Guidance

COVID-19 vaccination: a guide on pregnancy and breastfeeding

Updated 11 April 2022

Applies to England

COVID-19 vaccination is strongly recommended for pregnant and breastfeeding women.

The coronavirus (COVID-19) vaccines available in the UK have been shown to be effective and to have a good safety profile. It is important to have your COVID-19 vaccinations to protect you and your baby.

COVID-19 vaccination in pregnancy

The Joint Committee on Vaccination and Immunisation (JCVI) has now advised that pregnant women are more at risk of severe COVID-19 disease. They are reminding pregnant women to have their COVID-19 vaccines as soon as possible. They should not delay vaccination until after they have given birth. This is to protect them and their babies. In the UK, over 100,000 pregnant women have been vaccinated mainly with Pfizer and Moderna vaccines and they have a good safety profile.

These vaccines do not contain live coronavirus and cannot infect a pregnant woman or her unborn baby in the womb.

Evidence on COVID-19 vaccines is being continuously reviewed by the World Health Organization and the regulatory bodies in the UK, US, Canada and Europe.

Pfizer and Moderna vaccines are the preferred vaccines for pregnant women of any age who are coming for their first dose.

Anyone who has already started vaccination and is offered a second dose whilst pregnant, should have a second dose with the same vaccine unless they had a serious side effect after the first dose.

Why you need the vaccine if you are pregnant

If you have COVID-19 disease in later pregnancy, both you and your unborn baby are at increased risk of serious disease needing hospital treatment, and intensive care support. UK data has shown that almost every pregnant woman with COVID-19 disease who needed hospital treatment or intensive care, had not been vaccinated. The overall risk from COVID-19 disease for you and your new baby is low but has increased since the first waves of COVID-19.

COVID-19 vaccines in pregnancy give you high levels of protection against disease. There is reassuring information on the safety of COVID-19 vaccines given to pregnant women in the UK, as well as other countries.

It is important that you are protected with all your vaccine doses to keep you and your baby safe. Don’t wait until after you have given birth.

Pregnant women with underlying clinical conditions are at higher risk of suffering serious complications from COVID-19.

Risk factors for pregnant women

If you have underlying medical conditions such as:

• immune problems
• diabetes
• high blood pressure
• heart disease
• asthma

Or if you are:

• overweight
• over the age 35
• in your third trimester of pregnancy (over 28 weeks)
• of black and Asian minority ethnic background
• remain unvaccinated or partially vaccinated

You are at more risk from COVID-19 than women of the same age who are not pregnant.

Getting pregnant

There is no need to avoid getting pregnant after COVID-19 vaccination. There is no evidence that COVID-19 vaccines have any effect on fertility or your chances of becoming pregnant.

If you are pregnant

COVID-19 vaccines offer pregnant women the best protection against COVID-19 disease which can be serious in later pregnancy for some women.

The first dose of COVID-19 vaccine will give you good protection. You need to get each of your doses on time to get the best possible protection. You should have your second dose 8 to 12 weeks after your first dose. You do not need to delay this second dose. If you have delayed your vaccination for any reason, have your vaccinations as soon as possible.

If you have already had a first dose of COVID-19 vaccine without suffering any serious side effects, you can have your second dose with the same vaccine when this is offered.

If your first dose was the AstraZeneca (AZ) vaccine you should also consider the information in the COVID-19 vaccination and blood clotting leaflet.

Don’t put off vaccination until after you give birth, make time to get the best protection we have against COVID-19 disease for you and your baby.

Booster vaccines

Pregnant women are eligible for a booster, 12 weeks after their second dose. The booster dose that is offered may be a Pfizer or Moderna vaccine.

Breastfeeding

The benefits of breastfeeding are well-known.

The JCVI has recommended that the vaccines can be received whilst breastfeeding. This is in line with recommendations from the US and the World Health Organization.

Side effects

Like all medicines, vaccines can cause common side effects. It may be helpful to make sure you know what to expect after you have the vaccine, especially if you have had your baby or have other children to look after.

Please read the What to expect after your COVID vaccination leaflet.

Continue to follow current national guidance

No vaccines are 100% effective so it is important to continue to follow current national guidance.

To protect yourself and your family, friends and colleagues, you MUST still:

• where advised wear a face mask
• wash your hands carefully and frequently
• open windows to let fresh air in
• follow the current guidance

Further information

The Royal College of Obstetricians and Gynaecologists (RCOG) and Royal College of Midwives (RCM) have a decision guide and other information you may find helpful on COVID-19 vaccines and pregnancy.

Pregnancy, breastfeeding, fertility and COVID-19 vaccine information on NHS.UK.

If you would like to discuss COVID-19 vaccination please contact your midwife, doctor, or nurse.