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COVID vaccines and fertility | COVID vaccine and pregnancy | COVID vaccines while breastfeeding

Becoming a new parent can be anxiety-inducing—whether you’re trying to conceive, expecting, or caring for an infant. You want to do everything you can to ensure your baby is as healthy as possible, and sometimes it’s not clear what’s best. The coronavirus pandemic has brought additional worry—and added to already-existing pregnancy anxiety.

Contracting COVID-19 infection is frightening and serious for everyone, but there is more concern for anyone who is pregnant or breastfeeding. “Unfortunately, yes, pregnant people are at increased risk of developing serious illness from COVID-19,“ says Alaina Brinley Rajagopal, MD, Ph.D., an emergency medicine physician in southern California. Pregnant women with preexisting conditions such as diabetes or obesity may be at even more risk. The American College of Obstetricians and Gynecologists (ACOG) states that research on transmission of COVID-19 from mother to child during pregnancy is ongoing. Current studies show that it appears to be rare. After birth, it’s unknown if COVID-19 can be transmitted via breast milk, but the majority of evidence suggests it is not transmitted via breastfeeding.

Thankfully, COVID-19 vaccines markedly decrease the risk of the mother contracting the infection. This helps both mom and baby. But, this is also one more decision for pregnant women to make.

Is it safe to get the COVID-19 vaccine if you’re trying to conceive?

“There is a myth going around about the vaccine supposedly causing infertility,” says Kevin Kathrotia, MD and COO of Millennium Neonatology in Charlotte, North Carolina. “This was addressed by ACOG—and has been disproven.”

The CDC recommends getting the COVID-19 vaccine anytime, this includes while trying or planning to conceive, stating: “There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems.”

Is it safe to get the COVID-19 vaccine during pregnancy?

Studies involving pregnancy and COVID-19 vaccines are ongoing and the results are encouraging.

Animal trials for the Pfizer, Moderna, and Johnson & Johnson’s vaccines found no safety concerns from receiving the vaccine before or during pregnancy. Pregnant women were initially excluded from the vaccine trials, but 57 unplanned pregnancies occurred during the testing for the Pfizer, Moderna, and AstraZeneca vaccines. The miscarriage rate between those who did or did not get the COVID-19 vaccine were not significantly different. Vaccinated pregnant women are being monitored on an ongoing basis.

“As of February 2021, over 20,000 pregnant people had been vaccinated in the United States with no adverse effects,” says Dr. Brinley Rajagopal. “Based on what we know about how vaccines work, and that pregnant people are regularly vaccinated with other non-COVID vaccines without risk, it is unlikely the COVID vaccine poses a risk to pregnant people.”

What side effects are associated with COVID-19 immunization during pregnancy?

It is common to experience side effects after a COVID-19 vaccination, particularly after the second dose of the two-dose vaccines. Pregnant women have not reported different side effects from non-pregnant people after receiving Moderna or Pfizer vaccines.

Some common side-effects all who are vaccinated can experience after COVID-19 vaccination include:

Pain, redness, or swelling in the arm that received the shot
Tiredness
Headache
Muscle pain
Chills
Fever
Nausea

These vaccine-related side effects usually resolve within a few days. In the meantime, it is safe for pregnant women to take Tylenol (acetaminophen) for a temperature over 100.4 degrees Fahrenheit or muscle pain.

Should pregnant people get the COVID-19 vaccine?

Yes. The experts, the CDC, recommend that pregnant women get vaccinated for COVID-19. Ultimately, this is a decision that should be made with the guidance of a healthcare provider who knows the woman’s circumstances and medical history.

Dr. Brinley Rajagopal says a provider will consider questions such as: “Is the person in a high-risk job like working in a hospital or grocery store? Do they have any preexisting medical conditions like diabetes or obesity? Are people in their family in high-risk jobs? Are there a lot of people/kids who live at home and could potentially infect the pregnant person?”

Pregnant women are immunocompromised because of the pregnancy, and are encouraged to protect themselves against preventable infections. Physicians suggest pregnant women get the influenza vaccine, Tdap, and (now) the COVID-19 vaccine.

Does getting the COVID-19 vaccine during pregnancy protect the baby?

There is evidence that pregnant women who are vaccinated against COVID-19 pass on some protection against the virus to their infants. Further research is expected to find beneficial results to the baby when their mother receives COVID-19 vaccination during pregnancy, as is the case with other vaccines that have been studied such as the pertussis vaccine.

The best time to receive the COVID-19 vaccine during pregnancy (to give maximum protection to the infant and how long that protection lasts) is not yet known.

Is it safe to get the COVID-19 vaccine while breastfeeding?

While the COVID-19 vaccine specifically has not been studied in breastfeeding mothers, similar vaccines have shown no risk for lactating women or their infants. Because of this, the COVID-19 is believed to be safe for nursing infants as well.

“According to the CDC, because non-live vaccines pose no risk for lactating people or their infants, COVID-19 vaccines are also not thought to be a risk,” says Dr. Kathrotia. “Therefore, lactating people may choose to be vaccinated.”

Dr. Brinley Rajagopal was confident enough in the evidence supporting the safety of the COVID-19 in lactating people, she got the vaccine while she herself was breastfeeding.

“Studies have shown that antibodies with neutralizing capacity can be passed to infants in breast milk, so it actually can give the baby some immunity if the parent gets vaccinated while breastfeeding,” says Dr. Brinley Rajagopal. “This is great since babies can’t currently be vaccinated and clinical trials are just starting for children.”

Additional resources on pregnancy and COVID vaccines

MotherToBaby is a free and confidential, CDC-recommended resource to connect with an expert and ask questions about the COVID vaccine and pregnancy.

Experts speak English or Spanish and can be reached by phone at 1-866-626-6847 or by live chat through their website. They can also be reached via email.

All COVID-19 vaccinated, including pregnant women, are encouraged to enroll in the V-safe program. V-safe is a free smartphone-based tool that uses text messaging and web surveys to give personalized health check-ins after the COVID-19 vaccine.