Should I get the COVID-19 vaccination during pregnancy?

Key facts

  • COVID-19 infection in pregnancy can cause serious illness and complications for pregnant women and their babies.

  • There is strong evidence showing that COVID-19 vaccines are safe in pregnancy and help prevent serious illness. 

  • Women can get a COVID-19 vaccine at any stage in pregnancy, whenever their next recommended dose is due.

  • Information and recommendations about COVID-19 vaccines may continue to change.

Last updated on 1 November 2023.

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Overview

Making sense of changing recommendations and evidence about COVID-19 vaccines is hard, especially when you’re making decisions about COVID-19 vaccination in pregnancy. As a pregnant woman, it is recommended that you stay up to date with the recommended COVID-19 vaccine doses for your age and risk profile.

Vaccine recommendations are determined by the Australian Technical Advisory Group on Immunisation (ATAGI). ATAGI makes its recommendations based on the latest available data about case numbers, hospitalisation and infection rates, safety reports, and research evidence from around the world. 

The recommendations can change for many reasons. These include the availability of vaccines, the severity of different COVID-19 variants, the level of vaccination in the community, the rate of hospitalisation, and availability and effectiveness of different treatments.

Changes to the recommendations can be confusing, but it doesn’t mean they are based on poor quality evidence. In fact, we have strong research evidence showing the dangers of COVID-19 infection, particularly for pregnant women and their babies. We also have evidence from many studies now that show there are no safety concerns for your pregnancy. 

The safety and impacts of COVID-19 vaccines have been studied in several different ways. The first studies about COVID-19 vaccines were trials, which did not include pregnant women. This is normal for vaccine trials, which usually start by focusing on ‘average’ adults without significant medical conditions.

But now we have a lot of real-world evidence showing that COVID-19 vaccines are safe and work well for pregnant women.4 This evidence comes from studies where researchers collected information directly from healthcare professionals and patients, looked at large databases of medical records, and compared the outcomes of pregnant women and babies who got the vaccine and those who didn't. These studies included hundreds of thousands of women in many different countries. More evidence is being collected all the time, including from clinical trials. All this research evidence shows that COVID-19 vaccines are safe in pregnancy.

What happens when you catch COVID-19 during pregnancy?

Pregnant women are more likely to get very sick from COVID-19 than women who are not pregnant. COVID-19 infection in pregnancy can be dangerous for your baby.

Pregnant women are more likely than other adults to become seriously unwell from COVID-19. They are about five times more likely to need hospital admission, two to three times more likely to need admission to an intensive care unit and three times more likely to need ventilation support to breathe compared with non-pregnant women of the same age.5-7

Pregnant women with COVID-19 are 1.5 times more likely to give birth prematurely, experience stillbirth, and encounter other pregnancy issues compared to pregnant women without COVID-19. Babies born to women who catch COVID-19 while pregnant are three times more likely to have to be admitted to a neonatal unit after birth.6,7

How can I protect myself and my baby from COVID-19?

Vaccination is the most effective way to protect yourself and your baby from the COVID-19 virus. In Australia, COVID-19 vaccines are recommended for all people over the age of five. This includes pregnant women at any stage of pregnancy, women planning pregnancy and women who are breastfeeding. For pregnant women the recommended vaccine is Pfizer (Comirnaty) or Moderna (Spikevax).8 

Babies under six months of age are not eligible to receive a COVID-19 vaccine. From six months to five years, children are only eligible for vaccination if they are at higher risk of COVID-19 infection, and have certain medical conditions.

When should I be vaccinated?

You can get a COVID-19 vaccine at any stage of your pregnancy, while you are breastfeeding, while you are actively trying to conceive, or while you are undergoing IVF treatment.9 Pregnant women can get a COVID-19 vaccine at the same time as other vaccines like influenza and pertussis. 

Protection against COVID-19 weakens over time. If it has been more than six months since your last COVID-19 vaccine, or since you last had COVID-19, then you may be eligible for another dose. You can check the latest recommendations here.

The most effective way to protect yourself and your baby against COVID-19 is for you to have the COVID-19 vaccination during pregnancy. Babies cannot have a COVID-19 vaccine until they are at least six months old. Between six months and five years, only children with high-risk medical conditions are able to be vaccinated. If you have a COVID-19 vaccine while you are pregnant, the antibodies you produce will transfer across the placenta to your baby to give them some protection at birth.

