Much like my post on the fertility concerns people have about the COVID vaccines, I want to start this post by assuring women that their concerns are valid.
Of course we want to protect our children.
We want to give our children what is best for them, sometimes even to the detriment of our own well-being.
Catholics value the precious gift that is life. Since life begins at conception, we need to look at what we should do to protect that life.
Many of us wonder if getting vaccinated the best thing for us and our children.
Please note that this pieces was written and published in early March 2021. Additionally, the information in this post primarily relates to the Moderna and Pfizer vaccines. Information may have changed.
Benefits
Women who are pregnant and contract COVID-19 are at a higher risk of severe illness and death.
The CDC includes pregnancy in the list of factors that put an individual “at increased risk of severe illness.” Pregnant women are also at an increased risk of death compared to women who are not pregnant.
Pregnant women might be at increased risk for severe COVID-19 illness. To reduce severe COVID-19–associated illness, pregnant women should be aware of their potential risk for severe COVID-19 illness. Prevention of COVID-19 should be emphasized for pregnant women and potential barriers to adherence to these measures need to be addressed.
Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status
Additionally, COVID-19 could lead to preterm birth.
The vaccines are effective in preventing COVID-19 disease. Preventing disease protects the health (and potentially the life) of the mother and unborn child.
Additionally, there could be a benefit for a breastfeeding child.
Antibodies and T-cells stimulated by the vaccine may passively transfer into milk. Following vaccination against other viruses, IgA antibodies are detectable in milk within 5 to 7 days. Antibodies transferred into milk may therefore protect the infant from infection with SARS-CoV-2.
ABM STATEMENT: Considerations for COVID-19 Vaccination in Lactation
The vaccines are effective in preventing COVID-19 disease. Preventing disease protects the health (and potentially the life) of the mother and unborn child. Click To TweetVaccinated pregnant and lactating women showed higher levels of antibodies when compared to samples taken from non-vaccinated pregnant women who contracted COVID-19 and recovered.
Researchers also found that vaccine-generated antibodies were present in umbilical cord blood and breastmilk samples, indicating they can be transferred to newborns.
Study finds COVID-19 vaccines protect pregnant, lactating women and their newborns
Risks
The CDC says that the side effects from the COVID-19 vaccines “are not expected to be any different for pregnant people than for non-pregnant people.”
The one thing I saw highlighted from a few sources is the concern about a fever. A fever is a normal immune response to receiving a vaccine, but it does introduce some risk to pregnant women and their unborn child. It can be treated with acetaminophen.
However, a pregnant woman who contracts COVID-19 may also run a fever.
Additionally, there are the typical side effects of the vaccine – sore arm, tiredness, chills, etc. People report differing effects and levels of severity. I’ve seen some people say that their arm was just a little sore while others say it knocked them down for a couple of days.
Available Information
Though there is not a lot of information about how the vaccine will affect pregnant women and their unborn children, what we do know seems promising. In this case, no news is good news, but additional studies need to be done. There are focused efforts for tracking outcomes of vaccination on pregnant women and their children.
Animal Studies
According to the report presented to the European Medicines Agency, animal studies using the Pfizer/BioNtech COVID-19 vaccine do not indicate direct or indirect harmful effects with respect to pregnancy, embryo/fetal development, parturition or post-natal development.
Vaccinating Pregnant and Lactating Patients Against COVID-19
FDA review of this study concluded that mRNA1273 given prior to mating and during gestation periods at dose of 100 µg did not have any adverse effects on female reproduction, fetal/embryonal development, or postnatal developmental except for skeletal variations which are common and typically resolve postnatally without intervention
Vaccinating Pregnant and Lactating Patients Against COVID-19
While safety data on the use of COVID-19 vaccines in pregnancy are not currently available, there are also no data to indicate that the vaccines should be contraindicated, and no safety signals were generated from DART studies for the Pfizer-BioNtech and Moderna COVID-19 vaccines.
Vaccinating Pregnant and Lactating Patients Against COVID-19
Unlikely to Pose a Risk
Based on current knowledge, experts believe that mRNA vaccines are unlikely to pose a risk to the pregnant person or the fetus because mRNA vaccines are not live vaccines. The mRNA in the vaccine is degraded quickly by normal cellular processes and does not enter the nucleus of the cell. However, the potential risks of mRNA vaccines to the pregnant person and the fetus are unknown because these vaccines have not been studied in pregnant people.
mRNA COVID-19 Vaccines
No plausible biological mechanism for how an inactivated, recombinant vaccine would cause harm to a breastfed baby has yet been proposed.
Why were breastfeeding women denied the covid-19 vaccine?
The US approach has been quite different [from the UK’s]. Recommendations from The Advisory Committee on Immunization Practices (ACIP), approved by the Centers for Disease Control (CDC), agreed from the outset that breastfeeding women could choose to receive or refuse the Pfizer/BioNTech vaccine.
Why were breastfeeding women denied the covid-19 vaccine?
We also have decades of knowledge from vaccinating pregnant and lactating individuals.
Early Results
Though more data is needed, so far, it seems that the mRNA vaccines are not causing negative outcomes for pregnant women and their children.
Anecdotes
Caitlynn Ott of Montana shared her reasons for participating in a vaccine trial as an expectant mother.
Recommendations
Nearly every organization I found said that pregnant women and lactating women should not be excluded from receiving the vaccine. Most advocate for pregnant and lactating women being able to make informed decisions to vaccinate or not vaccinate. The exception is the WHO. They advise against it but still say it could be considered.
CDC
People who are pregnant and part of a group recommended to receive the COVID-19 vaccine may choose to be vaccinated.
Pregnancy or Breastfeeding from the CDC
mRNA vaccines are not thought to be a risk to the breastfeeding infant. People who are breastfeeding and are part of a group recommended to receive a COVID-19 vaccine, such as healthcare personnel, may choose to be vaccinated.
