Pregnant people are at an increased risk for severe illness from COVID-19 compared with nonpregnant people. Andrea Edlow, M.D., a maternal-fetal medicine specialist at Massachusetts General Hospital, says that's why it's very important for pregnant people to take this virus seriously and get vaccinated.

These six things can help you stay safe during your pregnancy. Make sure to always check with your obstetrician or other health care provider if you have questions.

1. Ensure you and those who live with you get vaccinated if they are eligible. Remember that if you are getting a two-dose vaccine series, like Moderna or Pfizer, you will not be considered fully vaccinated until two weeks after receiving your second dose.

2. Limit in-person interactions with people who may have been exposed to the virus, including those people in your household.

3. Wear a mask in indoor public places. Keep space between yourself and others in crowded spaces.

4. If you are fully vaccinated and have a preexisting condition other than pregnancy or are taking medications that weaken your immune system, you may need to take additional steps to protect yourself.

5. Wash your hands frequently with an alcohol-based sanitizer or soap and water. Avoid touching your eyes, nose, and mouth.

6. Check with your health care provider and hospital or other birthing location to learn about their COVID-19 guidelines before you go. Some hospitals only allow a certain number of people in the delivery room, for example.

As of August 2021, the Centers for Disease Control and Prevention (CDC) strongly recommends that all pregnant people get vaccinated against COVID-19.

If you are pregnant or were recently pregnant, you are more likely to get severely ill from COVID-19 compared to people who are not pregnant. Pregnancy causes changes in the body that could make it easier to get very sick from respiratory viruses like the one that causes COVID-19. These changes in the body can continue after pregnancy.

Severe illness means that a person with COVID-19 may need:

• Hospitalization
• Intensive care
• A ventilator or special equipment to help them breathe

People with COVID-19 who become severely ill can die.

Certain factors can increase risk

Other factors can further increase the risk for getting severely ill from COVID-19 during or recently after pregnancy, such as:

• Having certain underlying medical conditions
• Being older than 25 years
• Living or working in a community with high numbers of COVID-19 cases
• Living or working in a community with low levels of COVID-19 vaccination
• Working in places where it is difficult or not possible to keep at least 6 feet apart from people who might be sick
• Being part of some racial and ethnic minority groups, which have been put at increased risk of getting sick from COVID-19 because of the health inequities they face

People with COVID-19 during pregnancy are more likely to experience preterm birth (delivering the baby earlier than 37 weeks) and stillbirth and might be more likely to have other pregnancy complications compared to people without COVID-19 during pregnancy.

What You Need to Know

• People who are pregnant or recently pregnant are more likely to get severely ill with COVID-19 compared with people who are not pregnant.
• Getting a COVID-19 vaccine can help protect you from severe illness from COVID-19.
• COVID-19 vaccination is recommended for people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future.
• People who are pregnant may receive a COVID-19 vaccine booster shot.
• Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing. These data suggest that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy.
• There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men.

Increased Risk for Severe Illness from COVID-19

Although the overall risks are low, people who are pregnant or recently pregnant are at an increased risk for severe illness from COVID-19 compared with people who are not pregnant. Severe illness includes illness that requires hospitalization, intensive care, need for a ventilator or special equipment to breathe, or illness that results in death. Additionally, people who have COVID-19 during pregnancy are at increased risk of preterm birth and stillbirth and might be at increased risk of other pregnancy complications.

Safety and Effectiveness of COVID-19 Vaccination during Pregnancy

Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy, although limited, has been growing. It suggests that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy. Below is a brief summary of the growing evidence:

