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

Updated May 1 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. Early findings from study on mRNA vaccines proves interesting. A large study of over 35,000 pregnant women has premilinary data showing no obvious signs of safety concerns of mRNA vaccines during pregnancy.
  3. Johnson & Johnson vaccine usage resumed. On Friday, April 23 after an extensive safety review, the FDA, the CDC, and the CDC’s Advisory Committee on Immunization Practices have recommended the Johnson & Johnson vaccine resume usage in the United States. The European Union and South Africa, countries that also suspended the use of the vaccine, have both resumed usage following safety reviews as well.
  4. No signs of safety concerns in animal studies. Research conducted on animals before and during pregnancy found no evidence suggesting concerns with vaccine safety in pregnant animals or their babies of the Moderna, Pfizer-BioNTech, or Johnson & Johnson/Janssen vaccine.

Current Status of the Vaccine Rollout

If you live in the US: Since the rollout in December, more than 240 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, almost 43.6% of the U.S. population has been vaccinated with at least one dose already, and 31% are fully vaccinated. Researchers estimate about 70% to 85% of people in the country need to have immunity to stop the rapid spread and the government has encouraged states to open eligibility to anyone by May 1. 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 49 million doses have been administered of the Pfizer-BioNTech, Oxford Uni-AstraZeneca, and Moderna vaccines, and currently, over half of UK adults have received 1 dose, and over 14 million 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, over 2.23 million doses have been administered so far to healthcare workers, border enforcement, care homes workers, and care home residents. The government has secured vaccines 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 now are working to fast-track vaccinations. If you’d like to check your vaccine eligibility and find out when you can receive it, use this helpful tool here.

If you live in India: Since mid-January, over 154 million doses have been administered and currently 127 million people have received the 1st dose, and 27 million people are fully vaccinated. To learn more about when you can receive it, how to register, or coronavirus in general, the Ministry of Health and Family Welfare answers Frequently Asked Questions here. A recent surge in coronavirus has some regions experiencing more cases than others. Based on the daily average of cases in the last 7 days per 100,000 people, top hotspot regions currently are: Lakshadweep, Goa, and Delhi. Regions with the most total cases are: Maharashtra, Kerala, and Karnataka. You can find more information about coronavirus hot spots 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 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 from 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: CDC states if you are pregnant, you can receive a COVID vaccine and suggests that having a conversation with a healthcare provider may be helpful in determining whether to receive a vaccine. 
  • Breastfeeding: CDC states if you are breastfeeding, you can receive a COVID vaccine. Clinical trials for the authorized vaccines have not included breastfeeding women, so data is not yet available on the safety of vaccines in lactating people or the effects of vaccination on a breastfed baby or on a mother’s milk production or excretion. However the way these vaccines work in the body is thought to not pose a risk to lactating people or their breastfeeding babies.
  • 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, but growing research available of safety during pregnancy
    • How the vaccine may transfer antibodies to the baby during pregnancy (following recent reports of passing antibodies mostly during the 3rd trimester)
  • Regarding the Johnson & Johnson vaccine, women younger than 50 should be aware of the rare risk of blood clots with low platelets after vaccination, and that other COVID-19 vaccines are available where this risk has not been seen. If you have already received the vaccine, here’s what you should know.

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, as well as all eligible people who may consider pregnancy in the future.

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

  • Pregnancy: The Joint Committee on Vaccination and Immunisation (JCVI) recommends that COVID-19 vaccines should be offered to pregnant women at the same time as the rest of the population, based on their age and risk group. The potential benefits and risks of vaccinating for mother and baby should be discussed with a healthcare professional to reach a joint decision. It’s also recommended that women who are trying to become pregnant do not need to avoid pregnancy after vaccination.
  • Breastfeeding: The JCVI says there is no known risk in giving available COVID-19 vaccines to breastfeeding women and breastfeeding women will now be offered vaccination at the time when they become eligible. Women who are breastfeeding should discuss the potential benefits and risks 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.

India Ministry of Health and Family Welfare

  • Pregnancy & Breastfeeding: India Ministry of Health and Family Welfare states that since pregnant and breastfeeding women have not been included in vaccine clinical trials so far, it’s recommended women who are pregnant or unsure if they’re pregnant; and lactating women, should not receive the COVID vaccine.

Recent Research Findings

Early findings from a large study on the safety of mRNA vaccines during pregnancy found no obvious signs of safety risks.

Published on 21 April 2021 in New England Journal of Medicine

A quick summary: Researchers studied data from over 35,000 women who identified as pregnant through the v-safe registry and the Vaccine Adverse Event Reporting System (VAERS) and found no obvious signs of safety risk with mRNA vaccines. Pain at the injection site was more common among pregnant women than nonpregnant women, however, fever, chills headache, and myalgia were less common. This is preliminary data and researchers will need additional follow-up data to determine the impact of mRNA vaccines on pregnancy, and maternal and infant outcomes.

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.

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 May 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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