Any time, and the sooner the better! It is safe for you and your baby to receive the COVID-19 vaccine at any stage in pregnancy. Given the risks of COVID-19 in pregnancy and complications for your health and your baby’s health, the sooner you can get vaccinated, the more protected you both will be.

‍Source:
‍The American College of Obstetricians and Gynecologists: Get Your Recommended COVID-19 Vaccine during Pregnancy
‍The American College of Obstetricians and Gynecologists: Vaccinations Needed during Pregnancy

Yes, any of the 2023-2024 COVID-19 vaccines are safe to receive anytime during pregnancy, when breastfeeding, while trying to get pregnant or if you may become pregnant in the future. Studies looking at the potential risks of the COVID-19 vaccines during pregnancy have been ongoing since before COVID-19 vaccines first became available. Thankfully, these studies have shown no increased risks of bad outcomes such as miscarriage, preterm delivery, or birth defects.

‍Source:
‍CDC - Getting the Updated COVID-19 Vaccine in Fall 2023
‍CDC - COVID-19 Vaccines While Pregnant or Breastfeeding
‍Safety and Effectiveness of Maternal COVID-19 Vaccines Among Pregnant People and Infants‍

Yes, the 2023-2024 COVID-19 vaccines have been proven to be safe to receive at any point in time, including while breastfeeding and while trying to get pregnant. In fact, getting the vaccine while breastfeeding can help protect your baby from COVID-19 infection as well.

Learn more here!

As of May 6, 2022, the Washington Department of Health paused the use of the Janssen COVID-19 Vaccine (Johnson & Johnson)  for people 18 years and older. The update followed guidance and recommendations from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) and the Western States Scientific Safety Review Workgroup.
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The update followed data presented to the ACIP about thrombosis and thrombocytopenia syndrome, or TTS. TTS is a rare but serious condition involving blood clots and a low blood platelet count seen in some people who received the J&J vaccine. Though TTS was rare, the FDA showed the risk of certain side effects warranted limiting the vaccine. Nationwide, 54 cases of TTS, including nine confirmed deaths, were reported, which is a fraction of a percent of the 14 million doses of J&J given overall. While TTS was been seen in both men and women, the most at-risk group was women 30 through 49 years old.
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The Pfizer-BioNTech and Moderna COVID-19 vaccines, both of which are mRNA vaccines and use a different method than the J&J COVID-19 vaccine to protect against the virus, have not been linked to blood clots at this time.

Source: 
‍Yale Medicine - The Link Between J&J’s COVID Vaccine and Blood Clots: What You Need to Know

In September 2023, the FDA 2023-2024 COVID-19 vaccines to help protect people against the COVID-19 virus. The Centers for Disease Control (CDC) recommends that everyone older than 6 months of age receive at least one dose of 2023-2024 COVID-19 vaccine.

Children 6 months - 4 years old may need more than one dose to be up to date.

Source:
CDC Updates Vaccine Recommendations

Viruses such as COVID-19 can mutate and change over time. The 2023-2024 COVID-19 vaccines are specially formulated to help protect you against the current COVID-19 variants. COVID-19 illness can still be very dangerous, even if you have been vaccinated or had a COVID-19 illness in the past. Additionally, immunity to COVID-19 decreases over time, regardless of if you have been vaccinated or had the illness in the past. Staying up to date on COVID-19 vaccination helps keep your immune system strong so your body can fight the virus.

Source: AAMC - What doctors and patients need to know

The 2023-2024 COVID-19 vaccines can help protect you from getting very sick from a COVID-19 infection. In past years, the COVID-19 vaccines have helped protect people from severe illness, including the need for hospitalization and even death. If you are pregnant or are recently pregnant you are more likely to get severely sick from COVID-19 compared to people who are not pregnant. Keeping yourself healthy during pregnancy is important for your and your baby’s health.

