Is the COVID vaccine safe for pregnant people? What about when you are breastfeeding?

Kristin Woodring found out she was pregnant in the fall of 2020. A pharmacist at UR Medicine’s Strong Memorial Hospital, she was eligible for a COVID vaccine a few months later. She was still early in her pregnancy—around 16 weeks—but the decision to get the shot was an easy one.

A pharmacist who works in the emergency department and ICU (intensive care unit), Kristin has been in contact with patients with COVID throughout the pandemic. For her, getting vaccinated was a huge relief. She took all the right precautions while working in the hospital, including using the appropriate personal protective equipment, distancing and handwashing, but she felt much better protected after being vaccinated.

“Everyone, including me, has reservations about taking or doing anything out-of-the-ordinary in pregnancy,” says Woodring, who delivered a healthy baby boy last May. “But I knew I had to keep myself healthy in order to keep my baby healthy. I also wanted to continue working and supporting my team at the hospital during an extremely busy and stressful time. The vaccine helped me do both.”

Kristin delivered Zachary at 39 weeks. She had no issues post vaccination, and Zachary was born healthy and with no complications.

But even after hearing positive stories like Kristin’s, it can be a difficult decision to get vaccinated before or while you are pregnant. Eva Pressman, M.D., chair of the Department of Obstetrics and Gynecology at the University of Rochester Medical Center, has heard first-hand the many concerns that people have.

A high-risk pregnancy expert, Pressman answers common questions that she’s received from patients and others throughout the pandemic:

Q: How do you know the vaccine is safe for women who are pregnant or breastfeeding when the vaccines were not tested on them? With no data, how do we make an informed choice?

A: Although it’s true that pregnant and breastfeeding women were not enrolled in any of the original studies, it turns out that many of the women that enrolled in those studies—several hundred, at least—were actually pregnant and didn’t know it at the time. So we do have original data from those women as well as studies that are ongoing specifically in pregnancy, and we have registries of more than 140,000 women who received the vaccine during pregnancy and reported information about their outcomes. We have all of this data on women who have been pregnant and breastfeeding when they received the vaccine, which does allow for a much more informed choice even though the original studies intended to not study pregnant people.

Q: What do we know about the vaccine and fetal development or complications?

A: We now have information from hundreds of thousands of pregnancies that the COVID vaccine does not increase the risk of birth defects or pregnancy complications like preeclampsia or pre-term labor. On the contrary, COVID infection has been associated with increased risk of pre-term labor, preeclampsia and miscarriage. We know that the vaccine is much safer in pregnancy than the disease itself.

Q: Does the vaccine raise the risk of miscarriage?

A: No. The data that we have from the COVID vaccine is that it does not increase the risk of miscarriage. On the other hand, COVID infection does increase the risk. So getting the vaccine might actually decrease your risk of miscarriage because it would decrease your risk of having a serious COVID infection.

Miscarriage is very common—occurring in 15 to 30 percent of pregnancies—and so, when they occur, many people have concerns that they did something that caused it to happen. This is almost never the case. Any serious health complication during pregnancy puts you at risk for miscarriage or pre-term delivery, and pre-term delivery puts your baby at risk for health complications. So, preventing severe COVID disease in pregnancy is really critical, and that’s why I worry so much about women who think they’re protecting their babies by not getting the vaccine; in reality they might be putting their babies at risk by not getting the vaccine if they get COVID while they are pregnant.

Q: Is it safe for lactating moms to get the vaccine?

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