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Pregnancy and COVID-19 vaccination

close up of a band aid on the arm of a pregnant woman

[6 MIN READ]

In this article: 

  • A Swedish maternal and fetal medicine specialist discusses the importance of COVID-19 vaccinations for pregnant people.

  • Many public health organizations recommend that people who are pregnant, are intending to become pregnant or who are postpartum or breastfeeding get the COVID-19 vaccine.

  • Persons who have COVID-19 during pregnancy are at higher risk for more severe illness from COVID-19 than non-pregnant people.

We know that thinking about becoming pregnant or being pregnant can be an exciting, scary and sometimes overwhelming time in a person's life. Add in the COVID-19 pandemic and it can be hard to sift through what feels like mountains of data to make an informed decision about your health and the health of your baby.

With that in mind, we spoke with Amber Wood, M.D., a maternal and fetal medicine specialist here at Swedish, to help us understand the COVID-19 vaccine recommendation from the Centers for Disease Control and Prevention (CDC) for people who are pregnant, considering getting pregnant or who are breastfeeding. Dr. Wood also discussed with us information about possible side effects and the dangers of COVID-19 to pregnant people and their babies.

"When you're pregnant, there's a lot of information you have to take in and many important decisions you have to make," says Dr. Wood. "But right now, we cannot stress enough how important it is for you and for the health of your baby to get vaccinated." 

What does the CDC say about COVID-19 vaccinations and pregnancy? 

  • COVID-19 vaccination is recommended for all people ages 6 months and older, including people who are pregnant, breastfeeding, trying to get pregnant now or might become pregnant in the future.
  • Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing. The data suggest that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy.
  • Pregnant and recently pregnant people are more likely to get severely ill with COVID-19 than  non-pregnant people.
  • Getting a COVID-19 vaccine can protect you from severe illness that could require hospitalization, supplemental oxygen or intubation. 
  • Read the CDC's safety data about getting the COVID-19 vaccine while pregnant or breastfeeding.

Should I get the COVID-19 vaccine?

Yes! We recommend that all pregnant people receive the vaccine since it is highly effective at preventing severe infection and almost all pregnant people can receive the vaccine safely.

It is also recommended that people who have gone through the initial vaccine series and are eligible for a booster receive one during pregnancy.

Swedish joins many other public health organizations, including the American College of Obstetricians and Gynecologists (ACOG), the American College of Nurse-Midwives (ACNM), the Society for Maternal-Fetal Medicine (SMFM), the American Society for Reproductive Medicine (ASRM) and the American Academy of Pediatrics (AAP), in recommending that people who are pregnant, are intending to become pregnant or who are postpartum or breastfeeding get the COVID-19 vaccine. 

I’m pregnant — why should I do this? 

Research has demonstrated that persons who have COVID-19 during pregnancy are at higher risk for more severe illness from COVID-19 than non-pregnant people. Although the overall risks remain low, people who are pregnant with COVID-19 infection are at higher risk for severe illness (illness requiring hospitalization, intensive care or assistance breathing with a ventilator or other special equipment). The presence of underlying medical conditions in pregnancy such as diabetes or hypertension can further increase the risk of severe COVID-19. 

We have also seen an increased risk of pregnancy complications, including pre-term delivery, pre-eclampsia (the onset of high-blood pressure during pregnancy) and even stillbirth in people with a COVID-19 infection during pregnancy when compared to people without a COVID-19 infection. 

Having a severe COVID-19 infection during pregnancy also increases the risk of neonatal intensive care admission. These severe infections are preventable by being vaccinated, which can save pregnant people, their baby and their family from complications related to severe COVID.

Are there COVID-19 vaccine side effects? 

Many people have no side effects after their COVID-19 vaccination. If side effects occur, most are mild and may include headache, fatigue, fever, body aches or soreness at the injection site. These side effects are signs that your immune system is working and responding to the vaccine to make antibodies so you will recognize and be able to fight off COVID-19 if you are exposed to it in the future. 

