COVID-19 Vaccine: I'm pregnant. Should I receive the vaccine?

Becoming pregnant against the backdrop of a pandemic can be stressful and with COVID-19 vaccines currently being distributed worldwide, many moms-to-be are struggling with the decision of whether or not to get vaccinated. While it’s true that pregnant women were excluded from the vaccine clinical trials, according to guidance from the CDC, the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine, pregnant women who want the COVID-19 vaccine, should get one.

Are pregnant woman at higher risk of getting severely sick from COVID-19?

COVID-19 can cause serious illness and even death in some people who contract the virus and pregnancy is considered a risk factor for more serious complications from the disease. Pregnant women are three times more at risk of an ICU admission and nearly two times more at risk of death from COVID-19. Pregnant women with other risk factors (obesity, increasing age, diabetes) are at even higher risk. In addition, there’s increased risk for certain racial and ethnic groups. There may also be an increased risk of preterm birth and stillbirth for those who acquire the SARS-CoV-2 infection.

How does the vaccine work?

The Pfizer and Moderna COVID vaccines are mRNA (messenger RNA) vaccine. The material in the vaccine contains instructions for the body to make a small part of the virus called the spike protein. When these proteins are made, the immune system is called into action. The body then begins to make antibodies against the spike protein.

This response can lead to common side effects such as body aches, soreness in the arm and in some cases a low-grade fever. These symptoms usually are mild to moderate and last for 1-3 days after the vaccine.

The mRNA is quickly broken down and eliminated from the body.  To be clear, it’s not possible to get COVID-19 from the vaccine. The mRNA vaccines do not contain live virus, they do not enter the nucleus of the cell and do not cause any genetic changes.  

Is the COVID-19 vaccine safe for pregnancy?

Pregnant and breastfeeding women were not included in the recent vaccine trials; however, future studies are expected to include pregnant patients. Some women in the studies did become pregnant during the trials and there was no increased risk of miscarriage among these women.  In addition, the Moderna vaccine also the tested the vaccine with pregnant rats and did not show any negative effects on fertility or fetal development. Based on the way the vaccine works it’s anticipated that the safety and efficacy of the vaccine will be similar to what was seen in non-pregnant patients. 

How effective is the vaccine?

Data suggests the vaccines are 95% effective and the full efficacy is achieved 1-2 weeks after the second vaccine dose is administered. In other words, 95% efficacy means that for every 100 unvaccinated people who get COVID-19, only 5 vaccinated people will actually get the virus. In addition, the severity of the illness is likely to be less for those who get the virus after receiving the vaccine. 

How do I decide if I should get the vaccine?

Deciding if and when to get the COVID-19 vaccine is a personal choice for every pregnant woman. Start by having a conversation with your doctor or healthcare provider who can provide the most current information regarding the vaccine. You should also consider how active the virus is in your community (it’s currently high in most communities in Utah), how well the vaccine works, your risk for COVID-19, and the safety data about the vaccine.