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COVID-19 vaccination, pregnancy and breastfeeding

Blog post | 12 Dec 2021

Everyone in Australia aged 12 and over can now receive a COVID-19 vaccine. However, if you are pregnant or breastfeeding, you might be wondering whether it is safe for you to get vaccinated.

The Therapeutic Goods Administration (TGA) has provisionally approved 4 vaccines for use in Australia:

  • Comirnaty (Pfizer)
  • Spikevax (Moderna)
  • Vaxzevria (AstraZeneca)
  • Nuvaxoid (Novavax)

All of the approved vaccines have been shown to prevent illness — particularly severe illness — if you become infected with COVID-19.

The Australian Technical Advisory Group on Immunisation (ATAGI) and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) have recommended that pregnant women should routinely be offered the Pfizer or Moderna vaccines at any stage of their pregnancy.

ATAGI also recommend everyone over 18 years old get a booster dose at least 4 months after receiving your second dose of a COVID-19 vaccine. You can have either Pfizer or Moderna for the booster.

Novavax is for people aged 18 and over. While pregnant and breastfeeding women can have the Novavax vaccine, there is more safety data on the Pfizer and Moderna vaccines than with the Novavax vaccine. However, there are no theoretical safety concerns relating to use in pregnancy, since the Novavax vaccine, similarly to other COVID-19 vaccines, is not a live vaccine.

Novavax is expected to be available in late February 2022 and can be used as a primary course for people aged 18 or older. At this stage, Novavax is not approved for use as a booster.

If you’ve already received a first dose of AstraZeneca, your second dose can be either the AstraZeneca, the Pfizer or Moderna vaccine. Have a discussion with your maternity care provider about which is the best choice for you. Pfizer or Moderna is preferred in pregnancy because there is more information regarding their safety in pregnancy compared with AstraZeneca.

Why has the recommendation for pregnant women changed?

Most vaccine and drug clinical trials rarely include pregnant women in their testing. When the early advice was given there wasn’t evidence confirming the safety of COVID-19 vaccines during pregnancy.

Reports from real-world evidence gathered in other countries show that the mRNA COVID-19 vaccines Pfizer and Moderna are safe to use in pregnancy. Emerging research shows that pregnant women have a similar immune response to mRNA vaccines as women who are not pregnant.

Based on the data now available, ATAGI and RANZCOG have updated their advice for Australian women.

Can I get the COVID-19 vaccine if I'm planning a pregnancy?

If you are planning a pregnancy, you can receive the vaccine. You don’t need to avoid becoming pregnant or delay pregnancy after getting vaccinated.

There is no evidence that women who become pregnant after being vaccinated have an increased risk of developing complications that will affect their pregnancy or their baby’s health.

Can I get the COVID-19 vaccine if I'm pregnant?

What are the risks of COVID-19 during pregnancy?

Most people who get COVID-19 will experience only mild to moderate cold and flu-like symptoms, such as:

  • fever
  • coughing
  • sore throat
  • shortness of breath
  • loss of smell
  • headaches
  • fatigue

However, pregnant women have a higher risk of complications due to COVID-19 compared to non-pregnant women of the same age. There is an increased risk of being admitted to hospital as well as needing ventilation.

Pregnant women who have other risk factors, including a pre-existing medical condition, are even more likely to need treatment in hospital.

The possibility of having a premature birth also increases if you become ill with COVID-19 and also a chance your newborn could need further care in hospital.

However, there is currently no evidence that COVID-19 increases the risk of miscarriage or birth defects.

What do the expert say?

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has released a joint statement with ATAGI recommending that pregnant women should be routinely offered the Pfizer or Moderna vaccines at any stage during their pregnancy.

The vaccines have been shown to reduce the risk of severe illness and can also help reduce the chances of transmission.

RANZCOG recommends that all pregnant women who work in high-risk environments where you are more likely to have contact with people who have developed COVID-19, such as healthcare, quarantine or border protection, should consider getting vaccinated against COVID-19.

Women who work in a high-risk environment might consider working in an area of lower risk for a period of time, working from home or taking leave.

You should also consider getting vaccinated during pregnancy if you:

  • have a health condition that puts you at risk of developing severe COVID-19 – such as diabetes, chronic respiratory conditions, high blood pressure, heart or kidney disease and obesity
  • are an Aboriginal or Torres Strait Islander person
  • live in an area where there are COVID-19 cases

Furthermore, recent evidence has found the presence of antibodies in cord blood, which suggests that pregnant women who have had the vaccine may pass on some level of protection to their baby.

If you’re pregnant and wondering whether you should get vaccinated, talk to your doctor, midwife or obstetrician on whether they might get vaccinated. It’s important to discuss your options and understand if the benefit is greater than the risk.

How do I book my vaccination?

If you have a specific health concern or you would prefer a full health assessment, you should book your vaccination through your GP or healthcare provider.

You can get vaccinated at:

  • state and territory-operated vaccination clinics
  • Commonwealth Vaccine Clinics
  • participating general practices (GPs) or pharmacies
  • Aboriginal Community Controlled Health Services

Use the Vaccine Clinic Finder to find an appointment. Some state and territory governments also provide the option to book an appointment at their clinics through their websites.

VACCINE CLINIC FINDER — Use the Vaccine Clinic Finder to book a COVID-19 vaccination.

What should I do if I don’t get vaccinated?

All pregnant women should continue to practise good hand hygiene, wear a mask, maintain physical distancing and get tested if you have any symptoms.

It’s also important to keep up to date with other vaccinations that are approved and safe for pregnant women.

You can get the influenza (flu) vaccine at any stage of your pregnancy.

Pertussis (whooping cough) vaccine is recommended between 20 and 32 weeks of your pregnancy. Your partner, along with close family and friends, should also get the whooping cough vaccine 2 weeks before the baby is due.

Both vaccines are free for pregnant women as part of the National Immunisation Program (NIP).

Can I get the COVID-19 vaccine if I'm breastfeeding?

Although there is only limited research on the COVID-19 vaccines in breastfeeding women, there are no concerns about the safety of mRNA vaccines, such as Pfizer or Moderna, for breastfeeding mothers or their babies.

Pfizer and Moderna are recommended for breastfeeding women and you do not need to stop breastfeeding before or after being vaccinated.

Breastfeeding women can safely receive nearly all other non-COVID-19 vaccines. The only exception is the vaccine against yellow fever, which is a live vaccine.

There is also evidence to suggest that breastfeeding women who have had the vaccine may pass on antibodies through breastmilk which may offer some protection to your baby.

Where can I go for more information?

Discuss your options with your doctor, midwife or obstetrician. It is entirely your decision on whether you get vaccinated while you are pregnant or if you wait until after your baby is born.

Call us and speak to a Maternal Child Health Nurse for personal advice and guidance.

Need further advice or guidance from our maternal child health nurses?

Healthdirect Australia acknowledges the Traditional Owners of Country throughout Australia and their continuing connection to land, sea and community. We pay our respects to the Traditional Owners and to Elders both past and present.

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The information is not a substitute for independent professional advice and should not be used as an alternative to professional health care. If you have a particular medical problem, please consult a healthcare professional.

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