COVID Vaccination and Pregnancy Summary of Key Information and Recommendations
Our stance is that receiving a vaccination for COVID is an individuals decision to make and that decision should be respected either way. Below is some information intended to help make an informed decision regarding the COVID vaccine in pregnancy and during lactation.
There are additional risks to the fetus if a pregnant woman were to contract COVID and have severe symptoms causing respiratory distress. A decrease in maternal blood oxygen seen in severe respiratory illness can cause a decrease in oxygenation to the unborn fetus possibly leading to permanent brain injury and or death. With no strong evidence to suggest detrimental side effects to a pregnant woman or the fetus with the COVID vaccinations along with the potential serious but unpredictable risks to an unborn fetus we do recommend that pregnant and lactating women receive the vaccination for COVID.
COVID-19 vaccine development and regulatory approval are rapidly progressing, thus, information and recommendations will evolve as more data are collected about these vaccines and their use in specific populations. This information is intended to be an overview of currently available COVID-19 vaccines and guidance for their use in pregnant, recently pregnant, and breast feeding individuals.
The U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the following vaccines:
Pfizer-BioNtech mRNA vaccine (BNT162b2): for use in individuals age 12 years and older as a 2-dose regimen given 3 weeks (21 days) apart.
Moderna mRNA-1273 vaccine: for use in individuals age 18 and older as a 2-dose regimen given 1 month (28 days) apart.
Janssen Biotech, Inc. (Johnson & Johnson) Ad26.COV2.S vaccine: for use in individuals age 18 and older as a single dose regimen.
After an explicit, evidence-based review of all available data, the Advisory Committee on Immunization Practices (ACIP) has issued interim recommendations for use of the Pfizer-BioNTech COVID-19 vaccine in persons aged ≥12 years for the prevention of COVID-19 (CDC 2021), the use of the Moderna-1273 COVID-19 vaccine in persons aged ≥ 18 years (CDC 2020), and the use of the Janssen (Johnson & Johnson) COVID-19 vaccine in persons aged ≥ 18 years (CDC 2021).
The America College of Obstetricians and Gynecologist (ACOG) recommends that pregnant individuals have access to COVID-19 vaccines.
COVID-19 vaccines should be offered to lactating individuals similar to non-lactating individuals.
Individuals considering a COVID-19 vaccine should read the information about the safety and efficacy of the vaccine, including information about data that are still unknown. A conversation between the patient and their clinical team may assist with decisions regarding the use of vaccines approved under EUA for the prevention of COVID-19 by pregnant patients. Important considerations include:
the efficacy of the vaccine
the risk and potential severity of maternal disease, including the effects of disease on the fetus and newborn
the safety of the vaccine for the pregnant patient and the fetus.
While a conversation with a physician may be helpful, it is not required prior to vaccination.
Similar to their non-pregnant peers, vaccination of pregnant individuals with a COVID-19 vaccine may occur in any setting authorized to administer these vaccines. This includes any clinical setting and non-clinical community-based vaccination sites such as schools, community centers, and other mass vaccination locations.
Pregnancy testing is not requirement prior to receiving any approved COVID-19 vaccine.
Importantly, claims linking COVID-19 vaccines to infertility are unfounded and have no scientific evidence supporting them. ACOG recommends vaccination for all eligible people who may consider future pregnancy.
Pregnant patients who decline vaccination should be supported in their decision. Regardless of their decision to receive or not receive the vaccine.
Expected side effects are a normal part of the body’s reaction to the vaccine and developing antibodies to protect against COVID-19 illness.
Women under age 50 including pregnant and lactating individuals can receive any FDA-authorized COVID-19 vaccine available to them. However, they should be aware of the rare risk of thrombosis with thrombocytopenia syndrome (TTS) after receipt of the Janssen COVID-19 vaccine and that other FDA-authorized COVID-19 vaccines are available (i.e., mRNA vaccines).
ACOG strongly recommends that all eligible persons receive a COVID-19 vaccine or vaccine series, depending on the product.
COVID-19 vaccines may be administered simultaneously with other vaccines, including within 14 days of receipt of another vaccine. This includes vaccines routinely administered during pregnancy, such as influenza and Tdap.
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