Now that the COVID-19 vaccine has become widely available to all adults, questions have been raised regarding its safety in expectant mothers, their unborn babies, and during breastfeeding. The Center for Disease Control (CDC), American College of
Obstetricians and Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine (SMFM) all recommend that COVID-19 vaccine be given to pregnant women as pregnancy is considered a risk factor for severe illness. No formal studies have been conducted to date but the CDC has been tracking 30,000+ women who were pregnant when they received the vaccine. So far, pregnant women have shown similar side effects to non-pregnant women and no increased risk of miscarriages, stillbirths, or preterm delivery have been linked to the vaccine. The fever that some experience following vaccination is usually low and transient, lasting 1-2 days. It can be managed safely with acetaminophen which is safe to use during pregnancy.
Certain vaccines are already routinely recommended and administered to pregnant women such as the influenza vaccine and Tdap (tetanus, diphtheria, pertussis) vaccine. These are given to protect the mothers from becoming ill which can lead to preterm delivery as well as transmitting the virus or bacteria to their newborns. Pregnant mothers who are vaccinated also produce protective antibodies against these illnesses that can pass through the placenta to their babies. This "passive immunity" keeps their babies safe during the vulnerable time following birth. While more studies are needed, antibodies against COVID-19 were found in umbilical cord blood of vaccinated women suggesting possible protection for their babies during pregnancy.
Benefits of breastfeeding are manifold - it provides all the nutrition that an infant needs for proper growth and healthy development, promotes bonding between the mother and child, provides passive immunity and protection against infection and illnesses, and best of all, is absolutely free and portable! Some mothers have raised concerns about whether it is safe to become vaccinated while they are breastfeeding. While further studies are indicated regarding the safety of the maternal COVID-19 vaccine in an infant who is nursing, observational studies have shown no adverse effects in these babies. Moreover, nursing mothers have tolerated the vaccine well without an increased risk of side effects or more severe side effects compared to those who are not breastfeeding. Recent studies show that anti-COVID antibodies can be detected in a vaccinated mother's milk as early as 2 weeks following immunization. This likely provides protection against COVID-19 in the breastfeeding baby which is great news!
A common concern circulating on social media has been the possibility of the virus's genetic material being passed on and incorporated into your baby's genes (DNA). The viral mRNA component of the vaccine is eliminated from the body within hours to days so is unlikely to reach the placenta. It also cannot enter the cell's nucleus where a person's genetic material is stored nor can it produce an intact virus in the baby and cause an active infection.
Ultimately, the decision whether to get vaccinated or not is up to the individual parent but it is strongly recommended at this time. Key factors to consider include:
Circulation of highly contagious delta variant of COVID-10 virus
Risk of severe illness based on genes and pre-existing health problems (including hypertension, diabetes, overweight/obesity), being mindful that pregnancy itself increases the risk of severe illness even in the absence of significant underlying medical problems
The potential effect of maternal COVID-19 infection on triggering preterm labor as well as her ability to care for her baby after delivery
The risk of transmitting the virus to her infant if she becomes infected
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