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COVID-19 vaccination and pregnancy

Information for women who are pregnant, breastfeeding or thinking about becoming pregnant, and who have been offered the COVID-19 vaccination.

All pregnant women over the age of 18 in the UK have now been offered a COVID-19 vaccine. This is because, although the initial large trials did not include pregnant women, we have now seen large amounts of data from the USA and from Scotland that have shown no safety problems from giving the vaccine to pregnant women. In addition, we now know that pregnant women are at higher risk of becoming severely unwell if they do catch COVID-19, with some needing admission to intensive care. There is also an increased risk of your baby being born prematurely.

The recommendation is that pregnant women are offered the Pfizer or Moderna vaccines in preference to the Oxford AstraZeneca. This is because the safety data from the USA on using the vaccination in pregnancy was all using those two vaccines. In addition, in the UK, the Oxford AstraZeneca (AZ) vaccine is not now recommended for people under 40 due to a small risk of a rare blood clotting issue. This risk is not thought to be any higher for pregnant women having the AstraZeneca vaccine, so if you have already had your first dose of AZ (for example, before you became pregnant) then you should have your second dose of AZ as planned.

It is recommended that you have the vaccination, but it is entirely your decision whether you have it or not. This information explains the potential risks and benefits so that you can decide whether or not to go ahead, or if you want to wait for more information to become available.

We know that the vaccinations are very effective at preventing severe illness and death from COVID-19 because of the large trials done before their introduction. We also know from these trials that the vaccines meet very strict safety criteria.

Pregnant women are at increased risk from severe illness and needing to go into hospital if they get COVID-19. This is particularly true in the third trimester (towards the end of pregnancy). Pre-term birth is also more common in those with COVID-19 than those without. The vaccine provides protection from these risks.

The COVID-19 vaccine is called a ‘non-live’ vaccine, which means that it does not contain any of the actual whole virus. It contains only a small part of the virus designed to help the body’s immune system recognise it in future and prevent it infecting someone. This means that you cannot get COVID-19 from the vaccine itself.

The COVID-19 vaccines have not yet been specifically through large-scale trials in pregnant women, which means we cannot definitely say that we are 100% sure there are no pregnancy-specific down-sides to the vaccination, or that the vaccine works exactly as well in pregnancy.

However, we do know:

  • None of the ingredients in the vaccine are harmful in pregnancy.
  • We have lots of experience of giving non-live vaccines in pregnancy (like the flu and whooping cough vaccines). This information from the hundreds of thousands of pregnancies tells us they are safe.
  • Although the vaccine was not specifically tested in pregnant women, during the trials there were people who discovered they were pregnant after having the vaccine or became so shortly afterwards. Information from these cases has shown there are no safety concerns or harm to the pregnancy.
  • Detailed data from over 130,000 pregnant women in the USA who have had the vaccine have shown no problems or safety concerns.
  • Like all vaccines, the COVID-19 vaccine can have mild side effects such as a sore arm or a slight fever. However, these do not affect pregnancy.

There is no need to avoid becoming pregnant after having had the COVID-19 vaccine (this is according to the Joint Committee on Vaccination and Immunisation).

There is no evidence that the COVID-19 vaccine has any effect on your fertility or the ability to get pregnant, and experts have no concerns about fertility and the vaccine. This is because we understand the way vaccines work in the body, and we also have lots of evidence from using similar vaccines that they have no effect on fertility.

Yes, you can. Though there have not been specific studies done yet on these particular vaccines on women who are breastfeeding, we know that there are no known risks associated with giving non-live vaccinations in breastfeeding. The benefit is that you are protected from COVID-19 infection. If you are unsure or want more information, ask your health care provider (such as a midwife, GP or obstetric doctor) to discuss the relative risks and benefits for you.

If you are uncertain or unsure, you can always contact your doctor/GP, nurse or midwife to talk about your particular circumstances and what the risks and benefits are for you.

If you are looking online for information, be careful to only use reliable sources such as gov.uk or NHS websites. There is a lot of misinformation online, particularly on social media, which can be worrying and confusing. This isn’t helpful when you are trying to make a decision.