Key TakeawaysTwo researchers released an article outlining the information doctors can pull from when discussing the risks and benefits of the COVID-19 vaccine with pregnant patients.The results of studies show that both mothers and babies benefit from vaccination against other respiratory diseases such as influenza and pertussis.Recent research suggests that pregnant and lactating women are more likely to have adverse health and pregnancy outcomes if hospitalized with COVID-19 owing to the respiratory impact of physiological changes associated with pregnancy.

Key Takeaways

Two researchers released an article outlining the information doctors can pull from when discussing the risks and benefits of the COVID-19 vaccine with pregnant patients.The results of studies show that both mothers and babies benefit from vaccination against other respiratory diseases such as influenza and pertussis.Recent research suggests that pregnant and lactating women are more likely to have adverse health and pregnancy outcomes if hospitalized with COVID-19 owing to the respiratory impact of physiological changes associated with pregnancy.

In the months since the Pfizer-BioNTech and Moderna COVID-19 vaccines received emergency approval, pregnant or lactating people, who are considered immunosuppressed, have received conflicting advice on their eligibility.

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The lack of either cohesive or decisive guidance has put the onus on clinicians to provide counsel. The researchers outline how doctors can synthesize the limited data available to them—facts about COVID-19 vaccines, the accounts of pregnant and lactating women who have received a COVID-19 vaccine, and studies on the effects of non-COVID-19 vaccines on pregnant and lactating women—to inform their patients on the benefits of the COVID-19 vaccine.The February article was published in the journalJAMA.

Official Recommendations

The Centers for Disease Control and Prevention (CDC) states that “people who are pregnant and part of a group recommended to receive COVID-19 vaccine, such as healthcare personnel, may choose to be vaccinated. A conversation between pregnant patients and their clinicians may help them decide whether to get vaccinated.”

Federal agencies, such as the U.S. Food and Drug Administration and the Advisory Committee on Immunization Practices, have avoided making an explicit recommendation on the vaccine one way or another.

On January 26, the World Health Organization (WHO) issued a statement that cautioned pregnant women against receiving the Moderna vaccine for reasons that were not specified, the article’s co-authorEmily Adhikari, MD, assistant professor of obstetrics and gynecology at the University of Texas Southwestern Medical Center, tells Verywell.

Just three days later, however, the statement was revised to clarify that “pregnant women at high risk of exposure to SARS-CoV-2 (e.g. health workers) or who have comorbidities which add to their risk of severe disease may be vaccinated in consultation with their healthcare provider.”

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Precedent for Vaccination in Pregnant and Lactating Women

COVID-19 vaccination wouldn’t be the first vaccine offered to pregnant people. Vaccination against influenza and whooping cough can confer lifesaving immunity on pregnant and lactating patients.

In a study of 3,693 pregnant women, influenza immunization during gestation was linked to a 19% reduction in maternal influenza, a 15% reduction in low fetal birth weight, and a 30% reduction in neonatal influenza.

COVID-19 Risk While Pregnant

COVID-19 infection can be particularly deadly in pregnant people for both the mother and fetus. Roughly 5% of all infected pregnant women have to be hospitalized for respiratory symptoms, Adhikari says.

An analysis of national surveillance data found that they were three times as likely to be admitted to the intensive care unit, 2.9 times as likely to require mechanical ventilation, and 1.7 times as likely to die as infected women of a similar age who were not pregnant.

In addition, they are also at significantly increased risk for preterm delivery and miscarriage. In a study of infected pregnant women, hospitalization was linked to a 10 to 25% increase in preterm delivery, though increases of as much as 60% were also recorded.

The disparity in symptom severity is a side effect of the unique physiology of pregnancy. In the nine months following conception, hormonal and physical changes put pressure on respiratory organs such as the lungs and diaphragm, oftentimes causing mild shortness of breath or difficulty breathing.

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“This means that [pregnant] women who develop severe pneumonia from COVID-19—which we think is about 5% of all [pregnant] women with the infection—have a harder time dealing with the stress from the infection, and may be more likely to have respiratory failure than non-pregnant women of similar age groups,” Adhikari says. This is also true of other respiratory diseases such as influenza, she adds.

What This Means For You

Information and Research Needed

Those who opt for the vaccine can expect to experience the standard side effects—“arm pain, body aches, low-grade fever, headache, and fatigue,” according to Adhikari—if they experience any at all.

However, that hasn’t helped soothe vaccine hesitancy.

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One reason for the outpouring of skepticism is the fact that the vaccines are mRNA-based. While mRNA vaccine technology has been in development for decades, it has never been used in a “widely available public health tool…in this context before,” Adhikari says. Its relative novelty, in addition to other factors, has fuelled fear and suspicion among certain communities.

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Adhikari believes that “data confirming safety and efficacy will be important to gather as more pregnant women are choosing to be vaccinated.”

Such efforts are already underway. On February 18, Pfizer announced that they had begun a clinical trial in about 4,000 healthy pregnant women between 24 and 34 weeks along following a successful animal study. The trial will monitor the women’s infants for six months after birth.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit ourcoronavirus news page.

5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Adhikari E, Spong C.COVID-19 vaccination in pregnant and lactating women.JAMA.2021;325(11):1039-1040. doi:10.1001/jama.2021.1658Centers for Disease Control and Prevention.Vaccination considerations for people who are pregnant or breastfeeding.World Health Organization.The Moderna COVID-19 (mRNA-1273) vaccine: what you need to know.Nationwide Children’s Hospital.The lungs in pregnancy.Pfizer.Pfizer and BioNTech commence global clinical trial to evaluate COVID-19 vaccine in pregnant women.

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Adhikari E, Spong C.COVID-19 vaccination in pregnant and lactating women.JAMA.2021;325(11):1039-1040. doi:10.1001/jama.2021.1658Centers for Disease Control and Prevention.Vaccination considerations for people who are pregnant or breastfeeding.World Health Organization.The Moderna COVID-19 (mRNA-1273) vaccine: what you need to know.Nationwide Children’s Hospital.The lungs in pregnancy.Pfizer.Pfizer and BioNTech commence global clinical trial to evaluate COVID-19 vaccine in pregnant women.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Adhikari E, Spong C.COVID-19 vaccination in pregnant and lactating women.JAMA.2021;325(11):1039-1040. doi:10.1001/jama.2021.1658Centers for Disease Control and Prevention.Vaccination considerations for people who are pregnant or breastfeeding.World Health Organization.The Moderna COVID-19 (mRNA-1273) vaccine: what you need to know.Nationwide Children’s Hospital.The lungs in pregnancy.Pfizer.Pfizer and BioNTech commence global clinical trial to evaluate COVID-19 vaccine in pregnant women.

Adhikari E, Spong C.COVID-19 vaccination in pregnant and lactating women.JAMA.2021;325(11):1039-1040. doi:10.1001/jama.2021.1658

Centers for Disease Control and Prevention.Vaccination considerations for people who are pregnant or breastfeeding.

World Health Organization.The Moderna COVID-19 (mRNA-1273) vaccine: what you need to know.

Nationwide Children’s Hospital.The lungs in pregnancy.

Pfizer.Pfizer and BioNTech commence global clinical trial to evaluate COVID-19 vaccine in pregnant women.

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