Tommy's PregnancyHub

The COVID-19 vaccine in pregnancy and breastfeeding

The UK’s mass vaccination programme is continuing with the Pfizer-BioNTech, Moderna and Oxford-AstraZeneca vaccines. Here, we explain what this means if you are pregnant, trying to become pregnant or are currently breastfeeding.
Image

Updated in line with The Joint Committee on Vaccination and Immunisation (JCVI) advice from 16th April 2021.

The Joint Committee on Vaccination and Immunisation (JCVI) updated their advice on 16th April 2021, stating that all pregnant women should be offered the COVID-19 vaccine as part of the UK roll out. They will be offered the vaccine at the same time as the rest of the population, based on their age and clinical risk group.

This means that anyone who is pregnant can make an individual decision about vaccination based on what is right for them. You don’t have to make that decision alone, and we would encourage you talk it through with your GP or midwife. They will be able to discuss with you the benefits and potential risks of vaccination, based on your personal situation.

Previously, the vaccine was only offered to pregnant women who are frontline health and social care workers or those who are extremely clinically vulnerable. The advice has been updated as the UK roll out has progressed. 

Key points 
  • If you are currently pregnant, you will be offered the COVID-19 vaccine at the same time as the rest of the population, based on your age and clinical risk group. This means you can make a decision based on your individual circumstances, supported by discussions with your midwife or GP. 
  • Pregnant women should be offered the Pfizer-BioNTech or Moderna vaccines where possible, after initial US trials on these types of vaccines showed no safety concerns. 
  • You can have the vaccine at any stage of pregnancy, but some may choose to wait until after 12 weeks but before the third trimester, when the risk of complications from COVID-19 may be higher.
  • You do not need to avoid becoming pregnant after having the vaccine. Depending on your individual situation, you may decide to delay trying for a baby until after you have been vaccinated. 
  • There is no evidence to suggest that COVID-19 vaccines will affect fertility.
  • There is no known risk in giving COVID-19 vaccines to women who are breastfeeding. Women who are breastfeeding should be encouraged to continue breastfeeding after being vaccinated. 
     

Is the COVID-19 vaccine safe for pregnant women?

Pregnant women were not part of the UK trial for the vaccines, therefore the safety information available is limited. A small number of women included in the UK trial became pregnant after receiving the vaccine and showed no causes for concern. 

Data has also been gathered from the US, where around 90,000 pregnant women were vaccinated, mainly with mRNA vaccines, such as Pfizer-BioNTech and Moderna. These results did not show any safety concerns and as a result, the JCVI advises that pregnant women in the UK should be offered the Pfizer-BioNTech or Moderna vaccines where possible.  

Until more research is done, it is not possible to say for sure that these vaccines are 100% safe in pregnancy. But there has been no evidence so far to suggest they are unsafe. Your midwife or GP can talk things through with you, to help you make a decision that is right for you. They can help you weigh any potential risks from the vaccine against the known possible complications from COVID-19. It may be reassuring to know that other non-live vaccines are routinely and safely offered to pregnant women. These include the flu jab and whooping cough vaccine, which can help protect you and your baby during pregnancy. 

There are plans to investigate the use of different COVID-19 vaccines in pregnancy, but none of these trials are running in the UK yet. 

Benefits of vaccination in pregnancy

Having a COVID-19 vaccine has been shown to help prevent serious complications from the COVID-19 infection.

Although most pregnant women experience mild symptoms of COVID-19, the risk of more severe complications increases in the third trimester. Women in their third trimester should pay extra attention to social distancing measures and seek support straight away if they are concerned about symptoms.

If you are a pregnant health or social care worker, having a vaccine will not change your occupational risk assessment. 

When in pregnancy can I have the vaccine?

The vaccine should work whatever the stage of pregnancy you are in. 

The first 12 weeks of pregnancy are most important for the baby’s development, so some women may choose to wait until after this to have their vaccination. 

Later in pregnancy, the risk of complications from COVID-19 increases and there is also a higher risk of the baby being born prematurely. Therefore, you may choose to have the vaccine before you enter the third trimester (28 weeks). 

If you are unsure, don’t be afraid to speak to your GP or midwife for more advice and reassurance.

Can I have the COVID-19 vaccine if I am breastfeeding? 

There is no known risk in having the COVID-19 vaccines if you are breastfeeding, so you will still be offered the vaccine.

It is important to be aware that there is no evidence to show that vaccine ingredients could pass to your baby through breast milk.

There is currently limited safety data for these specific vaccinations in breastfeeding. But there are many benefits to breastfeeding your baby, including protecting them against future infections. Therefore, women should be encouraged not to stop breastfeeding after vaccination. 

Should I have a COVID-19 vaccine before I become pregnant?

You do not need to avoid becoming pregnant after having the first dose of COVID-19 vaccine. Getting vaccinated before you become pregnant will help prevent COVID-19 infection and possible complications. Some people may choose to delay becoming pregnant until after they have had their first dose. This decision is personal to everyone and will depend on your individual circumstances. 

If you become pregnant after having only one dose of the vaccine, it is your choice whether to have the second dose after the recommended interval, or to wait until after 12 weeks of pregnancy.

I have had the first dose of COVID-19 vaccination, should I wait until after the second dose to try for a baby?

One dose of COVID-19 vaccination gives you good protection against infection, but it is thought that this is not long-lasting and may not protect you for the whole of pregnancy. 
If possible, we recommend that you complete the course of vaccination before you become pregnant.

You can discuss these risks with a doctor or your midwife, and you may want to use the RCOG and RCM decision tool to help you decide what to do next.

Does the COVID-19 vaccine cause fertility issues?

There is no evidence to suggest that COVID-19 vaccines affect fertility. For more information, visit the British Fertility Society (BFS) and Association of Reproductive and Clinical Scientists (ARCS).

Does the vaccine contain animal products? 

None of the vaccines that have currently been approved for use in the UK contain any beef, pork, gelatine or any other products derived from animals. If you are concerned about taking the vaccine because you are vegan or vegetarian, visit The Vegan Society or The Vegetarian Society websites.