Can I have the Covid vaccine if I'm pregnant or breastfeeding?

Are the Pfizer and AstraZeneca Covid-19 vaccines safe in pregnancy? And what about if you're breastfeeding or trying to conceive? Expert GP Dr. Philippa Kaye has the answers... Funk and Effortless.

With so much talk of the new AstraZeneca and BioNTech vaccines that are being rolled out across the UK - and the other Covid vaccines to come - we're all starting to wonder when the vaccine will be offered to us. But what happens if you're pregnant? Will you be offered the vaccine? And what about if you're breastfeeding? Or trying to get conceive?

We're getting lots of messages from women asking these questions, particularly as the AstraZeneca vaccine has now been approved for use in the UK and the UK Medical Officers' advice about having BioNTech vaccine in pregnancy or while breastfeeding has changed.

So here, courtesy of our expert family GP Dr. Philippa Kaye, is what we know so far…

Should I have the Covid vaccines if I'm pregnant?

You can have either the BioNTech or the AstraZeneca vaccine in pregnancy if "the potential benefits [of doing so] outweigh the risks", say experts at the Medicines and Healthcare products Regulatory Agency (MHRA).

This is new advice (issued 30 December 2020) and comes after initial advice that BioNTech vaccine (the only one licensed for use at the time) should not be given to pregnant women.

"Vaccine trials are not carried out on pregnant women - for obvious reasons," says Dr. Philippa, "so there is, to begin with, little medical data on how any of the new vaccines affect pregnant women.

This, taken together with the fact that pregnant women are not thought to be at increased risk of developing complications of Covid-19, meant that the UK's public-health experts took a precautionary approach with the BioNTech vaccine, advising women to wait until the end of their pregnancy before considering vaccination.

However, as further data from animal studies became available, this initial advice has been updated - and also applies to the rollout of the AstraZeneca vaccine. The new advice is that:

"The vaccine should only be considered for use in pregnancy when the potential benefits outweigh any potential risks for the mother and baby. Women should discuss the benefits and risks of having the vaccine with their healthcare professional and reach a joint decision based on individual circumstances"

Commission on Human Medicines, the independent UK regulator

In other words, if you are called to have either of the Covid vaccines - which in the early rollout (phase 1) of the vaccination programme would only happen if you are on the Priority List for Covid-19 vaccination, either because you are thought to be extremely clinically vulnerable or you are a frontline health or social care worker - you should talk to your midwife or GP and reach a decision together about whether to have the vaccine you are offered or not.

"Do bear in mind," says Dr. Philippa, "that if you are pregnant but not on the Priority List for Covid-19 vaccination, you are unlikely to be offered the vaccine in the first stages of vaccination, as priority will be offered to those at most risk of complications of the infection, starting with the most elderly and vulnerable."

Should I have the Covid vaccine if I'm breastfeeding?

Yes, you can, if - as with women who are pregnant the potential benefits [of doing so] outweigh the risks.

This is new advice (issued 30 December 2020) and comes after initial precautionary advice from Public Health England that BioNTech vaccine (the only one licensed for use at the time) should not be given to breastfeeding women.

"The risks of transmission will be different from when you are pregnant," says Dr. Philippa, "but again we didn't have much specific data with regards to the Covid vaccines and breastfeeding."

Now, as further data has become available, this precautionary advice has changed, and the UK Chief Medical Officers say:

"Breastfeeding women may be offered vaccination with either vaccine following consideration of the woman's clinical need for immunisation against COVID-19"

Joint Committee on Vaccination and Immunisation and UK Chief Medical Officers

What this mean is, if you are breastfeeding and are called to have either of the Covid vaccines - which in the early rollout (phase 1) of the vaccination programme would only happen if you are on the Priority List for Covid-19 vaccination, either because you are thought to be extremely clinically vulnerable or you are a frontline health or social care worker - you should talk to your midwife or GP and reach a decision together about whether to have the vaccine you are offered or not.

What if I'm trying to conceive?

You can have the vaccine and continue trying to get pregnant. And here, again, the initial precautionary advice has changed. The UK Chief Medical Officers now say:

"Those who are trying to become pregnant do not need to avoid pregnancy after vaccination"

UK Chief Medical Officers

Previous advice - again as a precautionary step before more research became available - was not to have the vaccine if you're trying to conceive or to have the vaccine but then delay trying to conceive for at least 2 months after having had the 2nd dose.

About our expert

Dr. Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy's, King's and St Thomas's medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr. Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.

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