COVID is dangerous. It is more dangerous in pregnancy.
- Pregnant COVID patients are 5 times more likely to end up in the intensive care unit than non-pregnant COVID patients.
- Preterm birth may be more common when a person has COVID.
1. The COVID vaccines prevent severe COVID and death. Getting a vaccine will prevent you from getting very sick with COVID.
2. The COVID vaccines may reduce spread. The vaccine may help keep you from giving COVID to people around you. As COVID infections go up in our communities, your risk of getting – and giving – COVID goes up too.
3. These vaccines have no live virus and do NOT contain ingredients that are known to be harmful to pregnant people or to the fetus. Many vaccines are routinely given in pregnancy and are safe (for example: tetanus, diphtheria, and flu).
- In the general population, millions of doses of the COVID vaccines have been given without serious side effects.
- For every million people who got a Pfizer or Moderna vaccine, fewer than 10 in a million had a severe allergic reaction. Common side effects are listed below.
- A study of over 35,000 pregnant people who got the vaccine showed no serious side effects.
What We Know
- In studies done by Moderna and Johnson & Johnson, there were no adverse effects on female reproduction or fetal development.
- So far, the mRNA vaccines have been given to over 100,000 pregnant people in the US who registered with the CDC.8
- A study of 2,456 pregnant people who got the vaccine at ≤20 weeks pregnant found no increased risk of miscarriage (12.8%). The rate of miscarriage was about the same as we see in pregnant people who have NOT gotten a COVID vaccine (10-25 %).8
- There was no increased risk of birth defects. Birth defects were seen in the same number of people as in the general population who have NOT gotten a COVID vaccine (3-4%).
- People getting the vaccine will probably have some side effects. These side effects are not worse in pregnant people.
Side effects are a normal response by the immune system. These effects are more common after the second vaccine dose. They were not more common in pregnancy. The most common side effects are:
Muscle pain (~38%)
- Chills (~32%)
- Joint pain (~24%)
Of every 100-500 people who get a vaccine, one will get a high fever (over 102°F).
A persistent high fever during the first trimester might increase the risk of fetal abnormalities or miscarriage.
- The CDC recommends using acetaminophen during pregnancy if you have a high fever.
- The CDC recommends the COVID vaccine for all people 5 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future.
- The Society for Maternal-Fetal Medicine (SMFM) recommends that pregnant, postpartum, and lactating people and those considering pregnancy receive the COVID vaccine. Vaccination is the best method to reduce maternal and fetal complications of SARS-CoV-2 infection.
- The American College of Obstetricians and Gynecologists recommends that pregnant and lactating individuals be vaccinated against COVID.
- The American Society for Reproductive Medicine recommends the COVID vaccine for women who are contemplating pregnancy or who are pregnant in order to minimize risks to themselves and their pregnancy.
1. Make sure you understand as much as you can about COVID and about the vaccine.
Ask a trusted source, like your midwife or doctor.
Think About Your Own Personal Risk
Look at the columns below and think about your risk of getting COVID (left). Think about your safety – are you able to stay safe (right)?
| The risks of getting sick from COVID are higher if...
|| If you are not at higher risk for COVID and...
|You have contact with people outside your home
||You always wear a mask
|You are 35 years old or older
||You and the people you live with can physically distance from others for the whole pregnancy
|You are overweight
||Your family, friends, and community are all vaccinated
|You have other medical problems like diabetes, high blood pressure, or heart disease
||You have had a severe allergic reaction to a vaccine
|You are a smoker
|Your community has low vaccination rates
|You are a healthcare worker or you work outside your home
|If any of the above apply to you, it probably makes sense to get the vaccine.
||If any of the above apply to you, you might choose to wait to get the vaccine. You need to know that without the vaccine, you are at higher risk of severe illness from COVID.
Thoughts about this tool?
Was this decision aid helpful? Please take a moment to give us feedback about this decision aid.
Tell the CDC about your experience with the vaccine
If you decide to get the vaccine, you will get a “V-safe information sheet” with instructions about the V-safe website and app. Consider registering so we can better counsel people in the future.
This information is compiled and is updated by the shared decision-making working group. All sources and research that back up the information in this materials appear below and are specifically cited in the pdf decision aid.
Shared Decision-Making: COVID Vaccination in Pregnancy Working Group from the University of Massachusetts Medical School – Baystate.
