COVID-19 vaccines, pregnancy and breastfeeding FAQs

COVID-19 vaccines are strongly recommended in pregnancy.

The Joint Committee on Vaccination and Immunisation (JCVI) define pregnant women as a ‘clinical risk’ group within the COVID-19 vaccination programme, emphasising the importance of them receiving their COVID-19 vaccination and autumn booster doses.

Vaccination is the best way to protect against the known risks of COVID-19 in pregnancy for both women and babies, including reducing the risk of admission to intensive care and premature birth.

The decision whether to have the vaccination in pregnancy is your choice. Make sure you understand as much as you can about COVID-19 and the vaccines available to you. You may want to discuss your options with a trusted source such as your doctor or midwife.

Yes. Pregnant women who have previously been vaccinated are eligible for the autumn 2023 booster vaccine.

Pregnant women can book their COVID-19 vaccine via the NHS booking system. 

A study comparing pregnant women who had a COVID-19 booster with those who had only had two doses of vaccine showed that having a booster dose significantly reduced the risk of getting COVID-19 and of severe illness from COVID-19 requiring admission to hospital. Having the COVID-19 booster vaccination also reduced the risk of pregnancy complications such as preterm birth and stillbirth.

We strongly encourage all pregnant women to have the COVID-19 autumn booster vaccination as it provides the best protection against the virus for you and your baby.

Pregnant women and women who are breastfeeding are already routinely and safely offered vaccines in pregnancy, for example to protect against influenza (flu) and whooping cough. Many of these vaccines also protect their babies from infection. These vaccines, like the COVID-19 vaccines, are non-‘live’ vaccines, which are considered safe in pregnancy.

More than 1.3 million women worldwide have had COVID-19 vaccines in pregnancy.

Studies following up nearly 350,000 pregnant women in the US and UK who were vaccinated in pregnancy have not raised any safety concerns. Since most of these women received mRNA vaccines, such as Comirnaty/Pfizer BioNTech and Moderna Spikevax, the JCVI advises that it is preferable for these mRNA vaccines to be offered to pregnant women in the UK, where available.

The UKHSA (formally Public Health England) and Public Health Scotland have reported that well over 150 000 pregnant women have received a COVID-19 vaccine in England and Scotland, with no serious adverse effects recorded. UKHSA data from December 2022 reported that 73.2% of women who gave birth had received at least one dose of COVID-19 vaccine prior to giving birth.

Current research indicates COVID-19 vaccines do not contain ingredients that are known to be harmful to pregnant women or to a developing baby.

The COVID-19 vaccines being used in the UK are not ‘live’ vaccines and so cannot cause COVID-19 infection in you or your baby. Vaccines based on live viruses are avoided in pregnancy in case they infect the developing baby and cause harm. However, non-live vaccines have been shown to be safe in pregnancy (for example, flu and whooping cough).

Studies have shown that protective antibodies from vaccination do cross the placenta, helping with the baby’s immunity to COVID-19. We know that catching COVID-19 during pregnancy can cause severe illness in a pregnant woman, which is why COVID-19 vaccine in pregnancy is so strongly recommended.

Studies have shown that protective antibodies developed from vaccination can transfer from mother to baby across the placenta, and after birth through breast milk, helping with the baby’s immunity to COVID-19. The degree of protection this provides to the baby is unknown at present and more research is needed.

Available data shows that a pregnant woman who has a COVID-19 vaccine is not at an increased risk of having adverse pregnancy outcomes. Worldwide data, looking at many thousands of people vaccinated in pregnancy, has reported no increased risk of miscarriage, preterm birth or stillbirth following vaccination. Nor does vaccination increase the risk of a small-for-gestational age baby or developing congenital anomalies.

One of these studies, from St George’s, University of London, published in the American Journal of Obstetrics and Gynecology (AJOG) on 9 August 2021, compared pregnancy outcomes for women who had received a COVID-19 vaccine and those who had not. The study found there were no significant differences between the two groups, with no increase in stillbirths or premature births, no anomalies with development and no evidence of babies being smaller or bigger.

