Why pregnant women are urged to get the Covid-19 vaccine

Vaccine hesitancy has become a pressing issue for pregnant women in Australia, with vaccination rates lagging below the general population. Here, the experts explain fact from fiction.

Women who are planning a pregnancy, already expecting, or who are breastfeeding may be uncertain about how the Covid-19 vaccine may affect them and/or their child.

Here, University of Melbourne VaxFACTS Associate Professor Margie Danchin and Mercy Health obstetrician Dr Alexis Shub respond to some key concerns.

Is the Covid-19 vaccine safe if I get vaccinated during pregnancy?

Yes, says Assoc Prof Danchin.

“The Pfizer or Moderna vaccines are recommended for women at any stage in pregnancy,” Assoc Prof Danchin explains.

“We’ve been giving flu and whooping cough vaccines during pregnancy for some time now and they give a two-for-one protection.

“They protect the mum-to-be and they offer some protection to a baby in the first months of life because antibodies cross the placenta and pass to the baby in breastmilk.”

Assoc Prof Danchin points out Covid-19 vaccines won’t be recommended or trialled in infants under six months, so they are vulnerable to the disease and rely on the people around them for maximum protection.

“Research is still trying to understand how well the Covid-19 antibody transfer does protect a baby but we do know antibodies have been measured in umbilical cord blood and breastmilk so we know they pass to infants,” she says.

Can I be vaccinated if there are complications in my pregnancy?

If you have complications in pregnancy there is even more reason to be vaccinated, Dr Shub says.

“Your baby may come early or be sick when born so it’s better if mum can be as healthy as possible and not get sick with Covid-19,” she says.

The vaccines are new – how do I know they won’t harm me or my baby?

A large study in the US showed no difference in common and expected side effects of Covid-19 vaccination between pregnant women and those who weren’t pregnant.

“About 800 women in that study were followed through to delivering their baby and there was no difference in terms of miscarriage, stillbirth, the number of low birthweight babies or congenital anomalies between women who received a Covid-19 vaccine and women who didn’t,” Assoc Prof Danchin says.

What are the risks if I get Covid-19 while I’m pregnant?

Women who get Covid-19 during pregnancy have a five times increased risk of being admitted to hospital than women who aren’t pregnant, Assoc Prof Danchin says.

“There’s a two to three-fold increased risk of a pregnant woman going to ICU or needing to go on to a ventilator, and there’s a 1.5 times increased risk of having a premature baby,” she says.

“This risk is higher for women who are obese, have high blood pressure or insulin dependent diabetes, or who are over the age of 35.

“Covid-19 can be more severe when you’re pregnant because your immune responses are altered.

“Carrying a baby and changes to your circulatory system mean pregnant women just fight infection less well.”

Do the vaccines affect my chance of becoming pregnant?

Dr Shub says there is no evidence the vaccines will cause infertility.

“Some women have had changes in their periods over recent months and this can happen at times of stress, like lockdowns, job losses or changes, or because of Covid-19 infection – but not because of the vaccine,” she says.

Can I breastfeed if I’m vaccinated?

Early data shows the antibodies produced in response to the vaccine that circulate in the bloodstream ready to fight the infection if we catch Covid-19 can pass through breastmilk and provide some protection to an infant, Assoc Prof Danchin explains.

“Any of the vaccines in our Covid-19 program can be had by a woman who is breastfeeding – AstraZeneca, Pfizer or Moderna,” she says.

“The vaccine itself doesn’t pass into breastmilk – it is broken down in the body and destroyed within a few days.”

Does it help if people around a pregnant woman are vaccinated?

Absolutely, Assoc Prof Danchin says.

“We call this cocooning,” she says.

“But the most important thing a pregnant woman can do to protect herself and her baby is to be vaccinated.

“We don’t want pregnant women to feel they need to exclude people who aren’t vaccinated, as long as they don’t have symptoms of course.”

To find out more, read the Australian Government information guide on the Covid-19 vaccine and pregnancy, breastfeeding and fertility.

Written by Sarah Marinos.