COVID Vaccination During Pregnancy
Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN
Content reviewed against published ACOG, CDC, NIH guidelines
Last reviewed:
Your health matters just as much as your baby's. If you are dealing with covid vaccination during pregnancy, here is what you need to know.
The short answer
COVID-19 vaccination is recommended during pregnancy by ACOG, CDC, and other major health organizations. COVID-19 infection during pregnancy significantly increases the risk of severe illness, ICU admission, preterm birth, and stillbirth. The mRNA vaccines (Pfizer, Moderna) have been extensively studied in pregnant people and shown to be safe and effective.
Key takeaways
- COVID-19 vaccination is recommended during pregnancy by ACOG, CDC, and other major health organizations. COVID-19 infection during pregnancy significantly increases the risk of severe illness, ICU admission, preterm birth, and stillbirth. The mRNA vaccines (Pfizer, Moderna) have been extensively studied in pregnant people and shown to be safe and effective.
- Usually normal when: Mild side effects (sore arm, fatigue, low fever) for 1-3 days after vaccination
- Call your doctor if: COVID symptoms during pregnancy (fever, cough, shortness of breath, loss of taste/smell) - seek testing and treatment promptly
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What Parents Should Know
According to ACOG, CDC, NIH guidelines, cOVID-19 vaccination is recommended during pregnancy by ACOG, CDC, and other major health organizations. COVID-19 infection during pregnancy significantly increases the risk of severe illness, ICU admission, preterm birth, and stillbirth. The mRNA vaccines (Pfizer, Moderna) have been extensively studied in pregnant people and shown to be safe and effective. At First trimester, cOVID vaccination is safe at any point during pregnancy, including the first trimester. Large studies have shown no increased risk of miscarriage. Common side effects are the same as in non-pregnant people: sore arm, fatigue, headache, and occasionally fever. Acetaminophen can be taken for side effects. It is generally considered normal when mild side effects (sore arm, fatigue, low fever) for 1-3 days after vaccination. However, you should contact your pediatrician promptly if cOVID symptoms during pregnancy (fever, cough, shortness of breath, loss of taste/smell) - seek testing and treatment promptly.
Normal vs. Concerning
By Age
What to expect by age
First trimester
COVID vaccination is safe at any point during pregnancy, including the first trimester. Large studies have shown no increased risk of miscarriage. Common side effects are the same as in non-pregnant people: sore arm, fatigue, headache, and occasionally fever. Acetaminophen can be taken for side effects.
Third trimester
Vaccination later in pregnancy provides maximum antibody transfer to the baby through the placenta. Antibodies from maternal vaccination have been found in cord blood and breast milk, providing passive immunity to the newborn. Stay up to date on recommended boosters.
What to Tell Your Pediatrician
- Describe when you first noticed covid vaccination during pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you have questions about which vaccine to get during pregnancy.
- Mention if you had a previous reaction to a COVID vaccine.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Mild side effects (sore arm, fatigue, low fever) for 1-3 days after vaccination
- Getting vaccinated at any trimester
- You have questions about which vaccine to get during pregnancy
- You had a previous reaction to a COVID vaccine
- You want to discuss timing of boosters
- COVID symptoms during pregnancy (fever, cough, shortness of breath, loss of taste/smell) - seek testing and treatment promptly
- Severe allergic reaction after vaccination - seek emergency care
What You Can Do at Home
- Keep track of when you notice covid vaccination during pregnancy — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that mild side effects (sore arm, fatigue, low fever) for 1-3 days after vaccination — this is generally within the range of normal.
- At First trimester, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
- While monitoring at home, seek immediate care if cOVID symptoms during pregnancy (fever, cough, shortness of breath, loss of taste/smell) - seek testing and treatment promptly.
Related Conditions
Influenza Vaccine in Pregnancy
The flu shot is recommended for all pregnant people during any trimester of pregnancy. Pregnant people are at higher risk for severe flu complications due to immune system and cardiopulmonary changes. The inactivated flu vaccine is safe and protects both you and your baby (through transferred antibodies) during the first months of life. The nasal spray flu vaccine should NOT be used during pregnancy.