As these are new vaccines, there are limited data on the long-term effects on babies born to women who received a COVID-19 vaccination in pregnancy. However, as with other non-live vaccines (such as flu and whooping cough), COVID-19 vaccines are not ‘live’ vaccines and so cannot cause infection, and these have been given to women in pregnancy for many years without any safety concerns.

The mRNA vaccines (Comirnaty/PfizerBioNTech and Moderna Spikevax) are also quickly broken down once they have been injected – within a few days of vaccination there will be no vaccine mRNA left.

More research is being done, monitoring both women and their babies’ health during pregnancy and for a year after the baby’s birth. We know the COVID-19 vaccines are safe in pregnancy, but this is the next step in looking at the level of protection they provide, what the best interval between doses is, and the immune responses produced in both the woman and the baby after vaccination.

Yes, if you are eligible for a booster vaccine because you’re at increased risk of getting seriously ill from COVID-19, this is strongly recommended. Getting vaccinated before pregnancy will help prevent COVID-19 infection and its serious consequences.

Women who are trying to become pregnant do not need to avoid pregnancy after vaccination.

COVID-19 vaccines are considered to be very safe and effective at any stage of pregnancy. There’s no evidence that you need to delay vaccination until after the first 12 weeks.

We recommend you complete the course of vaccination before giving birth, or before you enter the third trimester, when the risk of serious illness from COVID-19 is greatest.

Pregnant women are eligible for the autumn booster programme, which can be booked via the NHS booking system.

A single booster dose can be given at least three months after any previous dose.   The three month interval applies to any vaccine, regardless of the product given for the previous doses.

Some women with underlying high-risk medical conditions causing immunosuppression may also be advised to have additional boosters (this is because women with these specific conditions may not respond as strongly to their earlier doses of the vaccine). If you are in this group and are pregnant, it is particularly important to complete your recommended vaccination course to protect you and your baby.

Yes, if you are eligible to receive an autumn booster vaccine because you are in a vaccine priority group then you can receive this during IVF treatment. More information is available from the Human Fertilisation and Embryology Authority (HFEA).

It may be sensible to separate your vaccination dates by a few days from some treatment procedures (for example, egg collection and embryo transfer in IVF), so any symptoms, such as fever, might be more easily identified as effects of the vaccine or the treatment procedure. Your medical team will be able to advise you about the best times for your situation.

There is no evidence to suggest COVID-19 vaccines will affect fertility.

The theory that immunity to the spike protein could lead to fertility problems is not supported by evidence. Most people who contract COVID-19 will develop antibodies to the spike and there is no evidence of fertility problems in people who have already had COVID-19.

There has been no published evidence that reports fertility problems in people following vaccination against COVID-19, or in animal studies of mRNA COVID-19 vaccines.

As more evidence becomes available on the safety of each COVID-19 vaccine (from longer periods of follow up), we will update our advice.

COVID-19 vaccines are strongly recommended in pregnancy. Vaccination is the best way to protect against the known risks of COVID-19 in pregnancy for both women and babies, including admission to intensive care and premature birth.

More than half of women who test positive for COVID-19 during pregnancy have no symptoms at all, but some pregnant women can get life-threatening illness from COVID-19, particularly if they have underlying health conditions. In the later stages of pregnancy, women are at increased risk of becoming seriously unwell with COVID-19.

COVID-19 infection can also adversely affect your pregnancy. In pregnant women with symptoms of COVID-19, it is twice as likely their baby will be born early, exposing the baby to the risks of prematurity. A study also found that pregnant women who tested positive for COVID-19 at the time of birth were more likely to develop pre-eclampsia or need an emergency caesarean. Their risk of stillbirth was twice as high, although the actual number of stillbirths remains low.

The benefits of vaccination include:

• reduction in severe disease for the pregnant woman
• reduction in the risk of stillbirth and prematurity for the baby
• potentially reducing transmission to vulnerable household members.