Where do I go to get vaccinated?

The midwife or immunisation nurse at your antenatal clinic may be able to give you a COVID-19 vaccination. If not, then you can go to your GP, Aboriginal Community Controlled Health Service (ACCHS), or other immunisation provider. You can find COVID-19 vaccination services near you using the healthdirect Service Finder. 

If you need help making a COVID-19 vaccine booking, the Easy Vaccine Access service can help by putting you in touch with a trained operator from the National Coronavirus Helpline. 

For information about COVID-19 symptoms, COVID-19 vaccines, and vaccine clinic locations and contact information, phone the National Coronavirus Helpline on 1800 020 080.

How does the COVID-19 vaccine work?

The COVID-19 vaccines recommended for pregnant women in Australia are mRNA vaccines. They work by providing instructions to our cells to make the COVID-19 spike protein. The body then develops antibodies to the spike protein which circulate in the bloodstream ready to fight COVID-19 infection if that occurs. Both the mRNA in the vaccine and the spike protein are destroyed by the body within a few days to a week.

When your immune system sees this spike protein, it recognises it as a foreign invader and creates antibodies to fight it. The mRNA in the vaccine does not alter your DNA or cause any genetic changes, and it cannot be passed on to your baby through the placenta or through breastmilk. Only the antibodies that provide protection against COVID-19 infection are passed on to your baby.

Vaccinated pregnant women who catch COVID-19 are less likely to get very sick, have to go to hospital or be admitted into intensive care compared to non-vaccinated pregnant women.4,10,11

Evidence shows pregnant women who have been vaccinated for COVID-19 have a reduced risk of experiencing stillbirth, delivering prematurely, or their baby needing intensive care.4 Infants younger than six months of age whose mothers were vaccinated while pregnant are less likely to be hospitalised from COVID-19 infection, compared to mothers who were not vaccinated.12,13

No, the vaccine itself cannot cross the placenta into your baby. Studies of women vaccinated while pregnant have shown there is no mRNA or spike protein from the vaccine in umbilical cord blood, the placenta, or in babies after birth. The only thing that can pass to babies of vaccinated women is the protective antibodies produced by the mother’s body.

How safe is the COVID-19 vaccine?

The COVID-19 vaccine has been shown to be safe for pregnant and breastfeeding mothers and their babies.  

There is no increased risk of pregnancy complications because of vaccination and no increased health risks for your baby.14 There have been dozens of studies including hundreds of thousands of women vaccinated during pregnancy, and none of these studies found any increase in the risk of miscarriage, premature birth, stillbirth, low birthweight or other issues for babies.1,15

A person who has previously had an anaphylactic reaction to a component of the COVID vaccine should not be vaccinated. Other medical reasons are listed here.

No. You or your baby cannot get COVID-19 from any of the vaccines. None of the COVID-19 vaccines contain live virus.

Will I have a reaction to the COVID-19 vaccine?

Pregnant women are no more likely to experience side effects to COVID-19 vaccination than people who are not pregnant. The most common side effects of vaccination are injection site reactions, fatigue, headache, muscle pain, fever, chills and joint pain.16

If your symptoms last longer than a couple of days, or if you are worried about how you feel after your vaccination, you can get help from your doctor, or your nearest emergency department, or by calling Health Direct on 1800 022 222.

Less common side effects associated with vaccination include myocarditis and pericarditis.16

What else can I do to protect my child from COVID-19?

Getting vaccinated against COVID-19 during pregnancy is the best way to protect your baby against COVID-19.

You can also help protect small babies from getting COVID-19 by making sure that everyone around them has been vaccinated. It’s also sensible to keep small babies away from people who are sick, and to encourage anyone in the household who is unwell to cover their mouth when they cough or sneeze, to wash their hands regularly and to wear a mask.

How does the COVID-19 vaccine affect breastmilk and breastfeeding?

