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August 2021: The U.S. Food and Drug Administration (FDA) has fully licensed the Pfizer-BioNTech COVID-19 vaccine, also known as Comirnaty. This is a permanent approval that goes beyond emergency use status. Full FDA licensing shows that the vaccine continues to meet high safety and effectiveness standards. Read more about this update from the FDA.

July 2021: ACOG now recommends all pregnant women get a COVID-19 vaccine. Read the latest at Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients.

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Dr. Jacqueline Parchem was fully vaccinated against COVID-19 by mid-January 2021. She received both doses of the vaccine during pregnancy. Photos courtesy of Dr. Parchem.

The pandemic has been a lonely time to be pregnant. With all the restrictions in place, you may not get to share the experience of an ultrasound exam with your partner. The grandparents-to-be can’t cheer you on from the labor and delivery waiting room. It’s been lonely for us ob-gyns too, seeing so much joy stifled.

But these protections are in place for good reason. You only need to know of one heartbreaking story to understand how real the risks are for pregnant women. We all know of pregnant patients who have been critically ill or have died from COVID-19, including young, healthy people.

My perspective on this comes from my experience as a high-risk pregnancy specialist—and as a woman who happened to be pregnant during the pandemic. Every day, I feel my patients’ emotions like they’re my own.

A vaccine arrives

Now there is something to give us hope: the COVID-19 vaccines. I didn’t count on them being available before my February 2021 due date. To my pleasant surprise, my hospital system started offering the vaccines to health care workers in December 2020, as soon as they were available.

These vaccines had not been studied yet in pregnant or breastfeeding women. That left pregnant and breastfeeding health care workers who were eligible for vaccination to decide for ourselves: Do we get the shot or not?

Every day, doctors and patients make health care decisions under less-than-ideal circumstances. Some decisions have more safety data to back them up than others. As an ob-gyn, I always decide about recommending medications and treatments based on their known benefits and risks.

So I applied this same logic as I considered whether to get the COVID-19 vaccine myself.

A helpful framework

Pregnant or not, you can try this framework I used to think through whether to get vaccinated. In fact, these questions can be useful when making any health care decision.

1. What information do I have? We know that all of the COVID-19 vaccines are very effective at preventing illness from the virus. Studies show they are safe for adults. The vaccines do not contain live virus and cannot give you COVID-19.

Studies confirming vaccine safety in pregnancy had not started when I had to make my decision. (Those studies are just beginning now, and we are already seeing reassuring data from pregnant women who have chosen to be vaccinated.) But I knew that based on how the COVID-19 vaccines work, there is no reason to think they are unsafe for pregnant women. There also are no scientific reasons or evidence to believe that the COVID-19 vaccines cause infertility.

One more comforting point: We know many other vaccines are safe during pregnancy. In fact, the vaccines we give routinely during pregnancy protect the mother and the baby from illness. The mother’s antibodies can pass to the baby during pregnancy and breastfeeding.

2. What is my risk of getting sick? Pregnancy itself is a risk factor, as pregnant women may become more ill from COVID-19 than those who are not pregnant. Consider whether you also have any underlying health conditions that could make your risk of getting sick higher, such as obesity or diabetes.

Another factor: Your risk of getting sick varies based on how much contact you and those you live with have with people from outside your household. My daily exposure to colleagues and patients puts me at high risk. But if you work from home, that might be a different story. When in doubt, talk with your doctor.

Remember, this virus doesn’t discriminate. People can have COVID-19 and not show any symptoms. In my experience, most people who come down with this disease don’t know where they got it from. They thought they were doing the right things to prevent it.

3. What might happen if I don’t get a vaccine? Without a vaccine, you won’t have that layer of protection from severe illness. And we know that babies don’t do well when mom is sick. Plus, while vaccination is important for protecting you and your loved ones, it’s also key for our communities to eventually return to normal activities.

4. Will I have regrets? This question did it for me. I knew that if I didn’t get a vaccine and then got sick with COVID-19, I would regret it.

By mid-January 2021, I was fully vaccinated against COVID-19. My arm felt sore and the second shot left me a little tired. (Then again, it was my third trimester.) I felt so lucky to have this protection for the final weeks of my pregnancy—and beyond.

A personal decision

It’s natural to have questions about the COVID-19 vaccines. I know I did. What you hear from the news, social media, and other people can be overwhelming. So turn to a trusted source: your health care team.

As an ob-gyn, I’m here to give my patients the facts. I want to tell you all I know about the vaccines to help you make a fully informed decision.

No one is better equipped to make choices for your health and your family than you. For some people, that will mean waiting to get a vaccine. You can always change your mind later. But for me and most of my patients, the safest choice is getting the shot—and the protection that comes with it—as soon as we are able.

Published: March 2021

Last reviewed: March 2021

Copyright 2021 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

About the Author
A headshot of Dr. Jacqueline Parchem
Dr. Jacqueline Parchem

Dr. Parchem is an obstetrician–gynecologist and maternal–fetal medicine specialist at UTHealth/Memorial Hermann in Houston, as well as an assistant professor at the university’s McGovern Medical School. An ACOG Fellow, Dr. Parchem’s research interests include preeclampsia, racial-ethnic disparities in pregnancy, and pregnancy outcomes during the COVID-19 pandemic.