Answering 10 questions about the COVID-19 vaccine, pregnancy and breastfeeding

1. Are the COVID-19 vaccines safe?
COVID-19 vaccines have been tested in thousands of people in clinical trials prior to them receiving regulatory authorisation. As at end of July 2021, over 4 billion COVID-19 vaccine doses have already been administered globally and have generally been found to be safe. In South Africa, the South African Health Products Regulatory Authority (SAHPRA) reviews all available clinical data to ensure that all healthcare products that are approved for use in the country meet the requisite standards to protect the health and well-being of South Africans.

2. If it's safe, why weren't pregnant or breastfeeding people part of the original trials?
It's standard practice to exclude pregnant or breastfeeding people from the first round of vaccine and other medication clinical trials. Based on how COVID-19 vaccines work in the body, experts believe they are unlikely to pose a risk for people who are pregnant. Studies are now underway to do formal testing of these vaccination pregnant and breastfeeding people. Thousands of pregnant and breastfeeding women have received these vaccines already as part of the global vaccine roll-out programs and have been found to be safe.

3. Does pregnancy put me at higher risk of severe COVID-19 disease?
Unvaccinated pregnant people and those who recently delivered their babies are at high risk for severe COVID-19 disease. COVID-19 is associated with a higher risk of preterm birth and pregnancy complications including death.

4. Will the baby get protection if I get vaccinated?
Early scientific evidence shows that babies can get some level of protection when their mother is vaccinated. Protection comes from the mother's antibodies that are passed on to the baby inside the womb during pregnancy. After birth, antibodies may also be passed to the baby from the breast milk.

5. Will getting an mRNA vaccine (like Pfizer) change DNA?
It is biologically impossible for messenger RNA (mRNA) to change yours or your baby's DNA.

According to experts an mRNA vaccine cannot alter someone's DNA because: mRNA cannot enter the cell nucleus, where DNA lives. mRNA vaccines do not have the required tools that would allow for the mRNA to enter the nucleus or to be converted to DNA.

6. Should I stop breastfeeding to get vaccinated?
The World Health Organization (WHO) and SAHPRA do not recommend stopping breastfeeding in order to get vaccinated against COVID-19. COVID-19 vaccines are recommended for use in breastfeeding mothers.

7. Will getting vaccinated affect breast milk?
Since none of the COVID-19 vaccines use a live virus, getting vaccinated cannot infect you or your breastfeeding baby with the COVID-19 virus. Early studies into breastfeeding and mRNA vaccines show COVID-19 vaccines are extremely unlikely to cross into breast milk. The only thing a vaccination is likely to add to your breast milk is antibodies against COVID-19.

8. Were the COVID-19 vaccines rushed?
COVID-19 is a public health emergency that required an urgent response in order to save lives and livelihoods. Existing scientific technologies were leveraged to produce COVID-19 vaccines. The clinical trials were conducted as per usual to ensure safety and efficacy of the COVID-19 vaccine. The production process was however initiated around the same time as the clinical trials process to ensure quicker access to vaccination once the clinical data confirmed safety and efficacy. No short cuts were taken in the clinical trials testing phases.

Find out more: Eight reasons why COVID-19 vaccines have been created so quickly - and why they're safe and effective

9. Will getting vaccinated against COVID-19 affect my fertility?
There's no evidence the COVID-19 vaccines have any effect on your chances of becoming pregnant again in the future. You don't need to avoid getting pregnant after being vaccinated.

10. Do I still need a vaccine if I've already had COVID-19? While you do get some 'natural immunity' from having had COVID-19, these antibodies only stay in your body for three to six months. Unfortunately, it is possible to be infected with COVID-19 again after you've had the disease, especially if there are new variants. Getting vaccinated will give you longer-lasting and better protection against the virus than just having had the disease. You can get your vaccine 30 days following COVID-19 infection.

Read more: COVID-19 vaccines myths debunked: Don't be fooled by misinformation

This article is only meant to give you general information about COVID-19 vaccination, pregnancy and breastfeeding. If you have specific questions or concerns about COVID-19 and the vaccines, speak to your treating doctor.