‍Sources: 
‍CDC - Updated COVID-19 Vaccine for Fall/Winter Virus Season

You should wait at least two months from your last COVID-19 vaccine before receiving a 2023-2024 COVID-19 vaccine. If you have had the COVID-19 disease recently, you can wait three months before getting the vaccine. The CDC and the American College of Obstetrics and Gynecology say that any point in pregnancy, or while breastfeeding, is a safe and effective time to get a COVID-19 vaccine.
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‍Source:
‍CDC - COVID-19 Vaccines While Pregnant or Breastfeeding

All of the COVID-19 vaccines “train” the immune system to identify, attack and destroy a tiny piece of the virus. This is how your immune system “learns the enemy” and can then quickly respond and bring in waves of immune cells to defeat the real virus in the future.The Pfizer and Moderna vaccines work by introducing messenger RNA (mRNA) into muscle cells. The cells make lots of copies of the COVID-19 spike protein, which triggers the body to make a protective immune response. The mRNA is quickly degraded, because the cell breaks it up into small harmless pieces after a few days. mRNA is very fragile, which is one reason the Pfizer vaccine needs to be kept in very cold freezers.

There is no “live virus” in the COVID-19 vaccine or any other harmful ingredients, thus making the COVID-19 vaccine safe for pregnant and breastfeeding individuals.

‍Source: CDC: Understanding mRNA COVID-19 Vaccines

This is being studied, but appears to be rare.  Period changes might occur in far less than 1% of individuals and are short-lived. In the United Kingdom, out of more than 49.1 million women who have been vaccinated there were 41,332 reports of possible menstrual cycle changes (0.0008%). A normal period can vary widely from person to person and month to month. Exercise, diet and even stress can change a period, as well as lots of medications including birth control. Several studies in different countries indicate that the psychological stress of the pandemic has increased the irregularity of women’s periods. In a study of 127 women with the COVID-19 disease, 16% noticed changes in their menstrual cycle, which most commonly was reported as an irregular period. Interestingly, women reporting more COVID-19 symptoms were more likely to have an abnormal period. In summary, it appears that irregular periods are commonly reported after COVID-19 disease (16%), especially when women are ill, and rare after COVID-19 vaccination (<1%). More research is still being done on this topic.‍

‍Sources:
‍National Institute of Child Health and Development (NICHD): NIH funds studies to assess potential effects of COVID-19 vaccination on menstruation
‍American Journal of Obstetrics & Gynecology (AJOG): SARS-CoV-2 infection and subsequent changes in the menstrual cycle among participants in the Arizona CoVHORT study
‍Frontiers in Endocrinology: The Impact of the COVID-19 Pandemic on Women’s Reproductive Health
‍The Journal of Obstetrics and Gynaecology Research: The impact of COVID-19-related mental health issues on menstrual cycle characteristics of female healthcare providers
‍The Journal of Obstetrics and Gynaecology: Triangle of COVID, anxiety and menstrual cycle
‍The American College of Obstetricians and Gynecologists Labor of Love Podcast: Episode 3: “Understanding COVID-19 and Fertility”

Yes. There are many studies now supporting that COVID-19 disease can temporarily harm a man’s fertility or permanently harm a man’s ability to have an erection. After reviewing research databases, the American Society for Reproductive Medicine said, "No evidence of any connection between COVID-19 vaccines and male infertility was found, but there were 50 reviews, 17 commentaries/letters to editors and nine original articles on how COVID-19 disease could possibly impact male fertility." We have listed some of the ways that COVID-19 disease can do this below:

‍1. Temporary decrease in sperm count and quality: A severe illness (of any kind) is known to lower sperm counts in men for 3-6 months, as having a fever during a severe illness disrupts the process of making sperm. Therefore, it is not surprising that men who have had COVID-19 disease have been reported to have lowered sperm count and quality. In general, changes in sperm count due to an infection are typically short-term and recover after 3 months of time. Longer term studies of sperm count and quality in men recovering from COVID-19 are needed.

2. Testicle swelling and pain. Several studies indicate that about 10-22% of men with COVID-19 disease will experience swelling of the testicles and pain, possibly due to a direct infection of the testes.

3. Erectile dysfunction. COVID-19 is known to injure blood vessels in many organs including the lungs, heart and brain leading to higher rates of heart attack and stroke. A penile erection depends on strong blood flow into the penis and healthy veins as well as, testosterone. There are many reports and studies of men losing their ability to have an erection after COVID-19 disease, which may be due to blood vessel damage, lower testosterone and/or psychological distress. How frequently this might occur is unknown.