• COVID-19 vaccines do not cause COVID-19 infection, including in people who are pregnant or their babies. None of the COVID-19 vaccines contain live virus and cannot make anyone sick with COVID-19, including people who are pregnant or their babies.
• Early data on the safety of receiving an mRNA COVID-19 vaccine (Moderna or Pfizer-BioNTech) during pregnancy are reassuring.
  • Early data from three safety monitoring systems did not find any safety concerns for people who received an mRNA COVID-19 vaccine late in pregnancy or for their babies.¹
  • Scientists have not found an increased risk for miscarriage among people who received an mRNA COVID-19 vaccine just before and during early pregnancy (before 20 weeks of pregnancy).^2,3
  • The monitoring of COVID-19 vaccination during pregnancy is ongoing. CDC will continue to follow people vaccinated during all trimesters of pregnancy to better understand effects on pregnancy and babies.
• Early data suggest receiving an mRNA COVID-19 vaccine during pregnancy reduces the risk for infection. Recent studies from Israel compared people who were pregnant and received an mRNA COVID-19 vaccine with people who did not. Scientists found that vaccination lowered the risk of infection from the virus that causes COVID-19.^4,5
• Vaccination during pregnancy builds antibodies that might protect the baby. When people receive an mRNA COVID-19 vaccine during pregnancy, their bodies build antibodies against COVID-19, similar to people who are not pregnant. Antibodies made after a pregnant person received an mRNA COVID-19 vaccine were found in umbilical cord blood. This means COVID-19 vaccination during pregnancy might help protect babies against COVID-19. More data are needed to determine how these antibodies, similar to those produced with other vaccines, may provide protection to the baby.⁶
• No safety concerns were found in animal studies. Studies in animals receiving a Moderna, Pfizer-BioNTech, or Johnson & Johnson’s Janssen(J&J/Janssen) COVID-19 vaccine before or during pregnancy found no safety concerns in pregnant animals or their babies.
• No adverse pregnancy-related outcomes occurred in previous clinical trials that used the same vaccine platform as the J&J/Janssen COVID-19 vaccine. Vaccines that use the same viral vector as the J&J/Janssen COVID-19 vaccine have been given to people in all trimesters of pregnancy, including in a large-scale Ebola vaccination trial. No adverse pregnancy-related outcomes, including adverse outcomes affecting the baby, were associated with vaccination in these trials. Learn more about how viral vector vaccines work.

More clinical trials on the safety of COVID-19 vaccines and how well they work in people who are pregnant are underway or planned. Vaccine manufacturers are also collecting and reviewing data from people in the completed clinical trials who received a vaccine and became pregnant during the trial.

If you are pregnant and receive a COVID-19 vaccine, consider participating in the v-safe pregnancy registry

If you are pregnant and have received a COVID-19 vaccine, we encourage you to enroll in v-safe. V-safe is CDC’s smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after vaccination. A v-safe pregnancy registry has been established to gather information on the health of people who are pregnant who have received a COVID-19 vaccine. If people enrolled in v-safe report that they were pregnant at the time of vaccination or after vaccination, the registry staff* might contact them to learn more. Participation in v-safe is voluntary and participants may opt out at any time.

*Abt Associates has been contracted by the CDC to contact participants for CDC’s v-safe COVID-19 Vaccine Pregnancy Registry.

People who are Pregnant

COVID-19 vaccination is recommended for people who are pregnant. In addition, everyone who is ages 18 and older, including those who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future, should get a booster shot. Getting a COVID-19 vaccine can protect you from severe illness from COVID-19, and a healthy mom is important for a healthy baby. If you are pregnant, you might want to have a conversation with your healthcare provider about COVID-19 vaccination. While such a conversation might be helpful, it is not required before vaccination. You can receive a COVID-19 vaccine, including a booster shot, without any additional documentation from your healthcare provider.

CDC recommendations align with those from professional medical organizations serving people who are pregnant, including the American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine, along with many other professional medical organizations.

If you got pregnant after receiving your first shot of a COVID-19 vaccine that requires two doses (i.e., Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine), you should get your second shot to get as much protection as possible. If you experience fever following vaccination, you should take acetaminophen (Tylenol^®) because fever—for any reason—has been associated with adverse pregnancy outcomes.

If you are pregnant and have questions about COVID-19 vaccine

If you would like to speak to someone about COVID-19 vaccination during pregnancy, you can contact MotherToBaby whose experts are available to answer questions in English or Spanish by phone or chat. The free and confidential service is available Monday–Friday, 8am–5pm (local time). To reach MotherToBaby:

• Call 1-866-626-6847

People who are Breastfeeding

COVID-19 vaccination is recommended for people who are breastfeeding. In addition, everyone who is ages 18 and older, including those who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future, should get a booster shot. Clinical trials for the COVID-19 vaccines currently used in the United States did not include people who are breastfeeding. Therefore, there are limited data available on the:

• Safety of COVID-19 vaccines in people who are breastfeeding
• Effects of vaccination on the breastfed baby
• Effects on milk production or excretion

COVID-19 vaccines cannot cause COVID-19 infection in anyone, including the mother or the baby, and vaccines are effective at preventing COVID-19 in people who are breastfeeding. Recent reports have shown that breastfeeding people who have received mRNA COVID-19 vaccines have antibodies in their breastmilk, which could help protect their babies. More data are needed to determine what level of protection these antibodies may provide to the baby.