Tdap Vaccination During Pregnancy
The Tdap vaccine (tetanus, diphtheria, and pertussis/whooping cough) is recommended during every pregnancy, ideally between weeks 27-36 of the third trimester. This allows the birthing parent to produce antibodies that cross the placenta, protecting the newborn from pertussis during their first vulnerable months before they can receive their own vaccines.
Related Resources
Frequently asked questions
Is covid vaccination during pregnancy normal?
When should I call the doctor about covid vaccination during pregnancy?
When is covid vaccination during pregnancy normal?
What causes covid vaccination during pregnancy?
What should I mention to my pediatrician about covid vaccination during pregnancy?
Is covid vaccination during pregnancy normal at First trimester?
Is covid vaccination during pregnancy normal at Third trimester?
Should I go to the ER for covid vaccination during pregnancy?
Does covid vaccination during pregnancy go away on its own?
References
- [1]American College of Obstetricians and Gynecologists. COVID-19 Vaccination Considerations for Obstetric-Gynecologic Care. ACOG Practice Advisory, 2023. ACOG
- [2]Centers for Disease Control and Prevention. COVID-19 Vaccines While Pregnant or Breastfeeding. CDC, 2023. CDC
- [3]National Institutes of Health. COVID-19 Vaccination in Pregnant and Lactating People. NIH, 2023. NIH
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss COVID Vaccination During Pregnancy.
Things to mention
- Describe when you first noticed covid vaccination during pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you have questions about which vaccine to get during pregnancy.
- Mention if you had a previous reaction to a COVID vaccine.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- You have questions about which vaccine to get during pregnancy
- You had a previous reaction to a COVID vaccine
- You want to discuss timing of boosters
Urgent signs to report immediately
- COVID symptoms during pregnancy (fever, cough, shortness of breath, loss of taste/smell) - seek testing and treatment promptly
- Severe allergic reaction after vaccination - seek emergency care
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of covid vaccination during pregnancy are normal. Talk to your pediatrician if covid symptoms during pregnancy (fever, cough, shortness of breath, loss of taste/smell) - seek testing and treatment promptly.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Maternal Concerns
Influenza Vaccine in Pregnancy
The flu shot is recommended for all pregnant people during any trimester of pregnancy. Pregnant people are at higher risk for severe flu complications due to immune system and cardiopulmonary changes. The inactivated flu vaccine is safe and protects both you and your baby (through transferred antibodies) during the first months of life. The nasal spray flu vaccine should NOT be used during pregnancy.
Tdap Vaccination During Pregnancy
The Tdap vaccine (tetanus, diphtheria, and pertussis/whooping cough) is recommended during every pregnancy, ideally between weeks 27-36 of the third trimester. This allows the birthing parent to produce antibodies that cross the placenta, protecting the newborn from pertussis during their first vulnerable months before they can receive their own vaccines.
Dealing with Abnormal Prenatal Screening Results
An abnormal prenatal screening result can be terrifying, but it is important to understand that screening tests are designed to cast a wide net and have significant false-positive rates. Most people with abnormal screening results go on to have healthy babies after further testing confirms the baby is fine. An abnormal screening is a reason for more information, not a diagnosis.
Pregnancy Over 35 (Advanced Maternal Age)
While pregnancy after 35 carries some increased risks (including chromosomal abnormalities, gestational diabetes, and hypertension), the vast majority of people over 35 have healthy pregnancies and healthy babies. The term "geriatric pregnancy" is outdated and does not reflect reality. With appropriate prenatal care and monitoring, outcomes are excellent.
Amniocentesis Questions and Fears
Amniocentesis is a diagnostic test performed between 15-20 weeks that analyzes amniotic fluid to detect chromosomal conditions and genetic disorders with over 99% accuracy. The risk of pregnancy loss from the procedure is approximately 1 in 500-1,000 when performed by an experienced provider. Understanding the actual risks can help you make an informed decision.
20-Week Anatomy Scan Unexpected Findings
The 20-week anatomy scan checks your baby's major organs, structures, and growth. Most scans are completely normal. When unexpected findings are identified, they range from minor variants that resolve on their own to conditions that need further evaluation. Many findings require nothing more than a follow-up ultrasound to confirm the baby is developing well.