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Ask the Pediatrician: COVID-19 vaccines during pregnancy and breastfeeding

A question I commonly get from patients and friends is this: Should I get a COVID vaccine if I’m pregnant or want to become pregnant?

I asked myself that same question, and the answer is yes.

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My husband and I got our COVID-19 shots a few months before I got pregnant, and I got another COVID-19 shot during my pregnancy.

I am one of the hundreds of thousands of pregnant people living in the U.S. who got vaccinated around pregnancy, and I had a beautiful baby girl in February 2022.

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It’s natural to pause to think about a decision that affects not only yourself but also another person. I decided to get a COVID-19 booster shot when I became eligible during my second trimester. I knew that it would be beneficial to my health and the health of my newborn.

If you have questions or want to learn more about COVID-19 vaccination and pregnancy, I suggest you talk with your pediatrician or obstetrician. You’ll feel better knowing that you are making an informed decision.

Here are some answers to questions I’m frequently asked.

If I get a COVID vaccine during pregnancy, does it also protect my baby too?

Yes. Immunization during pregnancy allows your body to create antibodies that can be passed along to protect your baby.

Infants are recommended to start receiving COVID-19 vaccination themselves at age 6 months. Until then, immunization when you’re pregnant helps your immune system and your baby’s immune system.

We also now know that getting sick with COVID while pregnant can increase the risk of miscarriage or stillbirth. Vaccination helps protect you and your baby from the most serious outcomes of COVID illness.

What if I am on the fence and am thinking about waiting?

Waiting to get the COVID vaccine is risky. COVID-19 immunization is effective and helps prevent serious illness or hospitalization from COVID. Vaccination also helps decrease risk of long COVID (symptoms and conditions that can last weeks, months, or years after getting COVID).

If you get COVID while you are pregnant, you can become seriously ill. Getting sick with COVID can lead to a higher risk for miscarriage, pre-term birth, stillbirth and death. More than 29,000 pregnant people have been hospitalized with COVID and hundreds have died, according to the CDC.

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The benefits of the vaccine during pregnancy continue when you become new parents. I have seen some of the families I care for become so sick from COVID that they are unable to be with or care for their newborn. It is devastating. I encourage anyone who is on the fence to talk to their pediatrician or other medical experts.

Have vaccines been studied in pregnant people?

COVID-19 vaccination during pregnancy has been studied for years. Doctors and scientists have been monitoring pregnant people who received the vaccine, and more information confirming its benefits arrives all the time.COVID-19 vaccine safety has been monitored in tens of thousands of pregnant people. The Centers for Disease Control and Prevention, the Food and Drug Administration and other advisory groups continue to monitor safety.

The Vaccine Safety Datalink, the CDC and several health care organizations across the U.S. monitor and evaluate the safety of vaccines among pregnant people who choose to get vaccinated.

What about vaccines and fertility?

Thousands of people who have received COVID immunizations have gone on to get pregnant. A study of more than 2,000 females aged 21-45 years and their partners found that immunization of either partner did not affect the likelihood of becoming pregnant. And studies in men who were immunized show that sperm does not change afterwards.

Can I breastfeed after getting a COVID vaccine?

Yes. You can safely breastfeed after the vaccine. We are learning that protective antibodies can pass to the baby through breastmilk. I was comforted knowing that I passed along some immunity to my daughter through breastfeeding. This is one way I protected her until she became old enough to be immunized against COVID herself.

If you received a COVID vaccine while pregnant or breastfeeding, the American Academy of Pediatrics recommends the COVID vaccine for your baby when they turn 6 months old. That’s because the immunity you passed to your baby from the vaccine wears off over time. Also, COVID shots are periodically updated to incorporate protection from newer strains of the virus. My husband and I got the 2023-2024 updated COVID-19 shot, and we chose it to update protection for our now nearly 2-year-old daughter as well.

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Many pediatrician offices offer or will soon offer 2023-2024 updated COVID vaccines for babies, kids and teens. Contact your pediatrician’s office to find out the best time to schedule your child’s appointment. To find COVID vaccines for adults, visit vaccines.gov.

COVID-19 vaccination is transitioning toward more traditional pathways for getting and paying for health care. Look to find a location that carries the type of COVID vaccine you are eligible for and that accepts your health insurance/coverage. There are programs to assist those who are uninsured and underinsured. Most people still should not have to pay for the vaccine.

If you have other questions about receiving the COVID vaccine while pregnant, talk to your obstetrician or pediatrician. Having a conversation with a health care professional you trust can help you make the best c hoice.

For more information, go to HealthyChildren.org.

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Lisa M. Costello, MD, MPH, FAAP, is an Assistant Professor in the Department Pediatrics at West Virginia University (WVU) and a Pediatric Hospitalist at WVU Medicine Children’s Hospital. She is immediate past president of the West Virginia Chapter of the American Academy of Pediatrics as well as the West Virginia State Medical Association. She is also an advisor to the WV Department of Health and Human Resources Bureau for Public Health and serves as the medical lead for the Joint Information Center within the West Virginia Joint Interagency Task Force on COVID-19 and public health matters.


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