Prevent the Spread of COVID-19 after Vaccination: Follow Recommendations

After you are fully vaccinated, you may be able to participate in many of the activities that you did before the pandemic.

If you have a condition or are taking medications that weaken your immune system, you may NOT be fully protected even if you are fully vaccinated. Talk to your healthcare provider. Even after vaccination, you may need to continue taking all precautions. CDC recommends that people with moderately to severely compromised immune systems receive an additional primary dose of mRNA COVID-19 vaccine at least 28 days after a second dose of Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine. Talk to your healthcare provider about whether getting an additional primary dose is appropriate for you.

Vaccine Side Effects

Side effects can occur after receiving any of the available COVID-19 vaccines, especially after the second dose for vaccines that require two doses. People who are pregnant have not reported different side effects from people who are not pregnant after vaccination with mRNA COVID-19 vaccines (Moderna and Pfizer-BioNTech vaccines). If you experience fever following vaccination you should take acetaminophen (Tylenol^®) because fever—for any reason—has been associated with adverse pregnancy outcomes.

Although rare, some people have had allergic reactions after receiving a COVID-19 vaccine. Talk with your healthcare provider if you have a history of allergic reaction to any other vaccine or injectable therapy (intramuscular, intravenous, or subcutaneous).

Key considerations you can discuss with your healthcare provider include:

• The benefits of vaccination
• The unknown risks of developing a severe allergic reaction
• If you have an allergic reaction after receiving a COVID-19 vaccine during pregnancy, you can receive treatment for it.

People Who Would Like to Have a Baby

COVID-19 vaccination is recommended for people who are trying to get pregnant now or might become pregnant in the future, as well as their partners.

Johnson & Johnson’s Janssen (J&J/Janssen) COVID-19 vaccine: Women younger than 50 years old should especially be aware of the rare risk of blood clots with low platelets after vaccination. There are other COVID-19 vaccines available for which this risk has not been seen.

It is especially important for people who are or were recently pregnant, and those who live or visit with them, to take steps to protect themselves and others from getting COVID-19.

Limit in-person interactions with people who might have been exposed to COVID-19, including people within your household, as much as possible. If you or someone in your household is sick with COVID-19, follow guidance for isolation.

Important Ways to Slow the Spread of COVID-19

• Get a COVID-19 vaccine as soon as you can. Find a vaccine.
• Wear a mask that covers your nose and mouth to help protect yourself and others.
• Stay 6 feet apart from others who don’t live with you.
• Avoid crowds and poorly ventilated indoor spaces.
• Test to prevent spread to others.
• Wash your hands often with soap and water. Use hand sanitizer if soap and water aren’t available.

Keep all of your healthcare appointments during and after pregnancy. Visit with your healthcare provider for all recommended appointments. If you’re concerned about going to your appointments in person because of COVID-19, ask your healthcare professional what steps they are taking to protect patients from COVID-19, or ask about telemedicine options. If you need help finding a healthcare professional, contact your nearest hospital, clinic, community health center, or health department.

