Covid vaccines for pregnancy and babies: Sorting fact from chaos
Karen Kierpaul
From: Your Local Epidemiologist <yourlocalep...@substack.com>
Date: Wed, Jun 4, 2025 at 9:17 AM
Subject: Covid vaccines for pregnancy and babies: Sorting fact from chaos
To: <k.a.ki...@gmail.com>
Si quiere leer la versión en español, pulse aquí. The events of the past week around Covid-19 vaccines have created a whirlwind of confusion—especially for those trying to make the best decisions for themselves and their families. So this is for the parents, expectant families, and clinical care teams trying to do the right thing through all the noise. If that’s not you, I hope you’ll forward this to someone navigating early parenthood or practicing on the frontlines of medical care. Have more questions? I’ll be hanging out in the YLE chat live at 12pm PST today for paid subscribers. Come say hi! Let’s start with where things stand today: Pregnant women and children are still eligible for the Covid-19 vaccine. It’s effective. It’s safer than the disease. It helps during pregnancy and the first few months of life. Once a baby is 6 months old, the primary Covid-19 vaccine series remains important to build long-term immunity. But… didn’t I just see headlines saying pregnant people and kids aren’t eligible anymore?Yes. And this is very confusing. Let’s back up. Until recently, everyone over 6 months old was eligible for an annual Covid-19 vaccine every year. That included pregnant women who could get vaccinated during each pregnancy. And many did: last fall, 14% of pregnant women received the shot (~200,000 people). Then, the FDA Commissioner announced that vaccines would only be available to those over age 65 and those under 65 with a high-risk condition. This included pregnancy. Then, Health Secretary RFK Jr.—a longtime opponent of vaccination—announced that pregnant women and kids would no longer be eligible. This wasn’t based on any new data. And the decision wasn’t made with input from pediatricians, obstetricians, vaccinologists, or public health experts. THEN, after what appears to have been urgent conversations with CDC scientists, the CDC did not go through with removing pregnant women and kids from eligibility. Instead, they updated the guidance to say that vaccination should be based on shared clinical decision-making—meaning you can get the vaccine in consultation with your physician. This ping-pong decision-making bypassed the usual scientific process of vaccine policy. In other words, this is abnormal. But, today, you can still get the vaccine. Here is the official vaccine schedule from CDC. This could change again. Later this month, the CDC’s scheduled vaccine policy meeting will take place to discuss fall plans, and since they have already pushed back, I doubt that it will change again. RFK Jr. could veto it all at any point, too. Why does vaccination during pregnancy matter? And why should babies get vaccinated again?1. To protect you. Pregnancy puts extra stress on the body: lung function changes, blood clot risk rises, immune function shifts. Covid-19 infection adds another layer. Compared to nonpregnant people of the same age and health status, pregnant people with Covid-19 are more likely to require ICU care, need a ventilator, or die. They’re also at higher risk for complications like preeclampsia, blood clots, and cesarean delivery. 2. To protect your fetus before birth. Covid-19 infection during pregnancy increases the risk of preterm birth and, during previous Covid waves, stillbirths. (During the Delta wave, a study showed a 4-fold increase in stillbirths.) It can also damage the placenta, impairing antibody transfer. While risks have gone down (largely thanks to background immunity), they’re not zero. 3. To protect your newborn after birth. The human body is extraordinary. During pregnancy, you can pass protective antibodies to your baby through the placenta starting at about the 17th week of pregnancy and peaking ~4 weeks before delivery. Once born, the baby is well protected in the short term. If this transfer doesn’t happen, newborns are left largely unprotected. Antibodies will also occur in breast milk, but it’s difficult to tell how much of a role they play in protection.
Babies are at high risk.Even healthy babies are vulnerable to Covid-19 infection. Data from this past winter shows:
This is largely preventable by getting the vaccination during pregnancy. What the evidence says about safety and effectivenessThe original Covid-19 vaccine trials did not include pregnant women—this is common in early drug and vaccine research, though it’s increasingly being challenged. However, some trial participants became pregnant after enrollment, and no complications were reported. Also, vaccine companies conducted studies on pregnant rats, which showed no adverse effects. Based on this data, the American College of Obstetricians and Gynecologists (ACOG) and other medical organizations strongly recommend vaccination during pregnancy, and they continue to do so. Since then, multiple “real-world” studies (i.e., not tightly controlled clinical trials) across different populations have confirmed: the vaccine is safe and effective for pregnant women. We’ve seen this over and over again:
After birth: Why vaccination still matters at 6 monthsThe risk of severe Covid-19 outcomes significantly decreases after 6 months, largely because the baby’s immune system becomes stronger and stronger. However, if the pregnant mom gets vaccinated, the baby only gets antibodies, and these wane over time. Infant protection lasts only 4-6 months, as vaccination during pregnancy only transfers antibodies across the placenta, not memory cells. This is why the primary series for children is important, starting at 6 months old, so their immune system can remember Covid-19 for a long time. Other questions you’ve asked
Bottom linePregnancy is hard enough without politics getting in the way of protection. If you’re unsure or feel stuck, talk to your OB-GYN, midwife, or pediatrician. But know this: You still have the option to get vaccinated for Covid-19. And it could make a big difference—for you and your baby. Love, YLE P.S. If you have more questions, I’ll be in the YLE chat live at 12pm PST today for paid subscribers. Hope to see you there! Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. YLE is a public health newsletter that reaches over 380,000 people in more than 132 countries, with one goal: to translate the ever-evolving public health science so that people are well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below:
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