Sources:
Canadian Urological Association Journal: Effect of SARS-CoV-2 infection on semen parameters
‍The World Journal of Men's Health: Evaluation of SARS-CoV-2 in Human Semen and Effect on Total Sperm Number: A Prospective Observational Study

No. Thousands of women have become pregnant after receiving one or more COVID-19 vaccines. More than 4,800 people had a positive pregnancy test after receiving a first dose of either the Pfizer or Moderna COVID-19 vaccine. Another report documents more than 1,000 people becoming pregnant after receiving any COVID-19 vaccine. Medical societies that serve women who would like to become pregnant have overwhelmingly recommended that people thinking about becoming pregnant get the vaccine. Studies that included patients undergoing fertility treatments who also received the COVID-19 vaccine found that there were no problems with implantation or early pregnancy development.

In addition, there is no link to male infertility after receiving the COVID-19 vaccine. In fact, sperm count and quality has been studied in men before and after COVID-19 vaccination. Not only were there no harmful effects found, but sperm counts were also actually higher after vaccination. This was within normal individual variation and not thought to be due to the vaccination.

‍Sources:
The New England Journal of Medicine: Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons
‍COVID-19 Vaccination Coverage Among Pregnant Women During Pregnancy — Eight Integrated Health Care Organizations
‍The American College of Obstetricians and Gynecologists: COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care
‍American Society for Reproductive Medicine (ASRM): Patient Management and Clinical Recommendations During the Coronavirus (COVID-19) Pandemic
American Society for Reproductive Medicine (ASRM): Joint Statement Regarding COVID-19 Vaccine in Men Desiring Fertility from the Society for Male Reproduction and Urology (SMRU) and the Society for the Study of Male Reproduction (SSMR)
‍JAMA Network: Sperm Parameters Before and After COVID-19 mRNA Vaccination

Yes. Compared to natural infection, the vaccine triggers the body to make powerful protective antibodies, which are successfully transferred to fetuses during pregnancy. Many people have become sick with COVID-19 more than once, which is likely the case due to the weaker immune response that comes from natural infections.

Your disease is likely to be very mild and in some cases, people have no symptoms at all with a breakthrough infection. This means that your vaccine worked – it prevented a severe disease that could have killed you or caused a bad outcome in pregnancy. In studies of pregnant people hospitalized with COVID-19, 97% were unvaccinated.

‍Source:
CDC: COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes from COVID-19

Yes. The COVID-19 booster shot is recommended in pregnancy. If you are 5 months out from your second dose of the Pfizer or Moderna COVID-19 vaccines and are pregnant, you are due for your booster shot. You can receive your COVID-19 booster at any stage in pregnancy. This will help give your immune system an extra memory booster to continue protecting you and your baby against exposure to COVID-19.  Receiving a COVID-19 booster vaccine when you are eligible is extremely important in protecting you and your baby from severe disease.
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‍Sources:
The American College of Obstetricians and Gynecologists: Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients
Society for Maternal Fetal Medicine (SMFM): Provider Considerations for Engaging in COVID-19 Vaccine CounselingWith Pregnant and Lactating Patients
American Society for Reproductive Medicine (ASRM): Patient Management and Clinical Recommendations During The Coronavirus (COVID-19) Pandemic

The CDC is recommending that an individual should get any of the current COVID-19 vaccine boosters that are currently available.  The timing of boosters and which booster to obtain continues to change and evolve.  Please check the latest information on boosters from the CDC.
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‍Sources:
CDC: COVID-19 Booster Shots , Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson)
Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions
medRxiv: Heterologous SARS-CoV-2 Booster Vaccinations - Preliminary Report

Every few months it seems that we are confronted with a new COVID-19 virus variant. In the case of the Delta variant, pregnant people acquiring this COVID-19 variant were reported to have a 2-4 times higher risk of severe disease, preterm birth and needing to be placed on a ventilator. Whether new COVID-19 variants will cause more or less infections and severe disease in pregnancy will take time to figure out. As pregnant individuals are one of the highest risk groups for severe COVID-19 disease and death, it is extremely important to get vaccinated, receive a COVID-19 vaccine booster when eligible, stay careful with masking, social distancing and keeping your “bubble” small.