Considerations involving pregnancy, lactation, and fertility

COVID-19 vaccination is recommended for people who are pregnant, lactating, trying to get pregnant now, or who might become pregnant in the future.

Pregnancy

Staying up to date with COVID-19 vaccinations is recommended for people who are pregnant. Although the overall risks are low, pregnant and recently pregnant people (for at least 42 days following the end of pregnancy) with COVID-19 are at increased risk for severe illness when compared with non-pregnant people. Additionally, pregnancies affected by COVID-19 are at increased risk for preterm birth and stillbirths, and might be at increased risk for other complications.

A growing body of evidence on the safety and effectiveness of COVID-19 vaccination indicates that the benefits of vaccination outweigh any known or potential risks of COVID-19 vaccination during pregnancy.

A conversation between the patient and their clinical team may assist with decisions about the use of a COVID-19 vaccine; however, approval by a healthcare professional is not required before vaccination. Data on uptake of COVID-19 vaccination among pregnant people can be found on CDC’s COVID Data Tracker.

Side effects can occur after COVID-19 vaccination in pregnant people, similar to those among non-pregnant people. Acetaminophen can be offered as an option for pregnant people experiencing fever (fever has been associated with adverse pregnancy outcomes) or other post-vaccination symptoms.

Lactation

COVID-19 vaccination is recommended for all lactating people. Because clinical trials of COVID-19 vaccines did not include people who were lactating, there are limited data on the safety of COVID-19 vaccines in lactating people or the effects of COVID-19 vaccines on the breastfed infant, milk production, and milk secretion. Recent reports have shown that the antibodies developed from mRNA COVID-19 vaccination received both during and after pregnancy were present in breastmilk samples. More data are needed to determine if these antibodies convey protection against SARS-CoV-2 infection for neonates and infants.

Fertility

There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems. There is no recommendation for routine pregnancy testing before receipt of a COVID-19 vaccine. Those who are trying to become pregnant do not need to avoid pregnancy after COVID-19 vaccination.

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