Pregnancy or Breastfeeding from the CDC
FDA
While there have been no specific studies in these groups, there is no contraindication to receipt of the vaccine for pregnant or breastfeeding women. Pregnant or breastfeeding women should discuss potential benefits and risks of vaccination with their healthcare provider.
Pfizer-BioNTech COVID-19 Vaccine Frequently Asked Questions
ACOG
You can read their clinical guidance here, but the two takeaways related to pregnancy and breastfeeding are below.
“ACOG recommends that COVID-19 vaccines should not be withheld from pregnant individuals who meet criteria for vaccination based on ACIP-recommended priority groups”
“COVID-19 vaccines should be offered to lactating individuals similar to non-lactating individuals when they meet criteria for receipt of the vaccine based on prioritization groups outlined by the ACIP.”
ACOG and SMFM Joint Statement
ACOG and SMFM continue to stress that both COVID-19 vaccines currently authorized by the U.S. Food and Drug Administration should not be withheld from pregnant individuals who choose to receive the vaccine.
ACOG and SMFM Joint Statement on WHO Recommendations Regarding COVID-19 Vaccines and Pregnant Individuals
SMFM
Despite the categorization of pregnancy as a high-risk condition for severe COVID-19, hospitalization, and mortality, pregnancy remains an exclusion for participation in vaccine trials. The Society for Maternal-Fetal Medicine (SMFM) and other leading organizations, including the National Academy of Medicine, have consistently advocated for the inclusion of pregnant and lactating women in vaccination trials, particularly when the following criteria are met: (1) pregnancy poses increased susceptibility to or severity of a disease; (2) the best approach to protect the infant is through passive placental antibody transfer, which provides the most efficient and direct protection to the newborn before an infant can be vaccinated, and (3) there is an active outbreak. Ultimately, the existing practice of “protection by exclusion” is harmful and has been characterized as clinical experimentation on pregnant women, as vaccines are distributed and adminstered without the safeguards of research protocols in place. Furthermore, there is no biological plausibility for the exclusion of lactating women from these trials.
Society for Maternal-Fetal Medicine (SMFM) Statement: SARS-CoV-2 Vaccination in
Pregnancy
ASRM
after again carefully considering the existing data relating to the dangers of COVID-19 during pregnancy, the risks of the mRNA vaccines from Moderna or Pfizer, and our understanding of the underlying biological mechanisms involved, we stand by our recommendation that pregnant women and those seeking to become pregnant should be vaccinated.
American Society for Reproductive Medicine (ASRM) Position on COVID Vaccine Use in Pregnant Women
ABM
The Academy of Breastfeeding Medicine does not recommend cessation of breastfeeding for individuals who are vaccinated against COVID-19. Individuals who are lactating should discuss the risks and benefits of vaccination with their health care provider, within the context of their risk of contracting COVID-19 and of developing severe disease. Health care providers should use shared decision making in discussing the benefits of the vaccine for preventing COVID-19 and its complications, the risks to mother and child of cessation of breastfeeding, and the biological plausibility of vaccine risks and benefits to the breastfed child.
ABM STATEMENT: Considerations for COVID-19 Vaccination in Lactation
WHO
Pregnant women are at higher risk of severe COVID-19 than non-pregnant women, and COVID-19 has been associated with an increased risk of pre-term birth.
However due to insufficient data, WHO does not recommend the vaccination of pregnant women at this time.
In case a pregnant woman has an unavoidable risk high of exposure (e.g. a health worker), vaccination may be considered in discussion with their healthcare provider.
If a breastfeeding woman is part of a group (e.g. health workers) recommended for vaccination, vaccination can be offered. WHO does not recommend discontinuing breastfeeding after vaccination.
Who can take the Pfizer-BioNTech COVID-19 vaccine?
The vaccine can be offered to a breastfeeding woman who is part of a group recommended for vaccination (e.g. health workers); discontinuing breastfeeding after vaccination is currently not recommended.
The Moderna COVID-19 (mRNA-1273) vaccine: what you need to know
While pregnancy puts women at higher risk of severe COVID-19, very little data are available to assess vaccine safety in pregnancy.
Nevertheless, based on what we know about this kind of vaccine, we don’t have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women.
For this reason, those pregnant women at high risk of exposure to SARS-CoV-2 (e.g. health workers) or who have comorbidities which add to their risk of severe disease, may be vaccinated in consultation with their health care provider.
The Moderna COVID-19 (mRNA-1273) vaccine: what you need to know
A note on the WHO statement:
Decision-Making Support
I want to repeat the advice I gave in my post about fertility fears if you are pregnant or lactating and trying to decide whether or not to get vaccinated.
Pray.
Talk to your doctor.
Use reliable evidence when weighing your options.
The two resources below are helpful starting points.
A group of experts has created a decision-making guide to help those who are pregnant, lactating, or planning on becoming pregnant to decide whether or not they should receive the vaccine.
Lord, there is a lot of information to process about the COVID-19 vaccines. You know my fears. You know my love for my children and my desire to protect them. Please guide our research, our discussions, and our decisions surrounding vaccination. May we act in accordance to your will in this and in all things. Amen.
Thank you for the time and effort you put into creating this post. I am a new mom of a 1 year old, and my husband and I just began the discernment process for trying for our next child. I am of course nervous about the effects receiving the vaccine could have on my fertility as well as the development of my next baby. You did so much research that I found informative and comforting. Thank you again for doing this for us Catholic moms that want to support the dignity of life in all areas!
Thank you for your kind words! I am so glad you found it helpful. I’m a first-time mom to a 15-month-old, so I can relate to the challenges of discernment, especially in light of the pandemic. Praying for you both!