Should pregnant people get the Covid-19 vaccine?

It’ll only hurt for a minute.
It’ll only hurt for a minute.
Image: REUTERS/Carlos Garcia Rawlins
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Being pregnant during a global pandemic is complex enough. Doctor’s visits, shopping for baby stuff, birthing plans—it’s all made more complicated, and scarier, by the threat of a deadly sickness.

But now that people in the US and Europe have begun to receive the Pfizer-BioNTech Covid-19 vaccine, there’s an extra layer of confusion. If pregnant people are inclined to get the vaccine, should they?

Pregnant people are clearly in need of some extra protection. In the past few months, the US Centers for Disease Control and Prevention (CDC) noted that pregnancy is a risk factor for Covid-19, making pregnant people who are infected more likely than the average person to have severe forms of the disease and to die from it. The infection doesn’t seem to affect the pregnancy itself, only the mother.

That doesn’t necessarily mean expecting mothers should be lining up to get the vaccine. No pregnant person was part of Pfizer’s clinical trial—as is the case with most trials, since it’s generally not considered ethical—so there’s no data on how safe it would be for them.

Neither the CDC nor the US Food and Drug Administration (FDA) has recommended that pregnant people get the vaccine. Still, the American College of Obstetricians and Gynecologists (ACOG), among other groups, has pushed for pregnant people to be given access to the vaccine if they want it. The organization’s lobbying ensures that being pregnant or having recently had a baby won’t be a reason for healthcare and other frontline workers who are first in line to get the vaccine—and most at risk of infection—to be excluded. ACOG says it will update its guidelines as more information becomes available.

Once the vaccine becomes more widely available, more pregnant people will have to make this decision for themselves. Hopefully by then medical experts will have more information about side effects and overall safety for pregnant vaccine recipients; though there have been few surprises in the vaccine rollout so far, those who take it during pregnancy have to be careful about a common reaction to all vaccines—light fever, which should be avoided and controlled (with paracetamol or acetaminophen) during pregnancy.

In the meantime, misinformation has spread about a nonexistent link between fertility and the Covid-19 vaccine. One such piece of misinformation, for instance, states that the Pfizer-BioNTech vaccine would train the body to attack a protein that is important in the formation of the placenta. This is completely unfounded, and based on a lack of understanding not only of how mRNA vaccines work, but also on the structure of the placenta protein it would threaten. “It’s a myth, it’s inaccurate—there’s no evidence to support their perception,” Saad Omer, a vaccine expert at Yale University, told the New York Times.

Some parents-to-be may also worry about the potential impact of a vaccine on the fetus itself. With some other vaccines based on modified versions of viruses, it is possible for the fetus to come into contact with the virus, presenting a health risk. But the mRNA vaccine isn’t made with a virus, just a string of its genetic material. So while it makes sense that the vaccine wouldn’t present any risk to the fetus, we can’t know for sure since it has not been studied.