Later that year, Fauci backed an NIAID-sponsored clinical study, known as the “MOMI-VAX trial,” that examined the shot’s safety for new and expectant mothers, as well as the maternal immune responses in pregnant and postpartum women who had received or will receive the coronavirus vaccine.

In a statement accompanying the study’s announcement in June 2021, Fauci acknowledged that the United States still did not have sound clinical data — half a year after the shot’s approval for emergency usage — on how the COVID-19 vaccine affected so-called “pregnant and breastfeeding people.”

“Tens of thousands of pregnant and breastfeeding people in the United States have chosen to receive the COVID-19 vaccines available under emergency use authorization,” Fauci said at the time. “However, we lack robust, prospective clinical data on vaccination in these populations. The results of this study will fill gaps in our knowledge and help inform policy recommendations and personal decision-making on COVID-19 vaccination during pregnancy and in the postpartum period.”

The observational study stipulated that participants were not provided with the vaccine as part of the data collection process. NIAID was simply recording the vaccine’s effects on unborn babies and breastfeeding newborns when administered to women who voluntarily sought out the shot during pregnancy or within two months of delivery.

Researchers enrolled up to 750 pregnant women and 250 postpartum mothers, along with their infants, in the MOMI-VAX study group to examine the transfer of vaccine-induced antibodies from mother to child across the placenta or through breast milk. The study ultimately concluded that maternal vaccination against the coronavirus safely prevented SARS-CoV-2 infection in early infancy, though several of the study’s researchers were either hired contractors for Pfizer, received grant money from the vaccine developer to conduct clinical research, worked on federally funded trials of Moderna and Pfizer vaccines, or served as paid advisers to the two pharmaceutical corporations, according to conflict-of-interest disclosures. Moderna’s and Pfizer’s versions of the COVID-19 vaccine were among the iterations assessed in the study.

In the press release publicizing the study’s rollout, NIAID’s parent agency, the National Institutes of Health, told prospective recruits, “So far, COVID-19 vaccines appear to be safe in these populations.”

However, five months before the study started recruiting pregnant participants, Fauci privately told his colleagues that he believed the second dose of the COVID-19 vaccine might have the potential to inadvertently kill babies in utero.

“I asked around a bit more and another issue came up that you need to be aware of,” Fauci texted a group chat on Jan. 25, 2021, including Dr. Rochelle Walensky, then the director of the U.S. Centers for Disease Control and Prevention, and then-Surgeon General Dr. Vivek Murthy.

Fauci was answering an inquiry from Murthy asking if he or Walensky were aware of “any data or theoretical reason” why pregnant women considering vaccination should be wary of when in their pregnancies they should get the shot.

“Since many people have significant cytokines storm and fever after the 2nd dose, this theoretically could be associated with miscarriage in the 1st trimester,” Fauci continued.

Walensky replied, “Definitely a good point, esp after dose two.” Murthy agreed: “This is really helpful, thanks. I’ve been hearing the concern about the mRNA causing mutations in the developing fetus as well. That’s a really good point re the cytokine storm post second dose.”

Earlier in the text exchange, Walensky said, “[M]y understanding is that this is all data free,” with Fauci affirming, “There are no data or theoretical reason to believe that vaccinating early versus later in pregnancy would be preferred.”

“Yet, some people (even female health care professionals) feel concerned about injecting a ‘genetic’ vaccine very early in pregnancy,” Fauci added, about two hours before he consulted with others in the scientific community who flagged those miscarriage concerns, according to the text messages. “There is this misperception out there that we need to deal with that mRNA somehow can ‘get into your genes.’ When the misperception gets extended to an early developing fetus, the anxiety heightens.”

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In a follow-up text, Murthy linked to a public advisory published the next day by the World Health Organization, warning that pregnant women should not take Moderna’s version of the vaccine.

“Tony, Rochelle, did you see this announcement today from WHO saying they advise against pregnant women taking the Moderna vaccine bc of lack of data?” Murthy texted. “It has led to a flurry of questions. What is your take? I imagine we will all get asked about this.”

