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COVID and Pregnancy

Pregnant woman prepares to receive vaccine by having her arm sanitized.

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Key Takeaways

  • The COVID-19 booster is available to all pregnant women who have previously received a vaccine at least six months ago.
  • Booster shots of Pfizer, Moderna, and Johnson and Johnson are available. You can mix-and-match vaccines.
  • COVID-19 booster shots are safe and recommended in pregnancy, and can protect the pregnant parent and the baby from COVID-19 complications and death.

As we have heard many times: The best way to protect yourself from the serious complications of COVID-19 is to get vaccinated. However, making the decision to get a vaccine while pregnant can be overwhelming—you are probably worried about yourself and your baby. With booster shots are widely available, these concerns may be resurfacing. However, it is important to note that the COVID-19 booster shot is safe and effective for pregnant people.1

In Fact, the Center for Disease Control and Prevention (CDC) has recently recommended "urgent action" to increase COVID-19 vaccination in pregnant people across the country.2 In August 2021, 161 pregnant people died, and 22,000 more were hospitalized with COVID-19. The CDC reports that 97% of pregnant hospitalizations occurred in those who are unvaccinated. While 58.1% of the general population is fully vaccinated, only 31% of pregnant people are, even though the risk for severe complications from COVID-19 is higher for them, according to the CDC.3

Is It Safe to Get the COVID-19 Booster While Pregnant?

All eyes are turning to the COVID-19 booster in recent weeks, which pregnant people are eligible and encouraged to get as well.4 If it has been more than six months since you received your second shot of the COVID-19 vaccine, it is highly recommended that you receive the booster as soon as possible.4 OB/GYNs, the CDC, the American College of Obstetricians and Gynecologists (ACOG), and other esteemed organizations are all in agreement on this.5

At this time, Moderna, Pfizer, and Johnson and Johnson have received FDA and CDC approval to offer a booster shot. The CDC also states that you can mix-and-match shots; you do not need to get a shot from the same brand as your original dose.6

“We know that the threat of the Delta variant is real but the risk is greatly minimized in those that have been vaccinated and have had a booster," says Betsy Greenleaf, DO, FACOOG, FACOG, the medical advisor for pH-D Feminine Health, who practices in Howell, N.J. "Thus it is being recommended that pregnant women are vaccinated and receive a booster. Unvaccinated women have significantly higher risks of intensive care treatment, intubation, and death."7

How Does the COVID-19 Booster Impact a Fetus?

Pregnant people are encouraged to check ingredients in their beauty products, medicines, and foods, to keep their babies safe. It is natural to wonder how the booster shot may impact your growing fetus during pregnancy.

The COVID-19 vaccines have been shown to be safe for babies in all trimesters of pregnancy. The CDC has verified that there aren’t any increased risks of miscarriage in those studied groups who received the vaccine, nor were there any increase in birth defects or other complications.2

One of the most profound ways the vaccine impacts the fetus is by protecting it through antibodies, transferred from the pregnant parent. “A new study has shown that women that have been vaccinated may pass on immunity to their infants," Dr. Greenleaf says. "Thus another reason to be vaccinated and boostered." This means your newborn may be protected from COVID-19 after they are born, depending on the timing of when you got the vaccine.8

Heather Masters, MD, MS, an assistant professor of obstetrics and gynecology at the University of Cincinnati College of Medicine, explains the process. “When getting vaccinated, women make an increased number of antibodies, even more antibodies than getting the virus itself," she says. "Some of these antibodies are passed to the baby. When testing the blood of babies of vaccinated mothers, the babies have an increased number of antibodies, suggesting an increased duration of immunity for the babies."

Dr. Masters wants pregnant people to know that it is not the booster they should worry about in regards to their baby’s health, but rather the danger of not getting it. “While I certainly sympathize with the concern about getting the vaccine, unfortunately, the options are not just exposure to the vaccine or not," she says. "This decision to avoid vaccine exposure puts you at higher risk for an even riskier exposure: COVID-19. Many have lost their lives. The risk is not only for you, it is also your child's health. Women with COVID-19 during pregnancy have an increased risk of their baby being preterm, admitted to the NICU, and even dying. The decision to get vaccinated is for both your health and your child's."

The risk is not only for you, it's also your child's health. The decision to get vaccinated is for both your health and your child's

— HEATHER MASTERS, MD


Cindy Duke, MD, a board-certified OB/GYN, a reproductive endocrinology and infertility specialist, virologist, and the medical and laboratory director at the Nevada Fertility Institute, says the fetal benefits of the booster shot include decreasing the risk of stillbirth, pregnancy loss, and prematurity that is often caused by COVID-19. 

When is the Best Time to Get a COVID-19 Booster Shot While Pregnant?