• Talk to your healthcare professional about how to stay healthy and take care of yourself and the baby.
• Ask any questions you have about the best place to deliver your baby. Delivering a baby is always safest under the care of trained healthcare professionals.
• You should also talk to your healthcare professional if you think you are experiencing depression during or after pregnancy.
• Get recommended vaccines during pregnancy. These vaccines can help protect you and your baby.
  • Get a flu vaccine every year. Others living in your household should also get vaccinated to protect themselves and you.
  • Get the Tdap vaccine to protect your baby against whooping cough, which can have similar symptoms to COVID-19. CDC recommends all pregnant people receive a Tdap vaccine during each pregnancy. In addition, everyone who is around the baby should be up to date with their whooping cough vaccine.
• Call your healthcare professional if you have any concerns about your pregnancy, if you get sick, or if you think that you may have COVID-19.
• Do not delay getting emergency care because of worries about getting COVID-19. Emergency departments have steps in place to protect you from getting COVID-19 if you need medical care.
  • If you need emergency help, call 911 right away. If someone else is driving you to the emergency department, call the emergency facility while you are on the way. If you must drive yourself, call before you start driving.
  • Tell them that you are pregnant or were recently pregnant and are having an emergency.
• Seek medical care immediately if you experience any urgent maternal warning signs and symptoms (for example, headache that won’t go away, dizziness, fever, severe swelling of hand, face, arm or leg, trouble breathing, chest pain or fast-beating heart, severe nausea and throwing up, or vaginal bleeding or discharge during or after pregnancy).These symptoms could indicate a potentially life-threatening complication.

If you have any symptoms of COVID-19, contact your healthcare professional within 24 hours, and follow steps for when you feel sick.

If you are diagnosed with COVID-19, learn about breastfeeding and caring for newborns when the mother has COVID-19. Current evidence suggests that breast milk is not likely to spread the virus to babies.

We still have much to learn about the risks of COVID-19 for newborns of people with COVID-19, however we do know these facts:

• Although the absolute risks are low, people who are pregnant or recently pregnant are more likely to get severely ill from COVID-19 compared with people who are not pregnant. People who have COVID-19 during pregnancy are also more likely to give birth early and experience a stillbirth.
• Most newborns of people who had COVID-19 during pregnancy do not have COVID-19 when they are born.
• Some newborns have tested positive for COVID-19 shortly after birth. We don’t know if these newborns got the virus before, during, or after birth.
• Most newborns who tested positive for COVID-19 had mild or no symptoms and recovered. Reports say some newborns developed severe COVID-19 illness.

Caring for your newborn in the hospital if you have COVID-19

Current evidence suggests that the chance of a newborn getting COVID-19 from their birth parent is low, especially when the parent takes steps (such as wearing a mask and washing hands) to prevent spread before and during care of the newborn.

Decide if your newborn is rooming-in with you in the hospital.

Talk to your healthcare provider about the risks and benefits of having your newborn stay in the same room with you. Having your newborn stay in the room with you has the benefit of making breastfeeding easier, and it helps with parent-newborn bonding.

Take precautions if your newborn is rooming-in with you in the hospital.

If you are in isolation for COVID-19 and are sharing a room with your newborn, take the following steps to reduce the chance of spreading the virus to your newborn:

• Wash your hands with soap and water for at least 20 seconds before holding or caring for your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
• Wear a mask whenever you are within 6 feet of your newborn.
• Keep your newborn more than 6 feet away from you as much as possible.
• Talk to your healthcare provider about how you can protect your newborn, such as using a physical barrier (for example, placing the newborn in an incubator) while in the hospital.

When your isolation period has ended, you should still wash your hands before caring for your newborn, but you do not need to take the other precautions. You most likely will not pass the virus to your newborn or any other close contacts after your isolation period has ended.

• If you had symptoms, your isolation period ends after:
  • 10 days since symptoms first appeared, and
  • 24 hours with no fever, without fever-reducing medicine, and
  • Other symptoms of COVID-19 are improving.
• If you never had symptoms, your isolation period ends after
  • 10 days have passed since you tested positive for COVID-19.

These timeframes do not apply if you have a severely weakened immune system or were severely ill with COVID-19.

Caring for your newborn at home if you have COVID-19

If you are in isolation for COVID-19, take the following precautions until your isolation period has ended:

• Stay home to separate yourself from others outside your home.
• Isolate (stay away) from other household members who are not infected, and wear a mask in shared spaces.
• Have a healthy caregiver who is fully vaccinated and not at higher risk for severe illness provide care for your newborn newborn (see recommendations below).
  • Follow recommended precautions if you must care for your newborn before your isolation period has ended.

