Pregnant, breastfeeding women cleared to get vaccine; Covid heightens adverse outcomes for infants and mothers

The Centers for Disease Control and Prevention updated its guidance for pregnant and breastfeeding women Wednesday, strongly encouraging them to get vaccinated against Covid-19. 

The guidance comes on the heels of a CDC analysis of existing safety data, finding no increased risk of adverse birth outcomes after women received at least one dose of the Pfizer or Moderna vaccine. There’s no evidence either vaccine adversely affects fertility in men or women.

RELATED: FDA approves Covid booster for immunocompromised individuals


Only about 23% of pregnant women have been vaccinated, according to CDC data, about half the rate of the general population. 

More than 147,000 pregnant vaccinated women are enrolled in a CDC study, so far resulting in more than 10,000 births. There is no evidence the vaccines (Covid-19 or otherwise) increase risks to the fetus. Not getting vaccinated poses a far graver threat. 

Pregnant women are three times more likely to develop a serious illness with Covid-19, explained Dr. Amelia Sutton, a Novant Health maternal fetal medicine specialist. “​​Covid and pregnancy poses extraordinary risk,” she said in a joint press call Friday. “There’s no question that the vaccine should be offered and given to pregnant women.”

Getting the vaccine is safe at any stage of pregnancy, Sutton said, indicating waiting until later is not recommended: Babies developing in the third trimester are especially vulnerable to adverse effects caused by a mother’s reduced respiratory capacity because of the way their lungs develop. 

“It’s unprecedented the number of pregnant women that are on a ventilator right now,” she said. “The vast majority are not vaccinated.”

Dr. Navin Bhojwani, system physician executive, Novant Health Women & Children’s Health Institute, cited a University of California San Francisco study released July 30 that shows pregnant women who contract Covid-19 have a 60% higher risk of preterm birth (before 32 weeks). The risk of preterm birth was 160% higher for Covid-positive pregnant patients with hypertension, diabetes, or obesity. 

Preterm births carry high risks for adverse health effects to infants. 

Unvaccinated pregnant women put both themselves and their unborn children at a far greater risk for myriad consequences, Bhojwani said. 

Novant began universally testing pregnant patients at the height of the pandemic last spring, and found about 3% were Covid-positive, he said. The rate dropped to below 1% this summer, Bhojwani explained, but has since climbed back up to 3%. “The 3% we’re seeing now are much sicker than they were last year,” he said. 

The biggest Covid-related risk to the unborn and infants is not physically catching the virus themselves –– if their mothers catch it, their chance of being born preterm greatly increases, meaning they don’t get a chance to develop fully before birth. 

Transmission from a Covid-positive mother to her baby is “rare to nonexistent,” Bhojwani said. Anecdotally, Bhojwani said a colleague who was vaccinated in her second and third trimester had her infant evaluated at six weeks old –– the newborn had Covid antibodies. 

Several studies have already identified the presence of Covid-19 antibodies in breastmilk. Research is underway to further solidify this connection. 

Sutton said many pregnant patients had been waiting on clear and concise guidance because they were excluded from the initial vaccine trials; health professionals are working to ensure their patients know it’s safer to vaccinate than to abstain. She encourages hesitant pregnant women to consult with their doctors instead of with their friends on the internet.

“Our hope is with these new recommendations we can get more people vaccinated,” she said.


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