COVID-19 boosters and pregnancy: Are they safe and should you get them?

Should you have your COVID-19 booster if you are pregnant?

The Department of Health and Social care is clear that the evidence shows catching COVID-19 carries a higher risk than getting vaccinated. It states vaccines and boosters continue to be the best ways for expectant parents to protect themselves (and their babies) against COVID-19. As Omicron continues to spread and cases increase, it has become apparent that two doses of the COVID-19 vaccine are not enough to ensure full protection. A booster is therefore required.

Dr Viki Male, a lecturer in reproductive immunology, stresses that we do not yet have data on how protective the booster is, specifically in pregnancy, since it is so new.

"The Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives both strongly recommend that if you are pregnant, you get your COVID-19 booster as soon as you are eligible for it. However, we don't have answers yet on how the boosters might increase immunity in pregnancy. What we do know is that, in the general population, the booster significantly increases protection against the Delta variant, and this is likely to be even more important against Omicron," she says.

Letting the facts get in the way of the conspiracy theories

While anti-vaxxers make up only a small minority of the UK population, conspiracy stories circulating on social media can still be frightening. It is understandable that pregnant people want the best for their babies, and one recent example claimed a huge increase in stillbirths among pregnant people taking up vaccination in Canada.

In fact, data from Vancouver Coastal health, where the conspiracy theory emerged, show there has been absolutely no increase in stillbirths since the vaccine was introduced: 0.3% of women had a stillbirth in April to late August 2021, compared to 0.33% in the previous year. In addition, a study of 13,956 pregnant women in Scandinavia found no increased risk of early pregnancy loss among those who were vaccinated against COVID-19.

By contrast, pregnant people who contracted COVID-19 infection were almost twice as likely to have a stillbirth as those who did not.

Should pregnant people be prioritised for boosters?

Dr Male believes being pregnant should make people a priority to have their COVID-19 booster jab, since pregnancy makes someone more vulnerable.

"If you catch COVID-19 after 28 weeks of pregnancy, it's more likely that the baby will be born preterm or stillborn. Also, I feel that we haven't been outspoken enough in encouraging pregnant people to protect themselves and their babies by getting vaccinated. Prioritising pregnant people would send a strong message that COVID-19 vaccination is safe in pregnancy, but COVID-19 is not," she explains.

Pregnant people have raised concerns over the lack of clear guidance on whether they should be prioritised for booster jabs, and the Joint Committee on Immunisation and Vaccination (JCVI) continues to review the decision.

It was announced by the JCVI this week that adults aged 18 and over should be eligible for their boosters. With regard to pregnant people, the first booster dose is available alongside the rest of the country, based on age.

Since we are still in the early stages of the booster roll-out, decisions are still being made on which groups should be prioritised, particularly since we do not yet know the extent of possible side effects.

At what stage in pregnancy is it safest to get vaccinated?

The Royal College of Obstetricians and Gynaecologists has recommended getting vaccinated before the third trimester. Research shows that pregnancy makes people particularly vulnerable to serious illness from COVID-19 in the third trimester.

"We now have evidence from hundreds of thousands of people who have had doses one and two of their boosters during pregnancy, telling us there's no increased risk of any complication associated with vaccination at any time in pregnancy. There are no concrete rules on how long you should wait before getting your vaccine; however, you should contact your GP if you have concerns and would like more advice," Dr Male says, even though there is strong evidence that COVID-19 vaccines are safe at any stage.

"You also don't need to wait for a certain time after you've had your other pregnancy vaccinations. You can arrange your COVID-19 vaccine whenever best suits. I would say that protection sooner is better than protection later, which is why we recommend getting boosted as soon as you are eligible. But if you have anxieties, talk them through with a medical professional."

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Are boosters safe for those who are breastfeeding?

Dr Male says we have good safety data for doses one and two of the COVID-19 vaccines while breastfeeding, and she says there are no concerns.

Regarding the boosters, many people who are breastfeeding have yet to have the booster, so we don't have data specifically on boosters and how they might impact on the ability to breastfeed.

However, there is no scientific reason to believe currently that the boosters would be unsafe, since the original vaccines themselves have shown they provide protection without any adverse effect on breastfeeding.

What side effects might a pregnant person experience after a booster?

The most common side effects after a COVID-19 vaccination or booster are (in order):

• A sore arm.

• Feeling tired.

• A headache.

• Body aches.

• A high temperature.

If these side effects bother you, you can take paracetamol. Dr Male assures that paracetamol is safe to take during pregnancy and it won't stop the vaccine working.

Where should you seek support if you have concerns about getting boosted while pregnant?

It's natural for your anxieties to be heightened during pregnancy, but especially during a pandemic and in the midst of a vaccine roll-out. If you are worried about getting vaccinated while pregnant, or want access to resources so you can make an informed decision, you can visit The Royal College of Obstetricians and Gynaecologists. Dr Male recommends their detailed Q&A page as a starting place.

However, if you would like to sit down and have a conversation with someone, do get in touch with your doctor or midwife. They will be able to address any specific worries you have.