Patient Care

COVID vaccines while pregnant or breastfeeding: what you need to know

Mar. 24, 2021
Kate Ocon with her daughter
Kate Ocon with her daughter

When Kate Ocon found out she was pregnant in November 2020, she thought about the COVID-19 vaccines on the horizon — and she thought she wouldn’t get one.

As a pharmacist, she wasn’t worried about vaccines in general. “But there was no data on vaccine and pregnant women,” she said. “I thought, ‘Maybe I’ll wait and see how it goes.’”

A lot has changed in the few months since then. Most significant is the sheer number of pregnant people who have gotten vaccinated.

Dr. Loralei Thornburg, a high-risk OB/GYN at UR Medicine, cites Anthony Fauci of the National Institutes of Health when people ask her how pregnant people have responded to the vaccines.

“I think Dr. Fauci put it best: In over 10,000 pregnant people who have received this vaccine, there have been no red flags. There has been no sign that there’s an increased risk.”

Compare that to not getting vaccinated: “In the tens of thousands of pregnant people who have gotten COVID, there is definitely evidence that patients are at an increased risk,” she explained.

It’s one reason that pregnant people became eligible for the vaccines early, along with others at high risk of severe effects from COVID.

“It makes sense with the physiology of pregnancy — we know that respiratory illness in pregnancy is much more severe than outside of pregnancy,” Dr. Thornburg said. “So it’s no surprise that pregnant people seem to be more at risk for getting severe versions of COVID, just like they’re more at risk for getting severe versions of the flu and the swine flu (H1N1).”

Pregnant people sometimes underestimate the danger of getting COVID, said Dr. Casey Rosen-Carole, Medical Director of Lactation Services at UR Medicine. And that can be tragic.

“I have seen pregnant people who are in comas after their babies are born,” Dr. Rosen-Carole said.

Dr. Thornburg said one of “the biggest problems is not understanding just how dangerous COVID is in pregnant people.”

See more videos about when to get the COVID vaccine during your pregnancy, and tips for breastfeeding.

That’s what ultimately convinced Kate Ocon, who also has a 17-month-old. She realized how damaging getting COVID could be — not just for her but for her infant daughter and husband, as well. She also knew other pregnant women who were getting vaccinated and sharing their stories on social media, saying they had experienced no problems and explaining it was “the best thing to do for my baby.”

Ocon received her second dose at the end of January and experienced a sore arm but no other side effects.

Once she gives birth, she can take comfort in a fringe benefit of the vaccines: A study conducted at the University of Rochester Medical Center showed that antibodies that fight COVID-19 will pass into breast milk while the actual virus does not.

At the start of the pandemic, when not much was known, “mom and baby were being separated,” said Dr. Rosen-Carole. Now, this study suggests that breastfeeding can help protect babies from COVID.

That’s also reassurance to anyone who wonders if the vaccine itself can somehow affect a fetus. As Dr. Thornburg pointed out, in pregnancy, there’s an instinct to think that doing nothing is the safest thing. But in this case, the science suggests the opposite.

The vaccines do not contain the actual virus, just a protein fragment that fools the immune system into thinking the virus is present. That protein disintegrates quickly in the body.

For anyone who still worries about a COVID vaccine somehow affecting a newborn, Dr. Rosen-Carole explained why the science can put that fear to rest.

“There are so many layers it would have to go through. It has to get into the mother’s blood. Then into the milk. Then stay in the milk and get into the baby. And then be active in the baby … That’s just not plausible.” Again, that’s because what triggers the immune system to form a defense against COVID is a tiny piece of protein in the vaccine that is quickly broken down. That’s also why it’s impossible to get COVID from the vaccines.

And the UR research showed that, in people with COVID, the virus itself was not transferred to breast milk, let alone the protein fragment that’s contained in the vaccine.

That’s why experts like Dr. Thornburg and Dr. Rosen-Carole have no hesitation in encouraging the vaccines in pregnancy and during breastfeeding.

As Dr. Thornburg put it, the real comparison is this: “The vaccines are very low risk, and the coronavirus does put you at risk.”