Current research suggests that people who are pregnant are at increased risk of severe symptoms, including illness that could result in hospitalization and death if they get COVID-19. Now, with the rollout of COVID-19 vaccines, pregnant people might be wondering if they should protect themselves through vaccination or take their chances against the COVID-19 virus. We spoke with Dr. Nathaniel G. DeNicola, a board certificated OB-GYN with Johns Hopkins Medicine about what pregnant people need to know to keep themself and developing baby well during this time.

Dr. Nathaniel G. DeNicola, OB-GYN with Johns Hopkins Medicine Dr. Nathaniel G. DeNicola, board certificated OB-GYN with Johns Hopkins Medicine

COVID-19 and Pregnancy

“We have seen that pregnant women do seem to be more susceptible to severe cases of COVID-19 than non-pregnant women. This is common for many other respiratory infections as well,” Dr. DeNicola explained. “The reason for this is that mom’s immune system is relatively weakened during pregnancy because there's so many physical and psychological demands.”

This is why it is especially important for pregnant women to take every protective measure they can to prevent illness. Maintaining social distance and good hand hygiene are important steps toward this goal. Dr. DeNicola also recommends that, since there are varying degrees of protection given depending on how a face mask is worn, pregnant people may want to talk to their healthcare provider about further protective options, such as a KN-95 mask, double masking, and avoiding a single layer, loose-fitting cloth face covering. 

It is also crucial that pregnant women continue to attend all scheduled doctor appointments. “The COVID-19 emergency response has revealed an advantage to telehealth that was simmering for a while but was accelerated by the pandemic. There are now protocols where pregnant women can have their prenatal schedule revised so they can maintain the same number of visits with their healthcare provider, but they can limit the number of in-person visits if need be. Virtual visits can’t entirely replace in-person care of course, but they can be a helpful tool to keep pregnant women as safe as possible during this time,” Dr. DeNicola advised.

If a pregnant woman does get COVID-19, in the majority of cases, supportive care and observation will be all that's required. Taking acetaminophen (Tylenol) is a safe way for pregnant women to ease symptoms like fever or muscle pain. For women who also struggle from other common respiratory conditions, like asthma, additional medication, like inhalers, may be prescribed. But, according to Dr. DeNicola, soon-to-be mothers can breathe easy when it comes to worrying about infecting their unborn child, “overall, it doesn't appear that COVID-19 crosses the placenta, so it does not appear to effect the fetus,” he said.

Vaccine Safety for Pregnant Women

The release of the COVID-19 vaccine offers an increased protective opportunity, especially for those who are pregnant and other groups at high risk for severe illness. The mRNA vaccine trials, such as Pfizer and Moderna, deliberately excluded pregnant or breastfeeding individuals, so our current knowledge is limited. However, 18 people who participated in the vaccine trails later became pregnant. Pfizer and Moderna have begun Phase 2 and 3 clinical trials into the topic. These studies will monitor 4,000+ healthy women between 24 and 34 weeks of gestation as they receive two doses of the vaccine. It will assess the safety and effectiveness for not only the mothers but the infants as well. 

Until these findings are available, we must rely on the current COVID-19 vaccine findings which have led most doctors to recommend that every individual, pregnant or not, receive the vaccine when it is available to them. 

“Pregnant women do have the option to get the vaccine which is a way of saying there we are not concerned about the risks,” Dr. DeNicola explained. “There are many things that we do not recommend for pregnant women, such as alcohol, tobacco or even sushi. Currently the COVID-19 vaccine is not on this list.” This is because mRNA vaccines do not contain the live virus that causes COVID-19 so they cannot give someone COVID-19. We also know that mRNA vaccines do not interact with a person’s DNA because the mRNA does not enter the cell’s nucleus. So, based on how mRNA vaccines work, experts believe they are unlikely to pose a specific risk for pregnant women, especially when comparing to the risk of becoming severely ill from COVID-19. 

What to Consider Before Getting the COVID-19 Vaccine

The Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine all agree that the new mRNA COVID-19 vaccines should be offered to all eligible pregnant and breastfeeding women. But before doing anything, you should discuss possible risks with your healthcare provider. “Currently we understand that it's a thousand-fold better to get the vaccine than to get the virus in terms of risk. Particularly for pregnant women who work in healthcare, getting the vaccine should be strongly considered,” said Dr. DeNicola. 

Vaccination side-effects have been well documented and can occur after receiving any of the available COVID-19 vaccines, but these side-effects are not any different for pregnant people and non-pregnant people. Once again, it is recommended that pregnant individuals monitor their symptoms and take acetaminophen for fever or pain if needed, which is safe for both them and the fetus, to combat any side-effects. 

Dr. DeNicola is a strong supporter of the vaccine and believes there are real advantages for pregnant women to consider.

“Along with the choices to either get the vaccine or get the virus, some people think there is a third option which is ‘I'm going to be careful and just not get either’,” he said. “Though you may be able to sustain that for a little while, if we see more surges or spikes like we have at various times during this pandemic, then the threshold to get the vaccine should really lower among people who have regular activity that involves any interaction with the public. This is because, in certain areas, if the infection rate becomes very dense, no matter how careful you are you may not be able to avoid it. That is just one more reason that I would suggest that anyone who is able should get the vaccine.”

To learn more about the COVID-19 vaccine, visit our Vaccine Tracker.

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