccinated against many diseases, including respiratory ones similar to COVID, like flu or whooping cough.

Will the COVID vaccine harm my fertility? 

If you’re trying to conceive or want to become pregnant in the future, there’s currently no evidence suggesting any vaccine, including COVID vaccines, cause fertility problems.

 Will I get COVID-19 if I get the vaccine?

The COVID vaccines don’t contain a live virus, meaning the vaccine itself can’t give you coronavirus. 

How do I know if I should get the COVID vaccine? 

As you’re making your decision it’s important to know where the information you hear or see is coming from (Baby2Body is science-backed and uses evidence-based research!), so you can fully understand the risks and benefits, and decide what’s best for you. We’ve listed the recommendations from major health organizations below, but they aren’t completely clear since research is still ongoing. What we do know from research is pregnant women with COVID are more likely to suffer from adverse health outcomes and pregnancy complications, such as preterm birth and being put on a ventilator. Ultimately, the choice to be vaccinated is yours and you should speak to your healthcare provider to discuss what’s best for you.

Recommendations from Major Health Organizations Around the World

Currently, major health organizations are being cautious with their recommendations as it comes to pregnancy and the COVID-19 vaccine. We know vaccines are generally safe, but more research needs to be done before recommendations can become more unified. This is why it’s universally recommended that women should talk to their healthcare providers about the benefits and risks of vaccinations for their unique case.

World Health Organization (WHO)

  • Pregnancy: WHO recommends pregnant women may receive the vaccine if the benefits outweigh the risks, such as a higher risk of contracting COVID due to a job (like healthcare workers) or who have underlying conditions that increase the risk of severe outcomes. There’s no evidence suggesting COVID vaccines would cause adverse outcomes during pregnancy, but since there’s limited data on this, it’s recommended you speak with your provider before getting vaccinated.
  • Breastfeeding: WHO recommends that the vaccine can be offered to those breastfeeding if they’re included in a recommended group (such as healthcare workers). The lack of research on vaccine safety in women who are breastfeeding or breastfed children “should be weighed against the potential benefits of breastfeeding, including the passive transfer of antibodies from breast milk”, the risk of adverse outcomes against COVID, and does not recommend stopping breastfeeding after vaccination.

Centers for Disease Control (CDC)

  • Pregnancy & Breastfeeding: CDC recommends that you may choose to be vaccinated if you’re pregnant or breastfeeding and part of a high-risk essential group (such as healthcare workers) offered a vaccine. You should discuss any questions with a healthcare provider. 
  • The CDC recommends you discuss these Key Considerations with your healthcare provider if you’re pregnant or breastfeeding: 
    • Your likelihood of exposure
    • Risks of COVID to you and your baby
    • The type of immunity the vaccine builds, known side effects, and the limited research available

American College of Obstetricians and Gynecologists (ACOG)

  • Pregnancy & Breastfeeding: ACOG recommends that vaccines be offered to pregnant or breastfeeding women based on the recommended priority groups. 

Royal College of Obstetrics and Gynecologists (RCOG) & Royal College of Midwives (RCM) 

  • Pregnancy: The Joint Committee on Vaccination and Immunisation (JCVI) recommends that vaccines be considered for pregnant women at high risk of exposure (like healthcare workers) or with underlying medical conditions that increase the risk of complications. The potential benefits should outweigh the potential risks for mother and baby and should be discussed with a healthcare professional. 
  • Breastfeeding: It’s recommended women who are breastfeeding understand that there’s a lack of research on these specific vaccinations in breastfeeding currently, but discuss the potential benefits and risk of vaccination with a healthcare provider. Although research is lacking, “there is no plausible mechanism by which any vaccine ingredient could pass to your baby through breast milk”, so you should not stop breastfeeding in order to get vaccinated against COVID.

Recent Research Findings

A study of 131 women found both the Pfizer-BioNTech and Moderna mRNA vaccines to be safe and effective during pregnancy and breastfeeding. Mild side effects experienced were similar to other reports from non-pregnant/breastfeeding adults.

Published on 25 March 2021 in American Journal of Obstetrics and Gynecology

A quick summary: The study included 3 groups of women: 84 pregnant, 31 breastfeeding, and 16 not pregnant. Researchers found antibody levels in pregnant and breastfeeding women to be similar to non-pregnant women and detected antibodies in the umbilical cord and breastmilk. These findings suggest pregnant and breastfeeding women receiving one of these vaccines can produce similar vaccine-immune responses as non-pregnant women, and possibly transfer some of those protective antibodies to baby.

The majority of women were White, not Hispanic or Latino, and had the 1st vaccine dose in the 2nd or 3rd trimester (average around 23 weeks). More research is needed to confirm these findings, as well as additional data for other racial and ethnic populations.

Researchers found no breast milk samples containing the virus and the majority of samples contained 2 types of protective antibodies. Interestingly, breast milk was found to have neutralization effects on COVID in vitro, and swabs from around the areola were likely to not have detectable levels of the virus.

Published on 9 February 2021 in mBio

A quick summary: Researchers collected 37 breast milk samples from 18 women infected with COVID and found no milk containing detectable viral levels. Over 75% of samples contained IgA and IgG antibodies for COVID — IgA antibodies act as the first line of defense for the immune system while IgG antibodies provide our bodies with longer-term protection. Around 64% of samples were found to neutralize the virus in vitro and reduce infectivity.

