Morgan called late Friday afternoon with a question about COVID-19 booster shots. She shared that she was 37 weeks along and had received both shots of the Pfizer COVID-19 vaccine back in February, at the very beginning of her pregnancy. Morgan wanted to do what was best to protect her baby, and asked if she qualified for the booster shot that was now available.
As a Teratogen Information Specialist at MotherToBaby California, COVID-19 vaccine questions are my number one inquiry right now. With the guidance continuing to evolve as the pandemic rages on, it can be hard for pregnant people to keep up! Luckily, that’s what we are here to help with. I shared with Morgan that although the vaccines are still working well to prevent severe illness, hospitalization, and death, overall effectiveness has been shown to decrease over time (called waning immunity). Because of this decreased protection, the Centers for Disease Control and Prevention (CDC) have recommended that certain groups who received their initial Pfizer-BioNTech vaccine series at least 6 months ago get a Pfizer booster shot. One of those groups that may choose to get a booster is individuals between the age of 18 and 49 who have underlying health conditions.
So, how does that apply to my pregnant caller Morgan? People who are pregnant and recently pregnant (42 days after delivery) fall under the umbrella of those with “underlying medical conditions” that may be more likely to get severely ill from COVID-19. We know that there are higher risks of ICU admission, need for a ventilator, and death when a person gets COVID-19 while pregnant, so protection of this group through vaccination is extremely important. I shared with Morgan that since it has been more than 6 months since she received her first two doses of the Pfizer vaccine, and since she is currently pregnant that she may choose to get a booster shot if she wants to, considering the individual benefits and risks.
Morgan and I went on to review the latest pregnancy data on the COVID-19 vaccines, which now includes thousands of women who have received mRNA vaccines (Pfizer or Moderna). Reassuringly, the data available does not suggest a risk for pregnancy complications (including miscarriage, preterm birth, stillbirth, effects on the baby’s growth, or infant death). Although Pfizer booster shots have not been specifically studied in pregnancy, they are the same dose and contain the same ingredients as the original Pfizer shots that are given. Most experts agree that the components of mRNA vaccines (like Pfizer) only stay in our bodies for a short time, and do not cross the placenta to reach the baby.
Morgan was happy to hear that she qualified for the Pfizer booster shot. Her three year old was in preschool, and although he wore his mask every day, she was still worried about him bringing home COVID and infecting her. She also visited her grandparents often, and wanted to keep them safe. For her, the benefits of protecting herself and her unborn baby definitely outweighed any potential risks.
Before we disconnected, Morgan asked about her sister-in-law who received the Moderna vaccine back in January and was now pregnant. “Would she be able to get a booster?” Unfortunately, the answer is “not yet.” At this time, the booster shot is only available for certain groups who completed their primary series with the Pfizer vaccine. Guidance for those who initially received a Moderna or Johnson & Johnson COVID-19 vaccine should be available in the coming weeks, but booster shots are not yet recommended for these individuals. I reminded Morgan that her sister-in-law still has good protection against becoming very sick or hospitalized from COVID-19 from her initial vaccination. Like everyone who is pregnant, she should continue to take precautions while she waits for guidance about a booster shot, such as wearing a mask and avoiding crowded indoor gatherings.
If you are unsure whether or not you qualify for a booster or you have other vaccine-related questions, please reach out to a MotherToBaby Specialist. And for anyone who has not yet received their initial COVID-19 vaccine, please know that it is strongly recommended before or during pregnancy by many organizations focused on maternal and child health, including the CDC, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine. If you would like to go over the latest pregnancy data for the COVID-19 vaccines or any other exposures, please give us a call.