The COVID-19 Vaccine And Pregnancy

By Chelsea Hughes, MD,
McLeod OB/GYN Dillon
McLeod Health and leading OB medical societies, including the American College of Obstetricians & Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM), recommend that all pregnant women receive the COVID-19 vaccine.

Evidence has shown the vaccine to be both safe and effective, based on reports of tens of thousands of individuals.
Unvaccinated pregnant women are at an increased risk of developing severe COVID-19 symptoms, which include but are not limited to, pregnancy complications, such as pre-term birth, ICU admission and maternal death.
The Delta variant appears to affect pregnant women much more severely than the original COVID-19 virus.
Before Delta became the more predominant variant strain, fewer pregnant patients had severe symptoms. They typically had mild-to-moderate, cough/cold symptoms.
Now that Delta is the predominant variant, more of these patients are developing severe symptoms and ending up in the Intensive Care Unit (ICU). With this strain, pregnant women have up to twice the increased risk of death, up to twice the risk of needing ICU admission and up to three times the need for invasive measures to help save their lives, such as ECMO (or life support).
Vaccinated pregnant patients can avoid the infection, the severe symptoms, the adverse effects of the virus itself and the long-term complications. In some cases, patients develop severe COVID-19 symptoms and must deliver as early as 30 to 32 weeks so that care teams can more effectively manage the patient. Ultimately again, the decision to be vaccinated relies on the patient.
The vaccine does not increase a pregnant woman’s chance of fetal loss. There is a certain unfortunate number of women who will have loss of their baby in pregnancy.
The vaccine itself does not increase that rate, but COVID-19 itself could. In addition, there is no evidence of any negative impact on fertility by the COVID-19 vaccine.
The best way a mother can protect her unborn is to give them passive immunity by receiving the COVID-19 vaccine while pregnant. The mom will develop an immune response, and her antibodies – and only her antibodies – will pass through the placenta down to baby.
With the vaccine, the risks themselves are no different than they would be for non-pregnant women or for anyone else in the population, such as muscle tenderness and pain, headaches, general malaise, overall ill feeling just after receiving vaccinations. These are very similar to the symptoms you would have after your flu vaccine or tetanus shot.
We have not found that there is any timeframe or trimester that is more beneficial or less beneficial. Ultimately, when a mother makes the decision to get the vaccine, getting it as soon as possible is always best.
For mothers who get the vaccine while breastfeeding, they can be assured that the vaccine is still helping the newborn. The antibodies created by the vaccine are passed through the mother’s breast milk. This is another good way to provide passive immunity to babies. Receiving the vaccine at any point during postpartum breastfeeding gives some protection for the baby.
If you are pregnant or breastfeeding and want to know more about the vaccines, please talk with your OB. Even after being fully vaccinated, pregnant and postpartum mothers should continue to take necessary precautions including wearing a mask and social distancing.
Dr. Chelsea Hughes received her medical degree at University of Texas Medical Branch in Galveston, TX. She completed her residency at University of Texas at Houston School of Medicine. To schedule an appointment with Dr. Hughes, please call 843-841-3825.

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