Question:

What do we know about COVID-19 vaccine safety for pregnant and lactating individuals?

Answer:

Some pregnant and lactating individuals have reported feeling hesitant about being vaccinated against COVID-19 because the vaccines weren’t tested on people like them.  That’s a reasonable concern. The NWHN wants everyone to have access to medical treatments that are safe and effective. Testing new medical products in “people like me” is an important aspect of health justice. 

But, we also know that some substances taken by a pregnant or lactating individual can harm fetuses and babies, so we protect infants and fetuses from being exposed to any new treatments until it is clear that the new treatment is safe and effective for adults who are not pregnant or lactating.  Once effectiveness is established, then researchers should take the next step and carefully assess whether there are any possible complications for pregnant or lactating individuals.  

That’s where we’re at right now.  All of the COVID-19 vaccines are safe and effective for adults who are not pregnant or lactating.  At the time the currently available vaccines were authorized by the FDA, the agency said “There are currently insufficient data to make conclusions about the safety of the vaccine in subpopulations such as …pregnant and lactating individuals...” The FDA also noted that Janssen (also known as Johnson & Johnson) conducted safety studies in female rabbits and did not find any abnormalities in animals born after their mothers were vaccinated before mating or during the pregnancy.  Also according to the FDA, Moderna did studies in female rats, with similarly good results.  The FDA does not mention any (reproductive toxicity) animal studies done by Pfizer.  

We know that pregnant people have been exposed to the vaccine, and so far, there have not been any reports of pregnancy complications.  However, the first vaccine was authorized in December, and it is too soon to know about the outcome of these pregnancies. Studies of pregnant women who have received the vaccine are underway, and we will have more information later this year. 

People who are pregnant right now will have to make a decision about being vaccinated without full information.  Many people feel that the risk of a potentially fatal disease, especially one that is more dangerous in pregnant people, outweighs the slight possibility of a currently unknown risk. The NWHN agrees with this and encourages pregnant people to seriously consider being vaccinated. The Centers for Disease Control and the American College of Obstetricians and Gynecologists also encourage pregnant people to consider getting vaccinated against COVID-19.

However, some people may decide to postpone being vaccinated until they give birth because they do not feel comfortable using something new while they are pregnant. That is not necessarily a safer choice, given that it is impossible to completely avoid exposure to the virus.  It may also be especially risky for Black, Latinx and Indigenous women who are three times more likely to be hospitalized with COVID-19 than are White women.  

People who are lactating also face a decision without full information, but in some ways they have more reassurance. Lactating individuals have been encouraged to receive all recommended vaccinations for many years and there have been no ill effects to their babies.  The only cases where nursing infants experienced complications from their parent’s vaccine were due to smallpox or yellow fever vaccinations, both of which use a weak version of a live virus.  None of the COVID-19 vaccines use live virus.  It is not possible to get infected from the vaccine.  

All existing science-based evidence suggests that the authorized COVID-19 vaccines do not harm pregnant/lactating individuals, embryo/fetal development, postnatal development or cause fertility problems. Most pregnant individuals should be eligible to receive a vaccine. Our advice: learn as much as you can, consult a trusted clinician if you have questions about your personal health status, and make the choice that is right for you. 

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