The COVID-19 vaccine and pregnancy
Monday 22 March 2021
This article was written during the Queensland response to the COVID-19 pandemic and reflects the information available at the date of publication. The content is based on the Australian Department of Health’s COVID-19 vaccination decision guide for women who are pregnant, breastfeeding, or planning pregnancy. Please check the Australian Department of Health COVID-19 webpage for updated information and current health advice regarding COVID-19 and vaccinations in Queensland.
There is a lot of misinformation circulating online about the COVID-19 vaccine affecting fertility and being unsuitable for pregnant or breastfeeding women. Much of this information is unscientific and factually wrong, causing unnecessary worry for many.
Based on research and common questions we see on our social media channels, we’ve pulled together answers around the vaccine, fertility, pregnancy, and breastfeeding to give you the facts you need.
About the COVID-19 vaccine
COVID-19 vaccine update
On 9 April 2021 the Australian Government updated its advice on the rollout of the AstraZeneca vaccine.
Queensland has two different COVID-19 vaccines available: Pfizer (also called Comirnaty) and AstraZeneca. Both vaccines are safe and offer strong levels of protection against COVID-19.
Can the vaccine affect my fertility?
No. There is no evidence to suggest any vaccines, including the COVID-19 vaccine, have any effect on male or female fertility.
According to a joint statement issued by the UK’s Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists, there is are no believable biological ways that the current COVID-19 vaccines would cause any impact on fertility.
If you are planning pregnancy
If you are planning a pregnancy, you can receive either of the COVID-19 vaccines available.
According to a statement from The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), “There is no evidence that women who become pregnant after receiving the vaccine are at increased risk of teratogenicity, miscarriage or maternal illness. Pregnancy need not be delayed after receiving the vaccine.”
You do not need to avoid becoming pregnant before or after vaccination. You are not required to have a pregnancy test before getting vaccinated.
If you become pregnant after your first dose, you might choose to have the second dose during pregnancy (see Factors to consider when deciding the timing of COVID-19 vaccination during pregnancy below) or you might choose to wait until after your pregnancy. It is important to note that the first dose may only provide partial protection against COVID-19, and this protection may be short-lived. You will only have full protection after two doses.
Talk to your doctor, pharmacist or midwife if you have any questions or concerns.
If you are pregnant
At this stage, the COVID-19 vaccine is not routinely recommended to be given during pregnancy as there is limited experience with the use of COVID-19 vaccines in pregnant women. As we learn more about the vaccines, this advice may change.
If you are pregnant, ask your doctor, pharmacist or midwife for advice before you receive this vaccine.
You should consider having a COVID-19 vaccine during your pregnancy if:
- you have medical risk factors for severe COVID-19
- you are at high risk of exposure to the virus that causes COVID-19 or very likely to be in contact with people with COVID-19.
You may prefer to wait until after your pregnancy to be vaccinated if:
- you have no risk factors for severe COVID-19
- you are not at high risk of exposure to COVID-19.
What do we know about COVID-19 vaccines in pregnancy?
The reason that the COVID-19 vaccines is not routinely recommended to be given during pregnancy, at this stage, is simply because we do not yet have enough information from clinical trials about the data for women who have become pregnant after having the vaccine. These trials are ongoing but may take many months before results are known, and will generally require a significant number of patients to make any meaningful conclusions.
Benefits of getting the COVID-19 vaccine during pregnancy
The COVID-19 vaccine will protect you against severe diseases of COVID-19.
This means, if you have the COVID-19 vaccine, and later get infected with COVID-19, the severity of illness that you experience is likely to be significantly reduced.
Possible harms from COVID-19 vaccination during pregnancy
All medicines and vaccines can cause side effects. If you do experience any side effects, most of them are minor and temporary. However, some side effects may need medical attention. Read about potential COVID-19 vaccine side effects.
The COVID-19 vaccines have not yet been studied in pregnant women. This means we do not yet know if there are extra side effects from this vaccine in pregnant women or in their babies, although this is very unlikely. However, based on our understanding of this vaccine, we do not expect it to cause any serious problems in pregnant women or their babies.
Other vaccines given during pregnancy such as influenza vaccine or whooping cough vaccine, do not cause more side effects in pregnant women or their babies. They do protect newborn babies from these diseases.
We also do not know if the vaccines are less effective in pregnant women than in non-pregnant women. Other vaccines routinely given during pregnancy (such as flu or whooping cough vaccine) are equally effective in pregnant women compared to non-pregnant women.
We do not know whether receiving the COVID-19 vaccine during pregnancy will provide protection to your baby against COVID-19, because this has not been studied.
