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.

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.

The RCOG are recommending pregnant women to get their COVID-19 vaccination as it has been shown to be the best way to protect against the known risks of COVID-19 in pregnancy for both women and babies.

Each individual should consider this advice alongside the potentials risks and benefits of the vaccine to make an individual, informed decision. 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 and we have learned more about the vaccine. 

Key points 
  • The RCOG are recommending vaccination for anyone who is pregnant, to help protect against the known risks of COVID-19 in pregnancy.
  • 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 if you have questions or concerns.
  • 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 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.

The RCOG have a decision guide that can help you make your decision. 

COVID-19 vaccine Q&A 

Is the COVID-19 vaccine safe for pregnant women?

Pregnant women were not part of the initial UK trial for the vaccines, therefore the safety information available is limited. Public Health Scotland have recently reported that 4,000 pregnant women have received a vaccine (up until May) with no serious side effects recorded.

Real-world data from the US (where pregnant women have been vaccinated mainly with the Pfizer-BioTech and Moderna vaccines, have not raised any safety concerns. 

The JCVI advises that pregnant women in the UK should be offered the Pfizer-BioNTech or Moderna vaccines where possible.  

As the COVID-19 vaccines were not tested in pregnant women (like most medications) we do not know for sure that they work as well in pregnant women as they do other adults. But there is no reason to think they won't be effective or that pregnant women will have worse side effects.

COVID-19 vaccines do not contain ingredients that are known to be harmful to pregnant women or to a developing baby. 

The COVID-19 vaccines that we use in the UK are not 'live' vaccines and so cannot cause COVID-19 infection in you or your baby. 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. 

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.

The first COVID-19 vaccine study for women who are pregnant has been launched across the UK. Find out more about this research trial.

What are the side effects from COVID vaccines?

In people that are not pregnant, the vaccines are known to have mild and short-lasting side effects, such as a fever or muscle ache, lasting a day or two. Reports of serious side effects, such as an allergic reaction or clotting problems have been very rare. 

There have been rare reports of serious blood clots related to the AstraZeneca vaccine. But this is not as relevant for pregnant women now because the JCVI recommends that you have the Pfizer-BioNTech or Moderna vaccine.

If you have had had a first dose of the AstraZeneca vaccine you should have the second dose of the same vaccine. There have been no reported concerns with the AstraZeneca vaccine and you are are not neccesarily at a higher risk of the type of blood clot reported as a very rare side effect just because you have a higher risk of other types of blood clots in pregnancy. 

Contact your GP or maternity team if you are concerned about any symptoms after vaccination. 

Should I have the COVID-19 vaccine?

COVID-19 vaccines are recommended in pregnancy and all pregnant women over the age of 18 have been offered the vaccine. Ultimately, it is your decision whether to have the vaccination in pregnancy. Make sure you understand as much as you can about COVID-19 and the vaccine before you decide. Your midwife or GP may be able to answer any questions or concerns.

Benefits of vaccination in pregnancy

COVID-19 vaccinations are recommended during 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

Studies have also shown that pregnant women with symptoms of COVID-19 are twice as likely to have their baby born early. If a baby is born prematurely, this can carry it's own risk for the baby. A recent study has also found that pregnant women who tested positive for COVID-19 at the time of birth were more likely to develop pre-eclampsia, more likely to need an emergency caesarean and their risk of stillbirth was twice as high (although the actual number remains low).

Potential benefits include reducing the risk of: 

  • severe symptoms for the pregnant woman
  • pregnancy complications that can affect the baby
  • passing the infection on to vulnerable household members. 

When in pregnancy can I have the vaccine?

You can have the vaccine whatever 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, although there has been no evidence to support this. 

One dose of COVID-19 vaccination gives you good protection against infection, but this may not be long-lasting​ through the whole pregnancy. 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 it is recommended that anyone who is pregnant tries to complete the course of vaccination before the third trimester (28 weeks). Doses are between 8 and 12 weeks apart. 

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? 

The Royal College of Obstetricians & Gynaecologists recommend that you do not stop breastfeeding in order to get vaccinated. 

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. 

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

You do not need to avoid getting pregnant after vaccination. 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.

Does the COVID-19 vaccine cause fertility issues?

There is no evidence to suggest that COVID-19 vaccines affect fertility. You can have the COVID vaccine during IVF treatment.

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.

Is there any more information that can help me make my decision?

Vaccination is recommended in pregnancy, but ultimately it is your decision. The Royal College of Obstetricians & Gynaecologists have provided more resources to help you decide:

Information leaflet and decision aid on Covid-19 vaccination in pregnancy

UK Teratology Information Service (UKTIS) monograph on non-live vaccination in pregnancy

Public Health England information for women of childbearing age, currently pregnant, planning a pregnancy or breastfeeding

What is the advice about going to work if I am pregnant and have been vaccinated?

The government's advice for pregnant employees states that employers must carry out a risk assessment for pregnant employees, taking into consideration the RCOG/RCM Guidence on coronavirus in pregnancy

Your employer should carry out a risk assessment whether you are vaccinated or not.