On Friday the U.S. Food and Drug Administration (FDA) issued the first emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine to be used on people 16 and older in the United States. As the proposed timeline for distribution for the vaccine for adults begins to become clearer, the Centers for Disease Control and Prevention (CDC) also shared their guidance on the use of the vaccine for special populations — including pregnant and breastfeeding people.
For Pregnant Individuals
Though the data on pregnant people shows that their absolute risk is low, per the CDC, there is an increased risk of these patients becoming severely ill (meaning potentially being admitted to an ICU, needing mechanical ventilation) if they do get COVID-19 or an increased risk of preterm birth or other adverse pregnancy outcomes. They note that while there’s no available data on pregnant people receiving any of the COVID-19 vaccines being tested right now — including the Pfizer-BioNTech vaccine — studies on this demo are planned.
As for safety, these vaccines are believed to be “unlikely to pose a risk for people who are pregnant” because they are mRNA vaccines. Per the CDC, unlike other vaccines which put “a weakened or inactivated germ into our bodies” to trigger an immune response, mRNA vaccines instead “teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects us from getting infected if the real virus enters our bodies.”
So, based on this working knowledge, the agency says that pregnant people who are “part of a group that is recommended to receive a COVID-19 vaccine (e.g., healthcare personnel)” can choose to be vaccinated.
“A conversation between the patient and their clinical team may assist with decisions regarding the use of vaccines approved under EUA for the prevention of COVID-19. While a conversation with a healthcare provider may be helpful, it is not required prior to vaccination,” per the CDC. “When making a decision, pregnant people and their healthcare providers should consider the level of COVID-19 community transmission, the patient’s personal risk of contracting COVID-19, the risks of COVID-19 to the patient and potential risks to the fetus, the efficacy of the vaccine, the side effects of the vaccine and the lack of data about the vaccine during pregnancy. Pregnant people who experience fever following vaccination may be counseled to take acetaminophen as fever has been associated with adverse pregnancy outcomes. Acetaminophen may be offered as an option for pregnant people experiencing other post-vaccination symptoms as well. There is no recommendation for routine testing before receipt of a COVID-19 vaccine. Those who are trying to become pregnant do not need to avoid pregnancy after Pfizer-BioNTech COVID-19 vaccination.”
For breastfeeding and lactating people
The agency notes that there is also not yet data on the “safety of COVID-19 vaccines in lactating people or the effects of mRNA vaccines on the breastfed infant or milk production/excretion.” Like with pregnant people, they note that mRNA vaccines are not thought to lead to be a risk to breastfed infants.
So they state that lactating people who are also included in the recommended demographics for vaccination can opt in for it.
The CDC’s guidelines are also in line with the messaging dropped by the American College of Obstetricians and Gynecologists (ACOG) over the weekend: “ACOG recommends that COVID-19 vaccines should not be withheld from pregnant individuals who meet criteria for vaccination based on ACIP-recommended priority groups. COVID-19 vaccines should be offered to lactating individuals similar to non-lactating individuals when they meet criteria for receipt of the vaccine based on prioritization groups outlined by the ACIP. Individuals considering a COVID-19 vaccine should have access to available information about the safety and efficacy of the vaccine, including information about data that are not available. A conversation between the patient and their clinical team may assist with decisions regarding the use of vaccines approved under EUA for the prevention of COVID-19 by pregnant patients.”
Before you go, check out our pregnancy bed rest essentials: