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Pregnant, breastfeeding or trying to conceive? Answers to your COVID-19 vaccine questions

Answers provided by Dr. Jerome Leis and Dr. Art Zaltz. Dr. Leis is the Medical Director of Infection Prevention and Control at Sunnybrook and Dr. Zaltz is Chief of the DAN Women & Babies Program at Sunnybrook.

I’m pregnant. Once it’s available to me, can and should I receive the COVID-19 vaccine?

Dr. Zaltz: Yes, you will be able to receive the COVID-19 vaccine in Ontario. The Ontario Ministry of Health has stated that people who are pregnant “may choose to receive the vaccine after informed counselling and consent.” The first step is to speak with your obstetrician, midwife or family doctor. They will review the risks and benefits of COVID-19 vaccination to help you decide what is right for you. You will be required, at the time of vaccination, to attest that you have had this discussion with your primary care provider or specialist.

Are pregnant women at increased risk of complications from COVID-19?

Dr. Leis: Most pregnant women who become infected with COVID-19 will have mild-to-moderate symptoms and many can be asymptomatic. However, we know from recent data that the rate of hospitalization was 11 per cent for pregnant women with COVID-19 and the rate of ICU admission was 2.3 per cent.

Why weren’t pregnant women included in the clinical trials for the COVID-19 vaccines?

Dr. Zaltz: The clinical trials for the COVID-19 vaccines currently being rolled out in Canada by manufacturers Pfizer and Moderna deliberately did not include pregnant women. It’s common practice for clinical trials to exclude pregnant women, with concerns about fetal development cited. However, we do know that some vaccine study participants became pregnant and to date there have been no adverse effects reported.

I’ve heard that those who are trying to get pregnant shouldn’t receive the COVID-19 vaccine as it affects fertility. Is that true?

Dr. Leis: There is no scientific reason that the vaccine would impact fertility. This is not a concern at all. It is true though that we don’t have research related to the use of vaccine in women who are trying to conceive or pregnant because they were not studied in clinical trials. It’s always wise to have a conversation with your health care provider to help you decide what is right for you.

I’m considering starting fertility/IVF treatments – is it okay to get vaccinated?

Dr. Zaltz: Vaccination creates a heightened immune response. Some fertility specialists suggest waiting a cycle or two after vaccination before starting treatment.

I’m pregnant and curious if the antibodies generated from the COVID-19 vaccine will be delivered to my baby?

Dr. Zaltz: Data for COVID-19 vaccination in pregnancy is not yet available, but we do know that in general, antibodies cross the placenta to offer protection to the fetus. For this reason, vaccines like the influenza shot are recommended during pregnancy. This is an additional potential benefit of vaccination in pregnancy but further research is needed for the COVID-19 vaccine specifically.

Are there any guidelines for timing to receive the vaccine in pregnancy (ie: first, second or third trimester?)?

Dr. Zaltz: The only consideration about timing relates to other vaccines, like the flu shot and Tdap (tetanus, diphtheria, pertussis) that are routinely recommended during pregnancy. If you choose to receive the COVID-19 vaccine during pregnancy or the postpartum period, the CDC recommends scheduling it at least 14 days before or 14 days after any other vaccination. Please talk to your health provider about the best timing for the COVID-19 vaccine.

Can I get the vaccine if I’m pregnant and have allergies?

Dr. Leis: For the most part, people with allergies can receive the vaccine. There are two exceptions:

  • People who have had an allergic reaction to polyethylene glycol, or PEG. PEG is a component in the vaccine that can elicit an allergy response. It is a very rare allergy, but it is important that people who have this allergy do not receive the vaccine.
  • Anyone who has had a reaction to the first dose of the vaccine should not receive the second dose.

More questions and answers

In April 2021, we hosted a Q&A on our Instagram account, inviting our followers to ask their questions about pregnancy, fertility and the COVID-19 vaccine to Sunnybrook experts.

Read the questions and answers on our blog