What if I get a high fever after getting vaccinated?

If you develop a fever over 100.4 degrees, we recommend taking acetaminophen such as Tylenol, as with fever from any cause in pregnancy. If you have a persistent fever or are concerned about another possible cause of your fever, you should contact your health care provider. 

Is there a risk of infertility after getting vaccinated?

Research shows no link between COVID-19 vaccines and infertility.  COVID-19 vaccination is also not associated with an increased risk of miscarriage. However, we do know that COVID-19 infection during pregnancy can lead to serious illness and problems including pre-term birth, which is why COVID-19 vaccination is recommended for all pregnant people.  

Is the COVID-19 vaccine safe for me and my baby?

Data from CDC monitoring systems in women who have received the vaccine have not found any safety concerns. In addition to preventing severe COVID-19 and its associated risks, vaccination during pregnancy also builds antibodies that may help protect the baby against COVID-19 after delivery. 

The mRNA technology behind this vaccine has been researched and used clinically for 10 years. The vaccine for COVID-19 is new because the disease is new, but the science behind it is not. These are not experimental drugs, and the U.S. Food and Drug Administration approved the Pfizer-BioNTech COVID-19 vaccine on Aug. 23, 2021.

I had COVID-19 already. Do I still need to get vaccinated?

We recommend the vaccine for people who have had an infection in the past as we are still studying how long people have immunity from COVID-19 after they have the disease. Immunity does seem to fade with time, as there are people who have had COVID-19 multiple times. 

Is it possible to still get COVID-19 after getting the vaccine?

COVID-19 vaccines do not cause COVID infection. However, no vaccines are 100% effective at preventing illness, so it is possible that you may have a COVID-19 infection after vaccination, although your risk of infection is significantly reduced after vaccination. We also know the vaccine is protective against the risk of severe infection and associated maternal and fetal risks, so it is still very important to be vaccinated.

I have a medical condition. Should I still get the vaccine?

We encourage you to speak with your health care provider about receiving the COVID-19 vaccine. There are rare cases where people should not get the vaccine, but it is safe for the vast majority of people. 

I am pregnant. What should I do if I was exposed to COVID-19 and have symptoms? Or if I test positive?

Follow CDC guidance if you are sick, but in general:

  • Stay home except to get medical care. Avoid public transport.
  • Talk to your health care provider over the phone before being seen in their office.
  • Separate yourself from others in your home.
  • Wear a face mask around others or when receiving medical care.

Contact your obstetrical care provider for guidance if needed, or to determine how or when you should come to a clinical appointment after a positive test result.

Many people, including those who are pregnant, will have mild symptoms and will be able to recover at home with supportive measures. Tylenol can be used in pregnancy per bottle instructions for fever relief. Make sure you are taking in enough fluids.

If you have any of the following emergency signs or symptoms, you should call 911 or come into the hospital right away. If you go to the hospital, try to call ahead to let them know you are coming so they can prepare. If you have other symptoms that worry you, call your OB-GYN or 911

  • Having a hard time breathing or shortness of breath
  • Ongoing pain or pressure in the chest
  • Sudden confusion
  • Being unable to respond to others
  • Blue lips or face

Find a doctor

If you have questions about COVID-19 vaccination during pregnancy, contact the Maternal and Fetal Specialty Care department at Swedish.  We can accommodate both in-person and virtual visits.

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.

Join our Patient and Family Advisory Council.

Additional resources 

One Vax Two Lives

You can help protect yourself and others from COVID-19

Questions about COVID-19 testing? A Swedish expert has answers.

New CDC Data: COVID-19 Vaccination Safe for Pregnant People

COVID-19 Vaccines While Pregnant or Breastfeeding

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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About the Author

There's a reason why more babies are born at Swedish every year than any other health system in western Washington - bringing babies into this world is our mission. The Swedish Pregnancy & Childbirth Team is committed to giving you relevant and actionable insights on how to care for yourself and your child as you navigate the trimesters of your pregnancy.