If you are breastfeeding
If you are breastfeeding, you can receive a COVID-19 vaccine at any time. You do not need to stop breastfeeding before or after vaccination.
The Australian Technical Advisory Group on Immunisation (ATAGI) says: Women who are breastfeeding or who are planning pregnancy can receive COVID-19 vaccine. There are no theoretical concerns regarding the safety of Comirnaty (Pfizer) or COVID-19 Vaccine AstraZeneca in these groups.
The Centers for Disease Control and Prevention (CDC) in the USA says: The COVID-19 vaccines authorized now are non-replicating vaccines, meaning they are able to create an immune response but do not reproduce inside host cells. Because non-replicating vaccines pose no risk for lactating people or their infants, COVID-19 vaccines are also thought to not be a risk to the breastfeeding infant. Therefore, lactating people may choose to be vaccinated.
The two vaccines currently being used in Australia are also non-replicating vaccines.
Factors to consider when deciding the timing of COVID-19 vaccination during pregnancy
If you choose to delay the second dose
- The two doses of Pfizer should be at least 3 weeks apart. The two doses of AstraZeneca should be at least 28 days apart, but most likely 12 weeks apart.
- Having one dose of the COVID-19 vaccine before or during pregnancy and waiting until after your baby is born to have the second dose, will still be effective in boosting your protection. You will not need to repeat the first dose.
- Having one dose only provides partial protection against COVID-19. We do not know how long or great protection from one dose will be, so it is still important to get the second dose.
Timing in relation to other vaccines
- There should be an interval of at least 14 days between a dose of the COVID-19 vaccine and any other vaccine. This applies to both doses.
- This may affect the timing of the two vaccines medical professionals routinely recommend during pregnancy:
- Influenza vaccine, which can be given at any time.
- Whooping cough vaccine, which is ideally given between 20 and 32 weeks of pregnancy. The influenza and the whooping cough vaccines can be given together on the same day.
- If you want to get the COVID-19 vaccine, talk to your immunisation provider about making a schedule for each vaccine dose you will receive during pregnancy. This will avoid any unnecessary delays.
- If you have any questions about this information, ask your immunisation provider, doctor, pharmacist or midwife.
- If you are breastfeeding, you can receive Pfizer or AstraZeneca vaccine at any time, and do not need to stop breastfeeding after vaccination.
- If you are planning a pregnancy, you can receive COVID-19 vaccine at any time.
- If you have an increased risk of being exposed to COVID-19, or of having severe illness, you should consider having a COVID-19 vaccine during pregnancy.
- You can choose to have a COVID-19 vaccine at any time during pregnancy; your immunisation provider can help you to decide the best time.
Making the decision – a summary
- 14 days apart from any other vaccine
- 21 days between two doses of Pfizer
- At least 28 days, but most likely 12 weeks apart between two doses of AstraZeneca.
Am I more at risk of getting COVID-19 if I'm pregnant or breastfeeding?
The World Health Organisation says pregnant women who are older, overweight, and have pre-existing medical conditions such as heart disease, hypertension and diabetes seem to have an increased risk of developing severe COVID-19.
Possible complications of COVID-19 in pregnant women and their babies
Pregnant women with COVID-19 have a higher risk of certain complications compared to non-pregnant women with COVID-19 of the same age, including:
- An increased risk (about 3 times higher) of needing admission to an intensive care unit.
- An increased risk (about 3 times higher) of needing invasive ventilation (breathing life support).
COVID-19 in also increases the risk of certain pregnancy complications including:
- A slightly increased risk (about 1.3 times higher) of having their baby born prematurely (before 37 weeks of pregnancy).
- An increased risk (about 3 times higher) of their baby needing admission to a newborn care unit
Pregnant women with certain underlying medical conditions are more likely to have severe illness from COVID-19 compared to pregnant women without these conditions. The conditions are:
- Being older than 35 years
- Overweight or obese (body mass index above 30 kg/m2)
- Pre-existing (pre-pregnancy) high blood pressure
- Pre-existing (pre-pregnancy) diabetes (type 1 or type 2)
- COVID-19 vaccination decision guide for women who are pregnant, breastfeeding, or planning pregnancy
- Statement from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists on COVID-19 vaccination
- Information on COVID-19 Pfizer (Comirnaty) vaccine
- Preparing for COVID-19 vaccination
- After your COVID-19 vaccination.
- COVID-19 vaccines: everything you need to know
- What’s really in a COVID-19 vaccine?
- Queensland Health
- Department of Health