Additionally, 70 swabs were taken from around the areola before and after washing the breast with soap and water, and before collecting milk samples. The virus was detected on 8 skin swabs but only 1 which was taken before washing was considered to be conclusively positive, and after washing the swab was negative. Although women were instructed to wear masks and gloves when taking samples, contamination from the skin might help explain why other swabs, as well as findings from other studies, may have inconclusive results or small, but detectable viral levels in breast milk.

 

This study offers more evidence that COVID antibodies can cross the placenta during pregnancy. It also suggests that women are not only transferring antibodies to their babies but also transferring more antibodies if they’re infected earlier on in their pregnancy.

Published on 29 January 2021 in JAMA

A quick summary: Researchers from Pennsylvania found that of the 83 women that had antibodies before giving birth, 72 of their babies had received antibodies. Antibodies that crossed the placenta were IgG antibodies, which offer longer-term protection (great news!). There were no babies in the study that had IgM antibodies, which are generally detected after an infection, so it’s likely the babies hadn’t been infected with the coronavirus but received the antibodies from mom. About half of the babies had just as many or more antibodies than in their mother’s blood. Experts aren’t sure though if these transferred antibodies will be enough to prevent babies from getting COVID-19 in the future.

On-Going Research Studies

Before participating in any research, be aware of the safety and scientific validity of the study. Know the potential risks and benefits of clinical studies and talk to your health care provider before deciding to participate.

If you live in the US:

  • Pfizer-BioNTech vaccine study. Pfizer-BioMTech is currently conducting a large-scale clinical trial on the safety and efficacy of their vaccine in about 4,000 pregnant women over 18 years old in their 2nd and 3rd trimesters of pregnancy. The study will have a placebo control group and will track safety information for 7 to 10 months, as well as the safety and antibody transfer in infants for up to 6 months after birth. If you’re interested in learning more or being involved you can find out more information here.
  • COVID-19 Vaccines International Pregnancy Exposure Registry (C-VIPER). Harvard School of Public Health is conducting an observational study to collect safety information from 5,000 women who receive a COVID vaccine during pregnancy. This will include women who have received at least 1 dose of a vaccine, or pregnant women unexposed to a vaccine before enrolling. If you’re interested in learning more or being involved you can find out more information here

If you live in the UK:

  • Evaluating Clinical Parameters of COVID-19 in Pregnancy (COpregVID). The Chelsea and Westminster House NHS Foundation Trust is conducting a retrospective case review using existing clinical data from participating centres and will include patients who were diagnosed with COVID-19 at the start of the pandemic as well as new and current cases. Data will be taken from National Health Service (NHS) electronic and paper notes, which will contain patient identifiable information, but measures will be taken to ensure confidentiality and data will be anonymized for research teams. If you’re interested in learning more or being involved you can find out more information here.

Online surveys available for multiple countries:

  • Risk Factors for Anxiety and Depression Among Pregnant Women During the COVID-19 Pandemic. This observational study is being conducted across 17 countries and enrolling 8,500 women to take their survey. This survey will measure the impact the pandemic has on mental health, as countries have different approaches to fighting COVID and everyday lives of pregnant women are affected in unique ways. If you’re interested in learning more or being involved you can find out more information here.

Do you have questions on COVID-19 and what it means for pregnancy and breastfeeding? Let us know in the questions below and we will do our best to get you the trusted information you need at this time.

Baby2Body

4 thoughts on “COVID & Pregnancy: Vaccinations & Latest Research Findings [Updated April 2021]

  1. What are the recommendations for protecting a newborn from COVID? Does the stroller have to be covered with a blanket (breathable) to act as a mask?

  2. 4,000 participants is not a large sample size when we take into account the “affects” of COVID on pregnancy were studied – if best read – on only 10,000 births from March 2020-March 2021. The data is not clear – as some women/babies could fit into more than one chart, for some reason some data could not be collected even though the total number shown is based on a certain sample size https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/special-populations/birth-data-on-covid-19.html

    Reading the wording from Mayo “Pregnant women who have COVID-19 appear more likely to develop respiratory complications requiring intensive care than women who aren’t pregnant, according to the Centers for Disease Control and Prevention.” there are several reasons pregnant women could “appear” at higher risk – outside of a pandemic we hear about how a large percentage of pregnant women in the US go into pregnancy with fertility issues, obesity and other comorbidities – which can develop during pregnancy as well – what is to say that these women would not have fallen more ill regardless of pregnancy status – the fact is that true research should cut out as many variables as possible to be effective in providing an answer or replication of research – which is hard to do with any individual pregnancy.

    It seems that all of the protocols for research and what is considered good research have gone out the window to rush something to market. We usually test things for years – have longitudinal studies that have quantitative data and are therefore presented that way – not qualitative “We think, it may be safe, we believe it won’t”.

    The scariest is the call for mitigation of litigation so that more pharmaceutical companies will include varied populations in their initial trials – no-one should be an unpaid guinea pig without reparations for injuries should they occur – we also seem to have an unwillingness to see anything from our history with medicine (Tuskegee airmen , thalidomide babies, twilight births, and more).

  3. Is there anywhere a person can apply to be a part of follow up research after being vaccinated and continuing to breast feed?

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