COVID-19 Vaccination Safety During Pregnancy

Risk of COVID-19 Infection During Pregnancy

Pregnant women are at increased risk for severe COVID-19 disease and death compared to non-pregnant women of reproductive age 1, 3
COVID-19 infection during pregnancy is associated with adverse pregnancy outcomes, including increased risk of preeclampsia or eclampsia (adjusted odds ratio 1.57), higher rates of preterm delivery (adjusted odds ratio 2.17), and increased risk of fetal death (adjusted odds ratio 2.21) 1
Symptomatic pregnant women have 2-3 fold higher rates of ICU admission, invasive ventilation, and mortality from COVID-19 compared to symptomatic non-pregnant women 4
Risk factors for severe COVID-19 in pregnancy include age >35 years, comorbidities (obesity, diabetes, cardiovascular disease), and Black or Asian race or Hispanic ethnicity 4

The Centers for Disease Control and Prevention (CDC) recommends COVID-19 vaccination for all people aged 12 years and older, including people who are pregnant, breastfeeding, trying to get pregnant, or might become pregnant in the future 2, 5
The World Health Organization (WHO) recommends COVID-19 vaccination for pregnant women when the benefits outweigh the potential risks 2, 5

Real-world data from 90,000 pregnant women collected through the V-safe COVID-19 vaccine pregnancy registry did not identify any safety signals 1

There are currently no data to guide recommendations for vaccine administration at a particular gestational age 1
The WHO does not recommend pregnancy testing before vaccination or delaying/terminating pregnancy because of vaccination 2

Recent studies demonstrate placental transfer of vaccine-specific anti-SARS-CoV-2 IgG antibodies 1
Anti-SARS-CoV-2 IgA and IgG antibodies have been detected in breast milk of vaccinated women for up to 6 weeks after the first vaccine dose 1

For pregnant women with high-risk conditions (healthcare workers, age >35, multiple gestation, chronic medical conditions), vaccination is particularly important 6
Contraindications to vaccination include severe allergic reaction to a previous dose or any component of the vaccine 6

Experts agree that vaccination poses minimal to no potential risk to the newborn during breastfeeding 7