In the days and months ahead, millions of Americans will be asked if they want the coronavirus vaccine, a mixture of mostly unpronounceable ingredients that prepare your immune system to fight the disease should you become infected.

For most people, according to a November poll, the decision to take the vaccine has already been made. Just over 70% of people say they will take it, up from 63% in August/September, the poll from the Kaiser Family Foundation shows.

Healthcare workers began getting the vaccine nationwide last week.

That potentially means millions are still facing a difficult decision in the future. Of that group, pregnant people, those who wish to get pregnant and the immunocompromised will have to weigh the unknown health risks with the benefits of the vaccine.

Aly Davis, a 30-year-old nurse in a Mobile, Ala., COVID-19 unit is one such person. She and her husband hope to get pregnant soon and have been trying in recent months. As a registered nurse and former scientific researcher, Davis doesn’t believe the recent and widespread rumors circulating on social media that the vaccine can cause infertility. But she still has some concerns about the overall health outcomes because most vaccines are not tested on pregnant women. 

Those fears are compounded by her role caring for patients battling a virus that has already killed 325,000 people and infected as many as 225,000 in one day earlier this month in the U.S. 

“It’s a serious consideration because I want to keep myself healthy so I can continue taking care of these patients,” said Davis. “But my personal ambitions and wanting to become a mother are also important to me. And a lot of young women in general have had to think about questions like that, even outside of the healthcare world. Do I want to delay pregnancy until after the pandemic? How safe is the vaccine? And I think that’s a question every young family has to think hard about before they make these choices.

“But as healthcare providers, we have to consider our actions really strongly because we want to be a good example to the community.”

The vaccine was first shipped from a Pfizer facility in Michigan on Dec. 13 and arrived at hospitals in the South as early as the next day.  While nearly all healthcare workers will be priority recipients of the vaccine, some states only received enough first-round doses for a portion of these workers. Alabama, for example, received enough Pfizer vaccine, which is administered in two doses weeks apart, for about about 10% of those deemed a priority, according to State Health Officer Dr. Scott Harris. 

The next round of deliveries arriving in Alabama are expected to be short by about 20,000 doses. Shortages of between 25% and 40% are expected across the country, according to the White House.  

While Davis welcomed medical advice from her doctor and other health professionals she works with that pregnant women should be perfectly fine taking the vaccine, there are some categories of people who should be careful and some that should avoid it altogether.

The U.S. Centers for Disease Control and Prevention (CDC) has said that the vaccine is safe for anyone over the age of 16, including anyone who is allergic to any component in the vaccination.

Children under the age of 16 are not currently receiving the vaccine as trials are ongoing.

The CDC recommends that medical facilities keep treatments for allergic reactions to the vaccine on hand just in case.

Immunocompromised people, such as those who have HIV/AIDS, or who take immunosuppressive medications or therapies, might be at increased risk for severe COVID-19, according to the CDC.

With regards to pregnant or lactating women, there is not currently enough official data on the safety of the vaccine so officials are leaving that decision up to individuals. 

“Covid-19 in a pregnant woman is not a good thing, so someone might decide that they would like to be vaccinated, but that’s not something that we’re recommending at this time,” said Dr. Peter Marks, the director of the FDA’s Center for Biologics Evaluation and Research, in a news briefing last week.

Twenty-three people involved in clinical COVID-19 trials became pregnant without issue earlier this year. In addition, the American College of Obstetricians and Gynecologists (ACOG) recommended the COVID-19 vaccine should not be withheld from pregnant or lactating individuals who meet criteria for vaccination based on the CDC’s recommended priority groups as they believe the benefits outweigh the risks.

Given that 76% of all healthcare workers in the U.S. are women, Davis thinks these questions will persist for many healthcare workers who want to get pregnant in the near future.

“I can’t be the only nurse that’s taking care of Covid patients with the same question on their minds and in health care that’s a lot of women,” said Davis. “Those people should consult their doctor, which I think is important for all women to do anyway. It’s important to talk to our doctors, health experts and listen to scientists before coming to these conclusions.”

Davis said she will take the vaccine this Wednesday.