Being pregnant does not disqualify you from getting the COVID vaccine, whether you’re looking at the CDC’s guidelines or newer ones from the World Health Organization. A few headlines have implied something different, so let’s break down what we know.
Whether to get the vaccine is a personal decision to make with your doctor
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Let’s be clear on what the recommendations actually are. In short, every organization agrees that people who are pregnant or thinking about becoming pregnant can get the vaccine.
Different agencies phrase this differently, but if you are at risk for being exposed to COVID (for example, if you work in health care) or if you are at risk for complications (for example, you have a heart condition), both the CDC and WHO recommend that you be able to get the vaccine.
The CDC says:
People who are pregnant and part of a [priority] group recommended to receive the COVID-19 vaccine may choose to be vaccinated. If they have questions about getting vaccinated, a discussion with a healthcare provider might help them make an informed decision.
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In other words, they consider vaccination to be a personal choice, and any pregnant person may choose to be vaccinated if the vaccine is otherwise available to them. Being pregnant does not change what priority group you are in.
The World Health Organization takes a slightly more pessimistic viewpoint, saying:
WHO recommends not to use BNT162b2 in pregnancy, unless the benefit of vaccinating a pregnant woman outweighs the potential vaccine risks, such as in health workers at high risk of exposure and pregnant women with comorbidities placing them in a high-risk group for severe COVID-19. Information and, if possible, counselling on the lack of safety and efficacy data for pregnant women should be provided. WHO does not recommend pregnancy testing prior to vaccination.
The American College of Obstetricians and Gynecologists has advocated that nobody should be standing between a pregnant person and their COVID vaccine. Christopher Zahn, MD, ACOG’s vice president of Practice Activities, said in a statement today:
The American College of Obstetricians and Gynecologists (ACOG) remains steadfast in its guidance that both COVID-19 vaccines currently authorized by the FDA should be made available to pregnant individuals who choose to receive the vaccine. However, we recognize that the conflicting recommendation from the World Health Organization could be unsettling for many pregnant individuals who are currently grappling with the decision about whether to get vaccinated. … ACOG strongly advocated for the inclusion of pregnant people in the COVID-19 vaccine trials so that we would currently have the data to support the safety and efficacy of the vaccines in this population. But even in the absence of this data, pregnant people should know that the way the vaccines work and early evidence from animal studies gives us reason to believe that there should be no harmful effects to the fetus or female reproduction.
ACOG has a guide here to help healthcare providers have a conversation with pregnant patients about whether the COVID vaccine makes sense for them.
Why the recommendations vary
For both the Pfizer and the Moderna vaccines (the two that currently have emergency use authorization in the U.S.), the clinical trials that showed the vaccine to be safe and effective did not enroll anyone who was pregnant. Even so, some people got pregnant during the trials, and the investigators have been following those people to find out how they and their babies are doing.
This lack of data explains why public health agencies may seem reluctant to recommend the vaccine to people who are pregnant or, in some cases, people who might become pregnant.
Still, there is no reason to believe that the vaccine would act any differently in people who are pregnant than in those who are not. Despite rumors that you may have seen, mRNA vaccines don’t alter DNA, and they aren’t known to cause infertility or problems with pregnancy. The vaccines do not contain the virus itself, and so far animal studies have not turned up any safety issues related to pregnancy or fetal development.
“Based on the mechanism of action of these vaccines and the demonstrated safety and efficacy in Phase II and Phase III clinical trials, it is expected that the safety and efficacy profile of the vaccine for pregnant individuals would be similar to that observed in non-pregnant individuals,” the ACOG conversation guide says.
Does it make sense to get the vaccine if I am pregnant?
People who are pregnant, compared to those who aren’t, are at increased risk of ending up in the ICU or experiencing severe illness if they contract COVID-19. What we know about the vaccines indicates that they are usually effective and safe. But due to a lack of information, we don’t know exactly how effective and safe they are for pregnant people. Depending on how you feel about those unknowns, and what level of risk you face otherwise, you’ll have to make a judgment call—but rest assured you will have your provider’s help with that.
If you are at low risk of complications, and if you don’t work a high risk job, you may decide that you’d rather wait until after pregnancy to get the vaccine. That’s a choice you absolutely have the ability to make. If you think that you would be better off with the vaccine than without it, that’s your choice as well. Talk to your provider about the risks and benefits, and about how you would like to navigate those.
If you might be pregnant, plan to become pregnant, or have recently been pregnant, recommendations still allow for you to be vaccinated. Even the WHO, which said the Moderna vaccine is “not recommended” in pregnancy, does not recommend requiring a pregnancy test before the vaccine, and does not recommend any particular length of time to wait after pregnancy.