The Covid-19 vaccine rollout is well underway across the country and almost any adult (and any child at least 12 years old) who would like to get the vaccine is now able to. If you are pregnant or breastfeeding, you might find yourself unsure about getting the vaccine. Perhaps have questions about its safety or efficacy. Or, you wonder what type of vaccine you should choose.
Whether you are becoming a mom for the first time or already have children, it is normal to have questions about getting vaccinated while pregnant or nursing. At MaternalWell, we want to support you as you make difficult choices surrounding your new baby. We have put together information to answer all your questions about receiving the Covid-19 vaccination during pregnancy and breastfeeding.
What Covid-19 Vaccines are Available?
There are three types of vaccinations that help protect you against the Covid-19 virus. Two of the vaccines are called mRNA vaccines, and the third is considered a traditional vaccine.
Messenger RNA (mRNA) Vaccines
Last December, the U.S. Food and Drug Administration (FDA) granted two vaccines for emergency use. The first vaccine authorized for use, made by Pfizer and BioNTech, has shown a 95% effective rate against the Covid-19 virus in large-scale clinical trials. The second Covid-19 vaccine, manufactured by Moderna, has an efficacy rate almost as high, around 94.1%.
The Pfizer and BioNTech, as well as the Moderna vaccines, are considered mRNA vaccinations. They are a new type of vaccination that essentially teaches our cells how to make a protein that triggers an immune response in our bodies. That immune response then produces antibodies that can protect us from the virus, should it ever enter our bodies. mRNA vaccines do not enter our DNA.
Traditional Vaccine
A third vaccine, considered a traditional vaccine, is made by Johnson & Johnson/Janssen Pharmaceuticals. It was granted authorization for emergency use on February 27 of this year. The Johnson & Johnson vaccine is 66% effective at preventing moderate to severe Covid-19 cases and offers 85% protection against more severe illnesses.
The Johnson & Johnson vaccine is a viral vector vaccine, or a traditional vaccine, as it gets “delivered” to your body’s cells in a different way than the mRNA vaccines do. It uses a disabled adenovirus to deliver the instructions to the cells in the virus. The adenovirus is not Covid-19 but can provide the correct instructions to your body to fight Covid-19.
What You Need to Know About Vaccinations and Pregnancy and Breastfeeding
Now that you understand the available Covid-19 vaccines, you may want to know how getting a vaccine may affect you during pregnancy and breastfeeding. At MaternalWell, we care about your health throughout and after pregnancy. We have outlined the essential things you need to know about getting vaccinated.
Getting a Covid-19 Vaccine While Pregnant or Breastfeeding
According to the American College of Obstetricians and Gynecologists (ACOG), pregnant and lactating moms can choose to be vaccinated. Agreeing with that sentiment, the Centers for Disease Control and Prevention (CDC) also encourages pregnant women to get vaccinated since they can get highly ill with Covid-19 compared with non-pregnant individuals.
The CDC says that while the severe risk from Covid-19 during pregnancy is low, pregnant women are at higher risk than non-pregnant individuals. Severe illness requires intensive care, hospitalization, or use of a ventilator or specialized equipment to breathe. It also includes disease that could result in death. In addition, pregnant women with Covid-19 have shown to be at increased risk of adverse pregnancy outcomes, like preterm birth, compared to pregnant people without Covid-19.
Safety of a Covid-19 Vaccine While Pregnant or Breastfeeding
While leading experts from the ACOG, CDC, and the Society for Maternal Fetal Medicine (SMFM) suggest that pregnant women should not avoid getting any one of the Covid-19 vaccinations available, there is limited data available about their safety. That is because pregnant people were excluded from initial clinical trials for each vaccine.
The mRNA vaccine does not contain any virus particles, which means there is no risk of the virus being passed onto the baby. Since other particles present in the vaccine are eliminated from our bodies within hours or days, they too are at very low risk of crossing the placenta.
Clinical trials testing the safety and efficacy rates in pregnant women are just getting underway or will be soon. Vaccine manufacturers are collecting and reviewing data from individuals who completed clinical trials who received the vaccine and later became pregnant.
A preliminary analysis of vaccine safety in pregnant women was published in the New England Journal of Medicine. The report analyzed information provided by over 35,000 pregnant recipients who received the Moderna or Pfizer/BioNTech vaccinations between December 14, 2020, and February 28, 2021. Participants completed surveys as part of a CDC program called V-safe. Almost 18,000 of those recipients have provided detailed information about their symptoms and pregnancy outcomes after receiving the vaccination. There were no safety concerns reported, and rates of miscarriage, preterm or low-weight babies born were consistent with studies of pregnant women before the pandemic. That means that pregnant women appear to have vaccine side effects that are the same for nonpregnant people.
In addition, studies in animals that received a Pfizer and BioNTech, Johnson & Johnson/Janssen, or Moderna Covid-19 vaccine before or during pregnancy found no safety issues in the pregnant animals or their babies. There was also no link found between the vaccine and infertility in animals.
Vaccinations Provide a Possible Safety Net for Babies in Utero and While Breastfeeding
In humans, vaccines are generally considered safe during pregnancy. Many are recommended. That is because the immunity generated from a vaccine in pregnant women can cross the placenta, providing the unborn baby with a safety net after birth.
