One of the biggest questions for those that are pregnant or lactating right now is if they should get the COVID vaccine while pregnant or lactating. This can be a very difficult question to answer since the vaccine was not studied in pregnant or lactating women. I wanted to put together this blog post for those of you looking for resources to weigh your decision and have them all in one place. It is important to remember that all of us need to make this decision based on what is right for your family. Every family’s situation is unique and the risks/benefits need to be weighed in order to make your own personal decision. This blog post is written to simply give you the resources you need to help you in your decision making. At the very end I will link out to studies or registries that are currently available if you decide to get the vaccine. These are especially important in collecting data from those of us who are choosing to get the vaccine and put together that much needed research we need.
UPDATED INFO AS WE GET IT WILL BE ADDED TO THE BOTTOM OF THIS POST!
How do mRNA vaccines work?
mRNA vaccines are NEW but the research behind them is not. Researchers have been studying them for decades and early stage clinical trials have been carried out in the past. You can read more about that here. The vaccine contains messenger RNA (mRNA) that is encapsulated by a lipid nanoparticle for delivery into host cells. The vaccine utilizes the body’s own cells to create the coronavirus spike protein which then stimulates your immune system to create antibodies against COVID-19. It is important to note that mRNA vaccines are NOT live virus vaccines. These mRNA vaccines will NOT alter your DNA (Advances in mRNA Vaccines & Developing mRNA-vaccine technologies).
ACOG | American College of Obstetricians and Gynecologists
“ACOG recommends that COVID-19 vaccines should not be withheld from pregnant individuals who meet criteria for vaccination based on ACIP-recommended priority groups. 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. “
“ACOG recommends COVID-19 vaccines 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. While lactating individuals were not included in most clinical trials, COVID-19 vaccines should not be withheld from lactating individuals who otherwise meet criteria for vaccination. “
In a nutshell, making an informed decision based off a risk vs. benefit conversation with your provider is recommended.
SMFM | Society for Maternal Fetal Medicine
“In general, SMFM strongly recommends that pregnant women have access to COVID-19 vaccines in all phases of future vaccine campaigns, and that she and her healthcare professional engage in shared decision-making regarding her receipt of the vaccine.”
“Healthcare professionals should also counsel their patients that the theoretical risk of fetal harm from mRNA vaccines is very low.”
ACOG & SMFM response to the WHO recommendations for the vaccine in pregnancy | in a nutshell, nothing changes from what they have already recommended above.
CDC | Center for Disease Control
“People who are pregnant and part of a group recommended to receive COVID-19 vaccine, such as healthcare personnel, may choose to be vaccinated. A conversation between pregnant patients and their clinicians may help them decide whether to get vaccinated with a vaccine that has been authorized for use under Emergency Use Authorization (EUA).”
“There are no data on the safety of COVID-19 vaccines in lactating women or on the effects of mRNA vaccines on the breastfed infant or on milk production/excretion. 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.”
ABM | Academy of Breastfeeding Medicine
“During lactation, it is unlikely that the vaccine lipid would enter the blood stream and reach breast tissue. If it does, it is even less likely that either the intact nanoparticle or mRNA transfer into milk. In the unlikely event that mRNA is present in milk, it would be expected to be digested by the child and would be unlikely to have any biological effects.
“While there is little plausible risk for the child, there is a biologically plausible benefit. 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.”
ASRM | American Society for Reproductive Medicine
“COVID-19 vaccination is recommended for women who are contemplating pregnancy or who are pregnant in order to minimize risks to themselves and their pregnancy.”
“The Task Force does not recommend withholding the vaccine from patients who are planning to conceive, who are currently pregnant, or who are lactating.”
All of these reputable groups suggest that the decision to receive/not receive the vaccine should be a case by case basis that involves a discussion with one’s provider.
With regards to infertility/pregnancy, preliminary results in rats show that it is safe thus far. You can read about this on pages 44-45 here.
“A combined developmental and perinatal/postnatal reproductive toxicity study of mRNA-1273 in rats was submitted to FDA on December 4, 2020. 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.”
Other tidbits of information/more resources below:
“Leaders in Women’s Health Encourage Healthcare Workers to Receive the COVID-19 vaccine” – written by all of the top leaders that I mentioned above! Very informative!
This decision making tool is great for those of you that are pregnant and want to see if the COVID-19 vaccine may be for you.
Moderna mentioned this week that its vaccine does produce neutralizing antibodies (study is not peer reviewed yet) for the UK and South African variants, but it is less effective against the latter. It will be exploring a possible booster shot that would increase efficacy against emerging variants that we are seeing globally.
If you received your COVID vaccine and you are PREGNANT, LACTATING or TRYING TO GET PREGNANT, opt into this registry here! This is a research study that is going to ask you some questions (takes about 20 minutes) and then they will follow-up if / when needed to gather more information! If you are nursing, they will ask you if you would be okay with donating some of your milk to test for antibodies 🙂
Mother to Baby is currently enrolling in some studies – fill out this form HERE if you are trying to conceive, currently pregnant or breastfeeding and received the vaccine.
Mother’s Milk Study out of UCSD is currently full (this is the one I am in) but will be accepting more participants March 1st. You can also email firstname.lastname@example.org to the study coordinators if you have any other questions. They are also accepting donations to help fund the study. You can donate HERE and in the notes section, write “Mommy’s Milk Study”)
Calling all pregnant women <10 weeks! This study is following women all the way through their pregnancy – This UCSF Aspire study is a nationwide prospective cohort study of pregnant women and their offspring during the COVID-19 pandemic.
If you are PREGNANT and received the MODERNA vaccine: There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to Moderna COVID‑19 Vaccine during pregnancy. Women who are vaccinated with Moderna COVID‑19 Vaccine during pregnancy are encouraged to enroll in the registry by calling 1‑866‑MODERNA (1‑866‑663‑3762)
My Vaccine Story Update
I am now three weeks POST my second shot! I pumped my last sample of milk for the study last week and will be shipping all the samples out this week! I am so excited! We won’t have results for a little while but I am really optimistic!
As for symptoms after my vaccine doses…..
I had no side effects after the first dose.
After the second dose, I had about 36 hours of fever up to 102, body aches and fatigue. It started 12 hours post vaccine. I took Tylenol and Motrin at the 24 hour mark and felt significantly better after that. I would absolutely get the vaccine again despite having some pesky side effects that were completely gone by day 3. I also think I had COVID in the past which is why I may have had a stronger reaction. I know many that have had zero side effects! However, I always want to be 100% transparent and tell you what I experienced personally.
Link to our story with COVID here
We have our first known case of an infant with SARS-CoV2 IgG antibodies detectable in cord blood after maternal vaccination! This is not peer reviewed yet but I am HERE FOR IT! 🙂
Mom to baby transmission of antibodies | this post written by one of my favorite epidemiologists talks about 3 studies that have proven that mom does transmit antibodies of Sars-CoV-2 to her baby in most cases