Some pregnant people are wondering about the best time to receive the booster vaccine while they are pregnant. The most important requirement is that it has to be six months past your second original vaccine. From there, there aren’t any official recommendations that one trimester would be better than another. Instead, it is best to get it as soon as possible.9

Some parents are opting to wait longer into the pregnancy past the first trimester when the miscarriage rate decreases. “For peace of mind, women may consider waiting until the second trimester or after 14 weeks of pregnancy when the general risk of miscarriage is lower," says Dr. Greenleaf.

However, the longer a pregnant person waits, the higher the chance they can contract COVID-19 as an unvaccinated person, leading to a host of potential complications.10

Should Breastfeeding Parents Get a COVID-19 Booster Shot?

If you have recently had a baby (within 42 days) and are breastfeeding, it’s recommended that you get the booster as long as it’s been 6 months since your last COVID-19 vaccine. It’s been proven that antibodies transfer to the newborn through breastmilk.11 This may be one of the best ways to protect your young baby who can’t get vaccinated themselves.

“If a breastfeeding parent falls into a high-risk group, they should get the booster," says Dr. Duke. "The booster in a lactating person would theoretically increase available antibodies in the milk. This helps to further protect gut health."

But it’s not exactly the same as getting a vaccine during pregnancy. “These antibodies don’t really become part of baby’s circulating antibodies, a contrast and downside of lactated antibodies when compared to the passive immunity if mom is boosted while still pregnant," Dr. Duke continues.

Are There Any Concerns Pregnant People Should Be Wary Of?

A new study, released October 4, finally gave experts a glimpse into just how effective vaccines are six months after receiving the second dose. They found that even at six months, the effectiveness for protection against COVID-19 related hospital admissions was still high. However, the chances of contracting the infection waned from 88% the first month to 47% after five months.12 This is why it is recommended you get a vaccine at least six months after your initial doses.

However, some pediatricians, such as Elisa Song, MD, a holistic pediatrician in Belmont, Calif., wonder if the booster is urgently necessary for pregnant patients. "While studies have not demonstrated significant immediate adverse effects in fetuses or babies of vaccinated pregnant and breastfeeding women, there have been no long-term studies on infant health after maternal COVID-19 vaccination," she says. "As a pediatrician, it is imperative that we not trade short-term benefits for long-term complications."

Her reasoning is that since the original vaccine provides high protection from serious COVID-19 complications even after six months, pregnant patients may not need the vaccine as urgently, particularly since there have not been long-term studies on the effects on fetuses. "Higher antibodies can indicate higher inflammatory response, which isn't necessarily a good thing," Dr. Song explains. "So if a mom has 90% protection against serious disease, hospitalization, or death even six months after being fully vaccinated, I don't know that a booster necessarily makes sense." Dr. Song notes that we will need to see further studies of the long-term implications of the COVID-19 booster for an infant.

What is important to be aware of is that if you are fully vaccinated against COVID-19 and are pregnant or breastfeeding, both you and your baby are protected from the serious complications of COVID-19, with or without a booster shot.

If you are unsure if you should get the COVID-19 booster shot while pregnant, talk to your healthcare provider. They can help you make the best decision for yourself and your baby.

A Few Final Tips from Our Experts

All three of our OB/GYN experts passionately stressed that pregnant people should get the COVID-19 booster. Dr. Duke adds that it is key to protect your baby against the risks of preterm birth if you were to contract a severe case of COVID-19, including lung disease, blindness, intestinal infection and necrosis, and neurological impairment like cerebral palsy.

She adds that pregnant people should get the flu shot soon in addition to their booster. There is a flu shot specifically for pregnant people, which is safe and will not give you the flu. “It protects against serious influenza infection which is as dangerous to a pregnant person as COVID-19,” Dr. Duke says.

The CDC says those who are able to get the booster due to pregnancy, including those who are up to 42 days postpartum, should do so as soon as they are eligible.9 In addition, Dr. Duke says the risk is even higher if the pregnant person is also a healthcare worker, frontline worker, immunocompromised, or has asthma, diabetes, or an autoimmune disease. “There are no real negatives [of getting a booster]," she concludes.

It really comes down to knowing the vaccines are safe, and they help protect people (including pregnant people) from COVID-19 complications.

— HEATHER MASTERS, MD


Dr. Masters recommends talking to your healthcare provider about receiving the booster and finding a location to do so. You can also call your local pharmacy, where it’s often readily available. “It really comes down to knowing the vaccines are safe, and they help protect people (including pregnant people) from COVID-19 complications," she says.

What This Means For You

If you are pregnant or breastfeeding, you should consider receiving the COVID-19 vaccine and booster. It has a significant impact on reducing your risk of COVID-19 complications, as well as those that affect your baby. It's been proven that antibodies transfer from the vaccinated parent in utero, as well as through breastmilk. Talk to your healthcare provider about any concerns.

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