When you’re an expectant or new parent, there are so many unknowns; when you’re also in the midst of a pandemic, the level of uncertainty rises to new heights. Every parent’s goal is to provide their little ones with the best chance at health and happiness, but it’s hard to determine what’s best for your family when you’re overwhelmed by a cacophony of opinions.

There are now two COVID-19 vaccines with Emergency Use Authorization (EUA) from the FDA. There are many questions about their efficacy and side effects, and pregnant and breastfeeding people have an additional set of concerns.

As a breastfeeding mother and physician, I certainly had many questions about the vaccines’ safety and effectiveness. Below are a few of the questions I had, along with the most common questions that have arisen in my practice when counseling pregnant or breastfeeding patients:

What are the two COVID-19 vaccines approved for use, and how are they different?

The two vaccines currently approved for use are the Pfizer-BioNtech mRNA vaccine and the Moderna mRNA vaccine. Both vaccines provide instructions to our cells on how to produce the spike protein on the surface of SARS-CoV-2 (the virus that causes COVID) that then activates our immune systems to produce antibodies against the virus.

The Pfizer vaccine is given in two doses 21 days apart and is approved for individuals 16 years and older. The Moderna vaccine is given in two doses 28 days apart and is approved for individuals 18 years and older.

What are the side effects of the vaccines?

Pain, swelling, and redness at the injection site are the most common local reactions. Chills, tiredness, and headache are the most common systemic reactions. Symptoms typically don’t last longer than a few days.

Does it matter which vaccine I get?

Both vaccines have similar efficacy and confer protection against SARS-CoV-2. Availability varies by region. Whichever vaccine you do receive you must ensure the second dose is the same type. No studies have been done on mixed product administration.

If I take the vaccine will my baby be exposed to it in utero or via breast milk?

The current vaccine trials did not include pregnant or breastfeeding people, so definitive information about transplacental or breast milk exposure is unknown. Given that the vaccines are not live vaccines and degrade very quickly, experts believe they’re very unlikely to pose any harm to a fetus or breastfeeding infant.

Are the vaccines approved for use in pregnant and breastfeeding individuals?

The American College of Obstetricians and Gynecologists (ACOG) recommends that the vaccine not be withheld from pregnant or breastfeeding people who meet the criteria for vaccination based on the Advisory Committee on Immunization Practices (ACIP) guidelines for vaccine administration.

Are pregnant or breastfeeding individuals at increased risk of side effects?

There are no indications that pregnant or breastfeeding people have a higher risk of experiencing side effects. Studies have shown that pregnant individuals who contract COVID-19 and are symptomatic are at higher risk of developing severe illness.

Will you take the COVID-19 vaccine?

Many patients want to know if I will take the vaccine. I did decide to be vaccinated and received my first dose two weeks ago. It was the best decision for my family, my community, and me.

When deciding on any health care intervention, it’s important to consider your individual health status and underlying medical conditions. If you have specific questions unique to your own health, make sure to discuss them with your primary health care provider. 

Resources:

Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States

Vaccinating Pregnant and Lactating Patients Against COVID-19

This information is for educational purposes only and does not constitute medical advice. Please reach out to your health care team with any questions.