KEY POINTS
- Impact from the transmission of SARS-CoV-2, the virus that is causing the COVID-19 pandemic, includes prioritizing pregnant individuals at high risk and will require a number of strategies for prevention, including immunization.
- The COVID-19 vaccine should not be withheld from pregnant and lactating people who choose to be vaccinated.
- For those pregnant and lactating individuals who may be concerned regarding the unavailability of further safety data, a conversation with their healthcare provider may help them with decision-making process but is not required prior to vaccination.
- Pregnant and lactating individuals who receive the vaccine are encouraged to enroll in safety monitoring systems such as the CDC’s V-safe program which is a smartphone-based, after-vaccination health checker.
- The Federal government and pharmaceutical companies should work together to enroll pregnant and lactating women in clinical trials and ensure surveillance studies monitor vaccination within individuals expected to receive it.
A full statement of COVID-19 Vaccination and Pregnant and Lactating People
COVID-19 vaccination efforts are moving forward quickly and new information and data regarding special populations, including pregnant and lactating people, will continue to emerge. While we expect that demand for the Pfizer-BioNtech mRNA vaccine (BNT162b2) and Moderna COVID-19 vaccine will exceed supply during the first months of the national COVID-19 vaccination campaign, the vaccine should not be withheld from pregnant and lactating women who choose to be vaccinated. This guidance is in line with the Centers for Disease Control and Prevention (CDC) and The American College of Obstericians and Gynecologists (ACOG) as is supported by the following:
- mRNA vaccines do not contain the live virus that causes COVID-19 disease and, therefore, an individual cannot become infected.
- mRNA vaccines do not interact with an individual’s DNA as it is degraded quickly by normal cellular processes and does not enter the nucleus of the cell, so cannot cause any genetic changes. Therefore, experts do not believe there will be an increased risk to pregnant or breastfeeding individuals.
While the actual risk is still unknown because these vaccines have not been studied in pregnant people, these studies are currently planned. However, as vaccine supply improves, it is recommended that COVID-19 vaccines should not be withheld from pregnant individuals who meet criteria for vaccination based on ACIP-recommended priority groups. For those who may be concerned regarding the unavailability of further safety data, a conversation between pregnant patients and their healthcare provider may help them decide whether to get a vaccination that has been authorized for use under Emergency Use Authorization (EUA). In these conversations, the level of COVID-19 transmission within the community and an individual’s risk of complications should be considered. While these conversations may be helpful in balanced and shared decision-making, it is not required prior to vaccination.
Since our inception, March of Dimes has promoted both domestic and global vaccine programs and advocated for federal and state funding to support full vaccination of children and pregnant people in according with CDC’s recommendation. In support of the national COVID-19 vaccination campaign we also urge the following:
- The Department of Health and Human Services must to work with Pfizer, Moderna and other companies to enroll pregnant and lactating people in safety and immunogenicity clinical trials without delay.
- The FDA, CDC and pharmaceutical companies must ensure surveillance studies commence soon that monitor vaccination during pregnancy and for lactating people within the population expected to receive the vaccine under the EUA.
- Pregnant and lactating women who receive the vaccine are encouraged to use the CDC’s V-safe program which is a smartphone-based, after-vaccination health checker. Alternatively, they can utilize other robust systems and data sources to conduct ongoing safety monitoring. We also encourage pregnant women to engage in pregnancy research registries. More information is available here: March of Dimes and Society for Maternal-Fetal Medicine.
- All eligible pregnant women should complete their full immunization schedule recommended by the CDC and are urged to get their flu shot.
March of Dimes also remains concerned that individuals of color are not only more likely to have severe illness and die from COVID-19, but do not have same degree of vaccine confidence as other populations. We will continue to advocate, as we’ve always done, for a number of policy and programmatic efforts to address the systemic and historic inequities that have eroded this trust. We are also proud to have recently awarded research grants to study the effects of COVID-19 on maternal and infant health through donations to our March of Dimes COVID-19 Intervention and Support Fund.