Kathaleen Barker, MD, FACOG; Assistant Professor of Obstetrics and Gynecology, Medical Director of Informatics for Women’s Health, Associate Director of Obstetrics. Dr. Barker is a practicing obstetrician gynecologist and medical informaticist. She is a leader of obstetrical safety and quality programs at Baystate as well as a leader of digital innovations to support safe obstetrics care.
Fadi Bsat, MD: Associate Professor of Obstetrics & Gynecology, Chief, Maternal-Fetal Medicine. Dr. Bsat serves on the Board of Directors of the Society for Maternal Fetal Medicine and is Chair Elect of its Practice Management Division.
Ashley Deutsch, MD; Director of Quality and Patient Safety, Department of Emergency Medicine, Baystate Medical Center – Dr. Deutsch is a practicing emergency physician and a leader of quality improvement in the ED at Baystate as well as the Director of Telemedicine. She is currently breastfeeding.
Andrew Healy, MD; Assistant Professor of Obstetrics and Gynecology, Medical Director of Obstetrics, Division of Maternal-Fetal Medicine. Dr. Healy has an interest in quality and safety work. In addition to efforts to improve the care of patients at Baystate Medical Center, he serves on the Patient Safety and Quality Committee of the Society for Maternal Fetal Medicine, the Massachusetts Maternal Mortality and Morbidity Review Committee, and works closely with the Perinatal-Neonatal Quality Improvement Network of Massachusetts (PNQIN).
Elizabeth Morgan, MD, MS; Assistant Professor, Division of Maternal-Fetal Medicine. Dr Morgan is a practicing Maternal Fetal Medicine Physician with a background in biohazardous threat agents and emerging infectious diseases. Her research interests include health disparities and maternal prenatal stress, and their effects on fetal growth and development.
Corina Schoen, MD, FACOG; Assistant Professor of Obstetrics and Gynecology, Assistant Director of Obstetric Research; Division of Maternal-Fetal Medicine. Dr. Schoen is a practicing Maternal-Fetal Medicine physician with research interests in the field of labor induction and preterm birth. She is a mentor for both residents and faculty in obstetric research. She is currently breastfeeding.
Elizabeth Schoenfeld, MD, MS; Vice Chair of Research; Department of Emergency Medicine; Dr. Schoenfeld is a practicing emergency medicine physician, Shared Decision-Making researcher, and decision aid designer.
Liza Smith, MD; Assistant Professor of Emergency Medicine, Assistant Program Director and Clerkship Director for Emergency Medicine. Dr. Smith is a practicing emergency medicine physician. She has a focus on medical education and metacognition--how physicians think and make decisions--and its applications in residency education. She is currently pregnant.
Lauren Westafer, DO, MPH, MS; Assistant Professor of Emergency Medicine, Research Fellowship Director; practicing emergency medicine physician, implementation science researcher, currently pregnant.
- DeBolt CA, et al. Pregnant women with severe or critical COVID-19 have increased composite morbidity compared to
non-pregnant matched controls. Am J Obstet 2020 Nov doi: 10.1016/j.ajog.2020.11.022
- Adhikari EH, et al. Pregnancy outcomes among women with and without severe acute respiratory syndrome coronavirus
2 infection. JAMA Network Open 2020 Nov 3(11):e2029256
- DiMascio D, WAPM working group on COVID-19. Maternal and Perinatal Outcomes of Pregnancy Women with SARScoV-2 infection. Ultrasound Obstet Gynecol. 2020 Sept. doi: 10.1002/uog.23107.
- Centers for Disease Control and Prevention. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–October 3, 2020.
- Abbasi J. COVID-19 and mRNA Vaccines—First Large Test for a New Approach. JAMA. 2020;324(12):1125–1127.
- FDA Pfizer Briefing.
- FDA Moderna Briefing.
- CDC: ACIP Evidence to Recommendations for Use of Pfizer-BioNTech COVID-19 Vaccine under an Emergency Use Authorization (Accessed Dec 14, 2020)
- CDC Information about COVID-19 Vaccines for People Who are Pregnant or Breastfeeding. (Accessed March 10, 2021)
- SMFM statement on COVID vaccination in pregnancy
- ACOG: Vaccinating Pregnant and Lactating Patients Against COVID-19 (Accessed December 14, 2020)
- WHO: The Moderna COVID-19 vaccine: what you need to know.
- Mutambudzi M, Niedwiedz C, Macdonald EB, et al. Occupation and risk of severe COVID-19: prospective cohort study of 120 075 UK Biobank participants. Occupational and Environmental Medicine Published Online First: 09 December doi: 10.1136/oemed-2020-106731
- ABM: Considerations for COVID-19 Vaccination in Lactation