Melanie Swift, M.D., COVID-19 Vaccine Allocation and Distribution, Mayo Clinic: Pregnant women should be offered the vaccine, and that is not just my opinion, that's the opinion of the American College of Gynecology and that's the opinion of the Society for Maternal-Fetal Medicine. These are experts and taking care of pregnant mothers, and they believe that women should be offered these vaccines. They really want to protect pregnant women from having severe outcomes from COVID.

Pregnant women are at increased risk for bad outcomes when they get COVID and even if they're healthy, the pregnancy itself makes them susceptible to some of the complications of COVID. So pregnant women are more likely to have severe COVID and more likely to be hospitalized, and any severe illness in pregnancy increases the risk to the outcome of the pregnancy.

Now we have registries of women who did choose to take the vaccine, because theoretically there's no reason it would be harmful for them to do so. We have some data that shows they haven't had any increased risk of bad outcomes from their pregnancies. Their babies have been just as healthy as their counterparts who weren't vaccinated. But looking at the transfer of immunity to their babies, there are some early signs from studies that have been conducted that are small, that show those antibodies do get transferred across the placenta to the baby. So Pfizer is enrolling about 4,000 women in a large study looking at the immunity that babies get when they're too young to be vaccinated. They could still get enough benefit from their mother being vaccinated to protect them from COVID in infancy. So it's still a question that's being answered. There are some very promising, early results.

There's absolutely no sign that it's any concern for breastfeeding mothers to take the vaccine. Perfectly safe for you to breastfeed after you've been vaccinated. Antibodies are detected in breast milk. Now, what we don't know is how well those antibodies get absorbed by the baby, and if they end up being protective or not. There's two ways that the baby could be getting antibodies from their mom. They could get it through the bloodstream, which we think is probably a pretty efficient way to immunize the baby, or they could get it through breast milk.

Pregnant women are sometimes confused by all of this understandably, and I would encourage them to talk with their ob/gyn, talk with their primary care provider who's taking care of them in their pregnancy and can advise them about the pros and cons of being vaccinated, and generally they're going to find reassurance there.

April 23, 2021