Pregnancy and Breastfeeding FAQ

We know you have many questions and concerns about the COVID-19 vaccines during your pregnancy or if you’re breastfeeding. For general information about the COVID-19 vaccine, see the Vaccine FAQ.

Julie Braga, MD, talks about the benefits and risks of the COVID-19 vaccines for pregnant and breastfeeding women.

Should women who are pregnant or breastfeeding get the vaccine?

Women who are pregnant, or are planning on becoming pregnant, should talk with their health care provider about the vaccine’s benefits and risks. During this conversation, you can decide what is best for you and your baby based on your risk of getting COVID-19, your risk of getting severe disease if you become infected with COVID-19, and the benefits and risks of getting the vaccine.

Were pregnant and breastfeeding women included in the vaccine trials?

Pregnant and breastfeeding women were not included in the vaccine clinical trials; therefore, the data on the safety of vaccines in pregnant and breastfeeding women are limited. A recently published review of the v-safe COVID-19 Vaccine Pregnancy Registry did not identify any signals for increased risk with the mRNA vaccines. Dartmouth-Hitchcock endorses access to COVID-19 vaccination for all pregnant women, especially high-risk pregnant health care workers.

Dartmouth-Hitchcock recommends that pregnant and lactating women engage with their health care provider in shared decision-making regarding their being vaccinated. This discussion should include reviewing available data on vaccine safety, risks to pregnant women from COVID-19 infection, and a woman’s individual risk for infection and severe disease. A few people who received the vaccine in the clinical trials did get pregnant. There have been no reports of any problems with these pregnancies, and they are continuing to be monitored.

Is the vaccine a live vaccine?

The vaccine is not a live vaccine. It is not possible to get COVID-19 from the vaccine. The COVID-19 vaccine is like the flu shot, which exposes the body to something that looks like the part of the virus so our bodies do the natural process of making antibodies to protect against disease.

There is only a very small chance that the vaccine crosses the placenta, so it’s unlikely that it even reaches the fetus, although we don’t know this for sure. The only people older than age 16 who should not get the vaccine are those who have had a severe allergic reaction to vaccines in the past.

Are pregnant women at an increased risk for severe illness from COVID-19?

Observational data shows that, while the chances for these severe health effects are not frequent, pregnant women with COVID-19 have an increased risk of severe illness, including illness that results in intensive care unit (ICU) admission, mechanical ventilation, and death. Additionally, pregnant people with COVID-19 might be at increased risk of worse pregnancy outcomes, such as preterm births and stillbirth.

What are the side effects and when may they occur?

Side effects may occur in the first 3 days after getting the COVID-19 vaccine. These include minor side effects like tiredness, mild to moderate fever, headache, and muscle aches and pain where the shot was given. Having symptoms is a sign that the vaccine is working, and antibodies are being made. Pregnant women who experience fever after receiving the COVID-19 vaccine should take acetaminophen (Tylenol) to treat the fever since very high fever can harm a baby. Acetaminophen is safe to use during pregnancy and does not affect how the vaccine works.

What are the benefits of getting the COVID vaccine?

The vaccine can help protect you from getting COVID-19. You must get both doses of the vaccine for it to be fully effective. It’s not yet known whether it prevents passing the virus to others if you do get COVID-19 or how long protection lasts. At this time, vaccinated people still need to wear masks and practice social distancing.

When you receive your first dose, you will also receive a COVID-19 vaccination record card. Bring your COVID-19 vaccination record card when you return for your second dose to ensure you are getting the appropriate vaccination. You should be sure to return to the same location where you received your first dose.

What is my risk of getting COVID-19?

Your risk of getting COVID-19 depends on the chance that you will come into contact with another infected person. This may be higher if you live in a community where there is a lot of COVID-19 infection or if you work in health care or another high-contact setting. The vaccine is being given first to health care workers, many of whom are considering pregnancy, pregnant, or breastfeeding.

Is it safe for breastfeeding women to get the vaccine?

Although lactating individuals were not allowed in the clinical trials, based on experience with other vaccines, the benefits of vaccination outweigh the very small safety concerns. You don’t have to delay or stop breastfeeding just because you get the vaccine.

What if I choose not to get the vaccine while I am pregnant?

If you choose not to get the vaccine while you are pregnant, you can get it after you have your baby. Talk to your health care provider about a plan to get the vaccine after pregnancy. No matter what you decide, it is important that you continue to follow COVID-19 infection prevention steps such as wearing a mask, washing your hands frequently, and maintaining physical distancing of at least 6 feet.