Recommended precautions for healthy caregivers helping care for newborns:

• Caregivers should wash their hands for at least 20 seconds before touching your newborn. If soap and water are not available, they should use a hand sanitizer with at least 60% alcohol.
• If the caregiver is living in the same home or has been in close contact with you and is not yet fully vaccinated for COVID-19, they might have been exposed.
  • People who have come into close contact with someone with COVID-19 should be tested to check for infection:
    • Fully vaccinated people should be tested 5–7 days after their last exposure.
    • People who are not fully vaccinated should get tested immediately when they find out they are a close contact. If their test result is negative, they should get tested again 5–7 days after their last exposure or immediately if symptoms develop.
    • Self-tests are one of several options for testing for the virus that causes COVID-19 and may be more convenient than laboratory-based tests and point-of-care tests. Ask your healthcare provider or your local health department if you need help interpreting your test results.
• They should wear a mask when they are within 6 feet of your newborn for the entire time you are in isolation, and during their own quarantine after you complete your isolation.

If a healthy caregiver is not available, you can care for your newborn if you are well enough.

• Wash your hands with soap and water for at least 20 seconds before touching for your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
• Wear a mask when within 6 feet of your newborn and other people during your entire isolation period. The mask helps prevent you from spreading the virus to others.
• Others in your household, and caregivers who have COVID-19, should isolateand avoid caring for the newborn as much as possible. If they have to care for the newborn, they should follow hand washing and mask recommendations above.

Once yourisolation period has ended, you should still wash your hands before caring for your newborn, but you don’t need to take the other precautions. You most likely won’t pass the virus to your newborn or any other close contacts after your isolation period has ended.

• If you had symptoms, your isolation period ends after:
  • 10 days since symptoms first appeared, and
  • 24 hours with no fever without fever-reducing medicine, and
  • Other symptoms of COVID-19 are improving
• If you never had symptoms, your isolation period ends after
  • 10 days have passed since you tested positive for COVID-19.

These timeframes do not apply if you have a severely weakened immune system or were severely ill with COVID-19.

Monitor your newborn for COVID-19 symptoms.

If your newborn has one or more of these signs or symptoms, they may have early symptoms of COVID-19 or another illness, and you should contact your healthcare professional.

• Fever (a temperature of 100.4 or higher is considered an emergency)
• Lethargy (being overly tired or inactive)
• Runny nose
• Cough
• Vomiting
• Diarrhea
• Poor feeding
• Increased work of breathing or shallow breathing

Current evidence suggests that breast milk is not likely to spread the virus to babies.

COVID-19 vaccination is recommended for people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future. In addition, everyone who is eligible, including those who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future, should get a booster shot. You should always wash your hands with soap and water for 20 seconds before breastfeeding or expressing breast milk,even if you don’t have COVID-19. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.

If you have COVID-19 and choose to breastfeed:

• Wash your hands before breastfeeding
• Wear a mask while breastfeeding and whenever you are within 6 feet of your baby.

If you have COVID-19 and choose to express breast milk:

• Use your own breast pump (one not shared with anyone else), if possible.
• Wear a mask as you express breast milk.
• Wash your hands with soap and water for at least 20 seconds before touching any pump or bottle parts, and before expressing breast milk.
• Follow recommendations for proper pump cleaning after each use. Clean all parts of the pump that come into contact with breast milk.
• Consider having a healthy caregiver feed the expressed breast milk to the baby. The caregiver should be fully vaccinated (at least two weeks after the 2nd dose of a 2-dose vaccine or two weeks after a 1-dose vaccine) and not be at increased risk for severe illness from COVID-19. If the caregiver is living in the same home or has been in close contact with you and is not yet fully vaccinated for COVID-19, they might have been exposed.
  • People who have come into close contact with someone with COVID-19 should be tested to check for infection:
    • Fully vaccinated people should be tested 5–7 days after their last exposure.
    • People who are not fully vaccinated should get tested immediately when they find out they are a close contact. If their test result is negative, they should get tested again 5–7 days after their last exposure or immediately if symptoms develop.
    • Self-tests are one of several options for testing for the virus that causes COVID-19 and may be more convenient than laboratory-based tests and point-of-care tests. Ask your healthcare provider or your local health department if you need help interpreting your test results.
• Any caregiver feeding the baby should wear a mask when caring for the baby for the entire time you are in isolation and during their own quarantine period after you complete isolation.