The UK Medicines and Healthcare products Regulatory Agency’s (MHRA) Yellow Card scheme collects and monitors information on safety concerns, such as suspected side-effects or adverse incidents involving medicines and medical devices, including vaccines. They have been analysing reports of miscarriage and stillbirth in pregnant women who have received the COVID-19 vaccines and have not identified any pattern to suggest the COVID-19 vaccines used in the UK, or any reactions to these vaccines, increase the risk of miscarriage or stillbirth.

Sadly, miscarriage is estimated to occur in about 1 in 4–5 pregnancies in the UK and most occur in the first 12–13 weeks of pregnancy (the first trimester). Stillbirths are estimated to occur in about 1 in 200 pregnancies in the UK.

Worldwide data shows that the rates of miscarriage were the same in those who had received a COVID-19 vaccine during pregnancy as in the general population who had not been vaccinated.

The COVID vaccines are known to have mild and short-lasting side-effects, such as a fever or muscle ache lasting a day or two. Reports of serious side-effects, such as allergic reaction or clotting problems, have been very rare.

Pregnant women who have been vaccinated can be monitored by The UK Teratology Information Service (UKTIS). Pregnant women can register directly with the MHRA Yellow Card Vaccine Monitor.

Another reporting mechanism for healthcare professionals is the PHE Inadvertent Vaccination in Pregnancy (VIP) system.

As of April 2022, pregnancy status is recorded in the national vaccination programme to make sure pregnant women and their babies’ outcomes can be followed up.

If you are pregnant you can have safely have a COVID-19 vaccine or booster at the same time as other vaccines, such as the flu jab or the whooping cough vaccine.

If they aren’t given together then they can be administered at any interval.

The COVID-19 vaccine is booked through the NHS booking system. The national flu vaccine programme is booked through your GP or pharmacist, and the whooping cough vaccine may be offered by your maternity service, or you can ask your GP or midwife. 

For the current round of boosters, the government are offering vaccines made by Pfizer, Sanofi-GSK and Moderna. All options that are being offered are safe in pregnancy and effective against developing severe COVID-19.

Receiving the booster vaccine as early as possible is more important than the type of booster vaccine given, and so the JCVI specifically recommend that the key priority is receiving a booster vaccine, not which type you receive. This is particularly important for pregnant women who are more at risk of severe illness and hospitalisation with COVID-19 in the third trimester.

One trial of COVID-19 vaccines in pregnant women in the UK is currently underway, and another is planned.

• A government-funded clinical trial investigating best COVID-19 vaccine dose interval for pregnant women was launched in England in August 2021. The study is being led by St George’s, University of London, and will gather more robust data on how best to protect pregnant women and their babies from COVID-19. The clinical trial will investigate the immune response to vaccination at different dose intervals, monitoring the protection provided by the vaccine for pregnant women and their babies.

COVID-19 vaccination is the best way to protect both women and their babies from COVID-19 and there are good data showing no adverse effects on babies following maternal vaccination. In line with UK Government and JCVI advice, we continue to recommend COVID-19 vaccination to those who are eligible and breastfeeding.

Unlike pregnant women, breastfeeding women are not automatically in a priority group for the booster. However, breastfeeding women who are part of another priority group eligible for the autumn 2023 booster, are recommended to have the vaccine.

Like all medicines, vaccines can cause adverse effects. These are usually mild and do not last long. Very common side-effects in the first day or two after your vaccine include: pain or tenderness in your arm where you had your injection, feeling tired and headaches, aches and chills.

You may also have flu-like symptoms and experience episodes of shivering or shaking for a day or two. If you develop a fever (your temperature is 38°C or above) you can rest and take paracetamol, which is safe in pregnancy.

You can report any suspected side-effects through the Yellow Card scheme, which allows the MHRA to monitor side-effects and ensure vaccines are safe.

If you are concerned about your symptoms, you can contact your GP or maternity team for further advice.