Fauci shrugged off the concerns, arguing that the benefits of immunization outweighed any risks. “I would say that in any vaccine in which data are lacking in pregnant women one must weigh the potential risks against the benefits,” Fauci replied. “COVID-19 can be a serious disease especially in pregnancy.”

In the text chain, Fauci also asserted that women were free to decide for themselves whether they wanted to receive the COVID-19 vaccine and emphasized that the vaccinated women had not widely reported any pregnancy-related complications since receiving the injection, nor did animal testing “raise any red flags.”

“In the vaccine trials, pregnant women were not allowed but following the EUA, a large number (more than 10,000) pregnant women have been vaccinated. No issues have arisen,” Fauci wrote. “The FDA and the [CDC’s Advisory Committee on Immunization Practices] and the [American College of Obstetricians and Gynecologists] are all permissive for pregnant women to have a choice. Animal [toxicity] studies did not raise any red flags.”

Murthy again agreed with Fauci’s assessment. “That’s what my sense was as well Tony which is why I was surprised to see WHO put out a strong like saying they do not recommend [M]oderna in pregnant women,” Murthy texted. “That’s a strong statement to make and potentially quite damaging to public confidence among pregnant women.”

“Agreed,” Walensky weighed in. She mentioned that the ACIP meeting was scheduled for the following day and suggested addressing that debate before the advisory committee. “Shall I flag it for them?” Walensky asked.

It is unclear if Murthy or Fauci, the country’s top COVID-19 expert, gave Walensky the go-ahead. The brief four-page batch of Fauci’s texts, containing excerpts from their conversation, is the first tranche of 34,000 text messages and 522 voicemails that were stored on his government cellphone.

The initial round of Fauci’s text messages released on Monday by Sens. Ron Johnson (R-WI) and Rand Paul (R-KY), of the Senate Homeland Security Committee, revealed another instance of Fauci’s private thoughts about COVID-19 appearing to be in direct conflict with what he was publicly saying at the time.

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Days after he cited the vaccine’s possible miscarriage risk over text, Fauci told the Journal of the American Medical Association that “no red flags” were identified in the Food and Drug Administration’s findings regarding the vaccine’s risk to pregnant women or their babies.

“The FDA, as part of the typical follow-up following the initial issuing of an EUA, have found thus far — and we’ve got to be careful — no red flags about that, about pregnant women,” Fauci said in a taped JAMA Network appearance on Feb. 3, 2021.

In August 2021, two months into the MOMI-VAX trial, Fauci told WhatToExpect.com, a pregnancy resource blog read by expectant mothers: “[T]here’s no indication whatsoever that there’s any increase of any adverse issues in a pregnant woman who was vaccinated compared to a pregnant woman who wasn’t vaccinated.”

“And we all know that [with] pregnancy, there is always a risk of a spontaneous miscarriage. There’s always situations when women get illness, there could be preeclampsia, things like that,” Fauci said. “However, when you look at the unvaccinated versus the vaccinated, there is absolutely no increased risk of that.”

Despite admitting there was little data to confirm that the COVID-19 vaccine is truly safe for pregnant women and unborn babies, Fauci insisted, “It’s really one of those things that’s kind of not a close call. It really is pretty clear that pregnant women should get vaccinated.”

In 2022, Dr. James A Thorp, a maternal-fetal medicine specialist, published an open letter to the American Board of Obstetrics and Gynecology detailing reports of fetal malformations and pregnancy losses associated with the COVID-19 vaccine.

Thorp also critiqued a peer-reviewed paper published in the New England Journal of Medicine, pointing out that because 700 of the 827 pregnant women studied had received their COVID-19 injection in the third trimester, which starts at 28 weeks, those 700 should have been excluded from the denominator used to calculate a spontaneous abortion rate of 12.6%, or 104 miscarriages out of 827 total participants, because spontaneous abortion refers to miscarriages occurring before the 20-week gestation mark.

Excluding the 700 third-trimester vaccinations, Thorp said the actual spontaneous abortion rate was 82%, or 104 out of 127 vaccinated women. Thorp said this adjusted rate was consistent with the 81% miscarriage rate disclosed in Pfizer’s legally mandated post-market analysis report.