Pregnancy, Breastfeeding and the COVID-19 vaccine

What is the bottom line for mothers when it comes to getting vaccinated and pregnancy and breastfeeding?

COVID-19 vaccinations do not cause infertility or change you or your baby’s DNA or genetic material. If you are pregnant you are at higher risk of complications if you do get a COVID-19 infection. So far we don’t have any evidence to suggest vaccination poses a risk of harm to you or your pregnancy and there is no current evidence that a COVID-19 vaccination will harm your baby if you are breast feeding. The Society of Obstetricians and Gynecologists of Canada strongly recommends women who are pregnant and breastfeeding be offered the COVID 19 vaccine when it is available to them.

We have recently had new information from experts in the field and our Ontario Society of Obstetrics and Gynecologists have welcomed the move to include pregnant women on the priority list for vaccines in the next phase. It is becoming clear that women who want the vaccine should not be excluded based on the absence of evidence and theoretical risks as so far we do not have any data to suggest harm to mother or baby. While pregnant and breastfeeding women were not included in the initial vaccine trials, we do know that pregnant women have a slightly higher risk of severe COVID 19 infection, including need for ICU admission. COVID-19 infection in pregnancy can also increase the risk of complications such as preterm birth.

Key things for women to consider when discussing vaccination with their provider include:

•How likely are you to be exposed to COVID 19 based on certain factors such as your occupation, your close contacts and/or where you live?

•What is your overall health? Pregnant women who are over age 35, have asthma, obesity, preexisting diabetes, preexisting hypertension and heart disease are at greater risk of severe COVID-19 infection.

•Your provider will discuss with you what we know so far about the safety of vaccination in pregnancy and also discuss what we don’t know.

•Your personal values with respect to tolerance of risk and your beliefs.

What if I’m considering pregnancy?

So far the COVID 19 vaccine is recommended in women who are reproductive age and are considering becoming pregnant in the future. There is no current information to suggest the vaccine causes infertility. It is recommended that if you receive the COVID 19 vaccine that you complete the entire vaccination series to have maximal protection ahead of pregnancy.

You don’t need to avoid becoming pregnant if you have received the vaccine. What if I’m breastfeeding? While breastfeeding women were not included in the initial trials, mRNA vaccines are not thought to be a risk to a breastfeeding infant based on our knowledge of other non-live vaccines.

If you receive the vaccine, The Academy of Breastfeeding Medicine does not recommend stopping breastfeeding after receiving the vaccine. Ultimately, it is each women’s personal choice as to whether or not they will be vaccinated. Hopefully with this information you will feel better equipped to make an important decision. If you are pregnant or breastfeeding, please consider discussing with your trusted healthcare provider.

If you have any questions or concerns please check the PEFHT website and links or contact your provider.

Dr. Helene Baldwin BSc MD CCFP is a medical practitioner specializing in family medicine with the Prince Edward Family Health Team.