Pregnant or trying to conceive? What to know about the COVID-19 vaccine and fertility

Updated August 2021. Information and guidance about COVID-19 care and vaccination continues to evolve. Please refer to the Centers for Disease Control and Prevention for the latest.

If you’re pregnant, trying to conceive or breastfeeding, you likely have questions about the COVID-19 vaccine—Is it safe for you? Are there any risks to your baby? Can the vaccine impact fertility for women of childbearing age?

As an OB/GYN and maternal fetal medicine specialist, I hear you. These are important questions to ask. As with any medical decision, it’s imperative that you feel confident making the right decision for you and your family’s health.

With that in mind, let’s address some common myths and fears around the COVID-19 vaccine and pregnancy.

Is the COVID-19 vaccine safe for pregnant women?

The Centers for Disease Control and Prevention (CDC) recommend vaccination for “all people aged 12 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future.” The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine (SMFM) also recommend all pregnant and lactating individuals be vaccinated against COVID-19.

More than 140,000 pregnant women have received the vaccine according to the CDC’s VSAFE system. Studies have also followed over 35,000 pregnant patients through their pregnancy following the vaccine. They have found no increase in side effects from the vaccine for pregnant and no adverse maternal or fetal outcomes have been found. Also, research has shown that none of the current available COVID-19 vaccines reach or cross the placenta. 

However, many people do experience mild side effects, such as soreness at the injection site, fatigue, headache, chills or fever within three days after getting the COVID-19 vaccine. To help manage these side effects for pregnant women, the Centers for Disease Control and Prevention (CDC) recommends taking acetaminophen, as this medication is safe to use during pregnancy and does not affect how the vaccine works.

Why should pregnant women get the COVID-19 vaccine?

Getting a vaccine during pregnancy is not a new concept—and in fact, many vaccines are routinely and safely given in pregnancy for the health of both mom and baby. For years, vaccines for illnesses like the flu, tetanus and diphtheria have been highly recommended for pregnant women. The antibodies from the vaccine can also pass to your baby, providing your little one with protection against the virus after they are born.

A study published in The American Journal of Obstetrics and Gynecology shows the vaccines are not only safe and effective for pregnant and breastfeeding women, but they may also offer some protection for their babies. When researchers compared the antibody levels to those of women who had been sick with COVID-19 during pregnancy, the antibody levels in response to the vaccine were higher.

But perhaps the most exciting discovery: Antibodies were also found in umbilical cord blood and breast milk.

COVID-19 can be dangerous for anyone but is certainly more dangerous for pregnant women. COVID-19 patients who are pregnant are more likely to require intensive care and ventilation. The COVID-19 virus has also been linked to an increased risk of preterm birth, premature rupture of membranes, growth problems with baby and stillbirth. Getting COVID-19 during pregnancy can be life-threatening for you and your baby, but getting the vaccine is a proven way to protect you both with very few risks.

Related: What to do if you’re pregnant and get COVID-19

Is the COVID-19 vaccine safe while breastfeeding?

According to the Academy of Breastfeeding Medicine, there is no reason to believe that the COVID-19 vaccine affects the safety of breastmilk. None of the current vaccines have been found in breast milk. It is a common misunderstanding that the COVID-19 vaccine contains the live virus and can potentially cause you to develop COVID-19. However, this is a myth. 

The vaccine does not contain the virus itself. It works by causing your body to make antibodies to fight off the infection. These antibodies formed from vaccines given during pregnancy pass into your breastmilk and to your baby, helping prevent future infections.

Can the vaccine impact fertility?

There is currently no evidence that the COVID-19 vaccine causes fertility problems in women or men, according to the CDC. In fact, the American Society for Reproductive Medicine (ASRM) and SMFM emphasized that there is no evidence that COVID-19 vaccination causes a loss in fertility.

Should you get the COVID-19 vaccine?

The CDC recommends that all people 12 and older, including people who are pregnant, breastfeeding, trying to get pregnant or who might become pregnant in the future. Getting the vaccine provides you with an effective form of protection against the virus during pregnancy and beyond.

When making the decision about whether or not to get the COVID-19 vaccine, consider your personal risk factors. You are at an increased risk of severe illness with COVID-19 if you:

• Work in healthcare
• Live in an area with a high rate of COVID-19 infections
• Have contact with people outside of your household who do not wear masks
• Are 35 years or older
• Are overweight
• Have other medical conditions such as diabetes, high blood pressure or heart disease
• Smoke
• Are a racial or ethnic minority

Ultimately, getting the vaccine is your choice. I urge you to consider your risk factors and consult your OB/GYN for guidance.