Another study, written by the American Journal of Obstetrics and Gynecology on March 25, 2021, shows that the Moderna and Pfizer/BioNTech vaccines appear effective and safe during pregnancy.
Furthermore, the study found that vaccinations may protect the babies. The study, which included 131 participants, showed that vaccinated pregnant individuals produced antibody levels similar to unpregnant women. It also found that mild side effects were also similar, such as fatigue and arm soreness. The most compelling discovery in the study was the presence of antibodies in the umbilical cord and breast milk, suggesting that babies may be partially protected from the Covid-19 virus when their moms are vaccinated.
What You Need to Know About Blood Clots and the Johnson & Johnson Vaccine
In April of this year, the CDC and Food and Drug Administration (FDA) recommended that the Johnson & Johnson vaccine be put on hold. This was done “out of an abundance of caution” following a small number of women that developed a rare blood clot disorder following their injection. After a thorough review of the cases, a federal health panel recommended that the “pause” be lifted, stating that the benefits of receiving the Johnson & Johnson vaccine outweigh the risks.
It is important to note that more than 6.8 million individuals in the United States have received the Johnson & Johnson vaccine. The number of individuals that developed the blood clotting disorder leading to the pause was scarce.
The blood clot, known as the cerebral venous sinus thrombosis (CVST), can cause a low level of blood platelets to be produced for 6 to 13 days after receiving a vaccination. If you receive the Johnson & Johnson vaccine and develop any of these symptoms, you should contact your medical provider immediately:
- Severe headache
- Blurred vision
- Seizures
- Fainting
- Leg pain or swelling
- Shortness of breath
- Pain in your abdomen (chest or stomach)
- Small red spots on the skin (called petechia)
- New or easy bruising
- New neurologic symptoms
While the development of blood clots following the Johnson & Johnson vaccine is rare, it is even lower if it had been more than three weeks since receiving your injection. If you have already received this vaccination and have concerns about it, reach out to your health care provider.
Possible Vaccine Side Effects During Pregnancy
While the risk of developing severe side effects to the Covid-19 vaccination is low, you may experience mild side effects. The Covid-19 vaccination will help your body protect itself from the virus, but side effects are considered typical signs that the body is building its immunity to fight the virus.
You may experience a fever one or two days after vaccination. This happened to about:
- 1% to 3% of people after the first dose of an mRNA vaccine
- 15% – 17% of people after the second dose of an mRNA vaccine
- 9% of people after the Johnson & Johnson single-dose vaccine
You may also experience some common effects on the arm where the vaccine is injected, including:
- Pain
- Swelling
- Redness
Or these common side effects throughout the rest of your body:
- Fatigue
- Muscle Pain
- Headache
- Chills
- Fever
- Nausea
Children and the Covid-19 Vaccine
The FDA has authorized the Pfizer and BioNTech vaccine for emergency use for teens 16 years and older. In late September 2020, Pfizer began enrolling children 12 and up in their trials.
The Moderna vaccine is currently authorized for those 18 years and older. In December 2020, Moderna started enrolling 12- to 17-year-old children and teens for a clinical trial.
Many times, vaccines are tested in healthy adults prior to being tested in adolescents (those 12 and older). Since the vaccine appears to be safe and effective in adults, researchers will begin testing it in kids aged 5 to 11, followed by younger children and babies.
In early May, President Joe Biden announced a push to vaccinate Americans, including children as young as 12 years old. Upon approval, he said that vaccines would be given directly to pediatricians so that parents can discuss their questions and concerns with their family doctors. He also noted the importance of children receiving the injection from someone they feel comfortable with. Vaccinations would also still be available to children 12 and older at community centers and pharmacies across the nation.
Although there is no vaccine currently authorized for use in the United States for anyone under the age of 16, Pfizer has requested approval to administer its vaccine to adolescents ages 12 to 15. Early insight suggested that kids 12 to 15 would not be approved for the vaccine until the late summer or early fall. However, that date has been moved up significantly! UPDATE: The FDA has recently approved Pfizer for ages 12 to 15 and will begin deployment immediately.
Other Information Parents Should Know About the Covid-19 Vaccine
Although it may be some time before children and babies are eligible to be vaccinated against Covid-19, they may benefit indirectly in the same way that newborns do from the Tdap, measles, and influenza vaccines. When the people around a baby are vaccinated, it can provide partial protection to that newborn because the vaccinated individuals are less likely to contract the viruses. In other words, the people that children are around will not contract Covid-19, so they will not pass it along to children and babies.
Recent research also shows that mothers who receive a Covid-19 vaccine can pass on protective antibodies to their babies through the umbilical cord, placenta, and breast milk.
While the Covid-19 vaccines are expected to play a major role in the ending of the global pandemic, they likely will not eliminate the virus altogether. Until that happens, it is recommended that everyone still practice good hygiene (washing hands), social distance, and wear a mask when in public.
MaternalWell
Mamas, you are not alone! MaternalWell is here to support you throughout your motherhood journey.
Our experienced specialists take a proactive approach to expecting moms’ physical, mental, and emotional health during this sensitive time.
Learn more about Covid-19 vaccines and pregnancy by scheduling a virtual visit with one of our licensed providers. We offer affordable and convenient access to excellent professional care through our telehealth platform. We can provide you with care in the comfort of your own home.
Please visit us at maternalwell.com.