Studies have shown that the COVID-19 vaccines are safe for breastfeeding mothers and their babies. The vaccines do not affect breastmilk production. The antibodies produced by the mother's immune system after vaccination can be passed to the baby through breastmilk, providing some protection against COVID-19.17 No part of the vaccine itself, including the mRNA, can be passed to the baby through breastmilk.18,19 

Does the COVID-19 vaccine affect future fertility?

No. Receiving the COVID-19 vaccine will not affect fertility for men or women. Multiple studies have shown that COVID-19 vaccination does not affect fertility or increase the rate of miscarriage or other pregnancy complications.4,20

Yes, multiple studies have shown that COVID-19 vaccination has no impact on pregnancy rates in IVF patients.20

  1. Male V. SARS-CoV-2 infection and COVID-19 vaccination in pregnancy. Nature Reviews Immunology. 2022;22(5):277-82.
  2. Nunes MC, Madhi SA. COVID-19 vaccines in pregnancy. Trends in Molecular Medicine. 2022;28(8):662‒80.
  3. Watanabe A, Yasuhara J, Iwagami M, Miyamoto Y, Yamada Y, Suzuki Y, et al. Peripartum Outcomes Associated With COVID-19 Vaccination During Pregnancy: A Systematic Review and Meta-analysis. JAMA Pediatrics. 2022;176(11):1098-106.
  4. Prasad S, Kalafat E, Blakeway H, Townsend R, O’Brien P, Morris E, et al. Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy. Nature Communications. 2022;13(1):1-8.
  5. Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(44):1641-7.
  6. Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370; m3320.
  7. Yang Z, Wang M, Zhu Z, Liu Y. Coronavirus disease 2019 (COVID-19) and pregnancy: a systematic review. The Journal of Maternal-fetal & Neonatal Medicine. 2022;35(8):1619-22.
  8. Australian Government Department of Health and Aged Care. COVID-19 vaccination – Shared decision making guide for women who are pregnant, breastfeeding or planning pregnancy 2021 [updated 2022 Dec 6 cited 2022 Feb 8]. Available from: .
  9. Australian Government Department of Health and Aged Care. COVID-19 booster vaccine advice  [updated 2023 Feb 8; cited 2023 Feb 11]. Available from: .
  10. Schrag SJ, Verani JR, Dixon BE, Page JM, Butterfield KA, Gaglani M, et al. Estimation of COVID-19 mRNA vaccine effectiveness against medically attended COVID-19 in pregnancy during periods of delta and omicron variant predominance in the United States. JAMA Network Open. 2022;5(9).
  11. Villar J, Conti CPS, Gunier RB, Ariff S, Craik R, Cavoretto PI, et al. Pregnancy outcomes and vaccine effectiveness during the period of omicron as the variant of concern, INTERCOVID-2022: a multinational, observational study. The Lancet. 2023.
  12. Halasa NB, Olson SM, Staat MA, Newhams MM, Price AM, Boom JA, et al. Effectiveness of maternal vaccination with mRNA COVID-19 vaccine during pregnancy against COVID-19–associated hospitalization in infants aged< 6 months—17 states, July 2021–January 2022. Morbidity and Mortality Weekly Report. 2022;71(7):264.
  13. Zerbo O, Ray GT, Fireman B, Layefsky E, Goddard K, Lewis E, et al. Maternal SARS-CoV-2 vaccination and infant protection against SARS-CoV-2 during the first six months of life. Nature Communications. 2023;14(1):894.
  14. Hui L, Marzan MB, Rolnik DL, Potenza S, Pritchard N, Said JM, et al. Reductions in stillbirths and preterm birth in COVID-19–vaccinated women: a multicenter cohort study of vaccination uptake and perinatal outcomes. American Journal of Obstetrics and Gynecology.  2023 May;228(5):585.e1-585.e16..
  15. Zhang D, Huang T, Chen Z, Zhang L, Gao Q, Liu G, et al. Systematic review and meta-analysis of neonatal outcomes of COVID-19 vaccination in pregnancy. Pediatr Res. 2023:1-9.
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  19. Golan Y, Prahl M, Cassidy AG, Gay C, Wu AH, Jigmeddagva U, et al. COVID-19 mRNA vaccination in lactation: assessment of adverse events and vaccine related antibodies in mother-infant dyads. Frontiers in Immunology. 2021: Nov 3;12:777103.
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