COVID-19 Vaccines: Answers From Ob-Gyns

COVID-19 is a new illness that affects the lungs and breathing. It is caused by a new coronavirus. Symptoms include fever, cough, sore throat, and trouble breathing. COVID-19 may also cause stomach problems, such as nausea and diarrhea, and a loss of your sense of smell or taste. Symptoms may appear 2 to 14 days after you are exposed to the virus. Some people with COVID-19 may have no symptoms or only mild symptoms.

Yes, you are strongly encouraged to be vaccinated. Vaccines are recommended for people age 5 and older. The American College of Obstetricians and Gynecologists (ACOG) recommends vaccination if you are pregnant, postpartum, breastfeeding, or planning a pregnancy. Find out how to get a COVID-19 vaccine near you through the CDC website.

For information about vaccines for children 11 and under, visit the American Academy of Pediatrics website healthychildren.org.

Yes, studies have shown that COVID-19 vaccines are safe and highly effective. The COVID-19 vaccines can prevent infection, severe illness, and death from COVID-19, including from new variants.

Before vaccines are given to the public, vaccines go through many layers of testing and reviews. The COVID-19 vaccines meet strict safety standards required by the U.S. Food and Drug Administration (FDA). Millions of people in the United States have safely received COVID-19 vaccines.

There are three COVID-19 vaccines in the United States: Pfizer, Moderna, and Johnson & Johnson. The Pfizer and Moderna vaccines require two shots. The Johnson & Johnson vaccine requires only one shot. The Pfizer and Moderna vaccines have been shown to be the most effective. Learn more from the CDC about the different vaccines.

• Most adults age 18 and older should get the Pfizer or Moderna vaccine.

• Adults can get the Johnson & Johnson vaccine if they have an allergy to ingredients in the other vaccines, have limited access to the other vaccines, or still prefer this vaccine after understanding the risks and benefits. Read “Is the Johnson & Johnson (J&J) vaccine safe?” below.

• Children and teens between 5 and 17 can only get the Pfizer vaccine.

If you are pregnant, postpartum, or breastfeeding, you should follow these same recommendations.

Yes. Over time, protection from a vaccine can decline. A booster dose improves (boosts) your body’s ability to protect you from illness. Everyone 12 and older should get a booster. This includes anyone who is pregnant, postpartum, or breastfeeding.

Pfizer or Moderna vaccines are recommended for booster shots. You do not need to choose the same vaccine that you originally received.

The timing of the booster depends on which vaccine you originally received:

• Johnson & Johnson—Get a Pfizer or Moderna booster at least 2 months after your first dose. You may get a Johnson & Johnson booster in some cases.

• Pfizer and Moderna—Get a Pfizer or Moderna booster at least 5 months after your second dose. You may get a Johnson & Johnson booster in some cases.

You can get a booster at any time during pregnancy. If you were originally vaccinated before pregnancy and you are now pregnant, you should still get a booster.

You may choose to get a second booster at least 4 months after your first booster if you are

• age 50 or older

• age 12 and older and have a weakened immune system

• age 18 or older and got two doses of the Johnson & Johnson COVID-19 vaccine (one primary dose and one booster dose)

Pfizer or Moderna vaccines are recommended for this second booster.

Pregnancy is not a reason on its own to get a second booster. But if you are pregnant and in one of the above categories, you can choose to get a second booster.

People who have weakened immune systems may need an extra dose of the vaccine. This is an extra “primary” dose—part of the first series of shots you get before you need a booster later. You may also need to get a booster shot sooner than other people. Read the current CDC guidelines on vaccines for people with weakened immune systems.

It’s common to feel side effects after getting a COVID-19 vaccine. There are different types of COVID-19 vaccines that have varying side effects. Side effects also vary from person to person. Some vaccines may make you feel like you have the flu for a few days. This is normal.

If you have a fever or other side effects after getting the vaccine, you can take over-the-counter (OTC) pain relief medication. If you are pregnant, the OTC medication acetaminophen is safe to take during pregnancy.

If you are worried about your side effects or they last more than a few days, talk with your health care professional.

Yes, you still need a vaccine even if you have had COVID-19 in the past. There is no way to tell how protected you are from COVID-19 after infection. Your level of protection may vary based on how severe your illness was, how long it has been since you were sick, and how old you are.

A growing amount of data shows that the COVID-19 vaccine gives more protection against future illness than the protection you might have after getting the virus. Getting a COVID-19 vaccine will help prevent you from getting COVID-19 again and strengthen your protection against severe illness.

Yes, you should get a COVID-19 vaccine during pregnancy. ACOG strongly recommends that all pregnant women be vaccinated against COVID-19. Getting a vaccine could help both you and your fetus. Remember that pregnant women have a higher risk of severe illness from COVID-19 than nonpregnant women. The vaccines are very effective at preventing infection, severe illness, and death from COVID-19.

When you get vaccinated, the antibodies made by your body may be passed to your fetus. These antibodies may help protect your baby from the virus after birth. How much protection your antibodies may provide is not yet known.

[Infographic: Why Should I Get the COVID-19 Vaccine While I'm Pregnant?]

Yes, a growing amount of data confirms that COVID-19 vaccines are safe during pregnancy. Scientists have compared the pregnancies of women who have received COVID-19 vaccines and women who have not. The reports show that these women have had similar pregnancy outcomes. Data do not show any safety concerns.

If you are pregnant and want to know more about the vaccines, you can talk with your obstetrician–gynecologist (ob-gyn). This conversation is not required to get a vaccine, though it may be helpful.

Learn more from the CDC about COVID-19 vaccines, pregnancy, and breastfeeding.

Yes, ACOG strongly recommends that breastfeeding women get a COVID-19 vaccine. Breastfeeding after vaccination is safe for the baby. There is no need to stop breastfeeding if you want to get a vaccine. When you get vaccinated, the antibodies made by your body may be passed through breast milk and may help protect your child from the virus.

Yes, if you are planning or trying to get pregnant, you should get a COVID-19 vaccine. There is no evidence that the COVID-19 vaccines cause infertility, and a growing amount of data confirms this. You also do not need to delay getting pregnant after you get a vaccine.

Learn more from the CDC about COVID-19 vaccines for people who would like to have a baby.

A recent study of nearly 4,000 people found there was a very small, temporary change in menstrual cycle length after vaccination. Periods were late by less than 1 day on average and returned to normal within 1 or 2 months.

Menstrual cycles often change a small amount from month to month. Temporary changes can be caused by many factors, including stress, lifestyle changes, and some underlying health conditions. Small changes in cycle length are normal and do not affect health or fertility.

More research is needed on this topic and in more diverse groups of people, but the results of this study are reassuring. This is good evidence that any effect of the COVID-19 vaccines on periods is temporary, small, and no cause for concern.

Yes, you can get a COVID-19 vaccine while you have your menstrual period. There is no need to reschedule.

There have been reports of COVID-19 vaccines causing swollen lymph nodes in underarms. This is a temporary side effect, but the swelling can make mammograms hard to read correctly. Because of this side effect, routine mammograms may be postponed for 4 to 6 weeks after you get a COVID-19 vaccine.

If you have any problems with your breasts or if you are at high risk for breast cancer, you should not delay your mammogram. If you do have a mammogram fewer than 4 to 6 weeks after getting a COVID-19 vaccine, tell the health care staff when you got your vaccine, which type of vaccine you had, and which arm the shot went in.

Remember, breast cancer screening is important health care that you should not skip. Read Mammography and Other Screening Tests for Breast Problems to learn more.

There have been rare reports of temporary inflammation in or around the heart muscle after vaccination with the Pfizer and Moderna vaccines. These conditions are called myocarditis and pericarditis. These cases have been seen mostly in male teens and young adults. Most patients do well with treatment and quickly feel better.

The risk of illness and death from COVID-19 is far greater than the rare risks of myocarditis and pericarditis. The CDC continues to recommend everyone age 5 and older get a COVID-19 vaccine.

All vaccines have gone through intense safety studies and health officials continue to track their safety. The Johnson & Johnson vaccine has potential risks, but they are very rare. The vaccine has been linked to two rare health conditions:

• Thrombosis with thrombocytopenia syndrome (TTS), a condition involving blood clots and other symptoms. Most cases of these blood clots have been reported in women under age 50.

• Guillain-Barré syndrome, an immune system disorder that affects the nervous system.

These conditions have only been reported in a few people out of every million doses of the Johnson & Johnson vaccine that have been given. But because of these rare risks, health officials recommend getting the Moderna and Pfizer vaccines instead of Johnson & Johnson. The Johnson & Johnson vaccine can still be given in some cases (read the question “Which vaccine should I get?” above).

If you choose to get the Johnson & Johnson vaccine, you should be aware of the potential risks.

Some hormonal birth control methods are linked to a small increased risk of blood clots. The type of blood clot related to birth control is different than the type of blood clot syndrome related to the Johnson & Johnson vaccine. There is no need to change birth control methods if you get the Johnson & Johnson vaccine. Hormonal birth control should not affect your risk of blood clots after getting the Johnson & Johnson vaccine.

COVID-19 vaccines work in different ways, and all of them are proven to be safe. It is important to know that:

• The vaccines cannot give you COVID-19. None of the vaccines uses the live virus that causes COVID-19.

• The vaccines do not affect your genes or DNA.

• There is no evidence that the COVID-19 vaccines cause infertility. ACOG recommends vaccination for anyone who may consider getting pregnant in the future.

Visit the CDC website for the latest information on COVID-19 vaccines.

Centers for Disease Control and Prevention (CDC)
www.cdc.gov/coronavirus/2019-ncov/vaccines
Learn about the vaccines that can protect you from COVID-19:

• COVID-19 Vaccines While Pregnant or Breastfeeding

• COVID-19 Vaccines for People Who Would Like to Have a Baby

• Vaccine Safety and Monitoring

• COVID-19 Vaccines are Effective

Vaccines.gov
www.vaccines.gov
Find a COVID-19 vaccine near you.

Mother to Baby: Ask an Expert
https://mothertobaby.org/ask-an-expert
Evidence-based information on the safety of medications and vaccines during pregnancy and while breastfeeding. U.S. and Canada residents can submit questions via email or phone call.

Antibodies: Proteins in the blood that the body makes in reaction to foreign substances, such as bacteria and viruses.

Fetus: The stage of human development beyond 8 completed weeks after fertilization.

Infertility: The inability to get pregnant after 1 year of having regular sexual intercourse without the use of birth control.

Menstrual Cycle: The monthly process of changes that occur to prepare a woman’s body for possible pregnancy. A menstrual cycle is defined as the first day of menstrual bleeding of one cycle to the first day of menstrual bleeding of the next cycle.

Menstrual Period: The monthly shedding of blood and tissue from the uterus.

Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women’s health.