Abstract

Pregnancy is an independent risk factor for severe covid-19. Vaccination is the best way to reduce the risk for SARS-CoV-2 infection and limit its morbidity and mortality. The current recommendations from the World Health Organization, Centers for Disease Control and Prevention, and professional organizations are for pregnant, postpartum, and lactating women to receive covid-19 vaccination. Pregnancy specific considerations involve potential effects of vaccination on fetal development, placental transfer of antibodies, and safety of maternal vaccination. Although pregnancy was an exclusion criterion in initial clinical trials of covid-19 vaccines, observational data have been rapidly accumulating and thus far confirm that the benefits of vaccination outweigh the potential risks. This review examines the evidence supporting the effectiveness, immunogenicity, placental transfer, side effects, and perinatal outcomes of maternal covid-19 vaccination. Additionally, it describes factors associated with vaccine hesitancy in pregnancy. Overall, studies monitoring people who have received covid-19 vaccines during pregnancy have not identified any pregnancy specific safety concerns. Additional information on non-mRNA vaccines, vaccination early in pregnancy, and longer term outcomes in infants are needed. To collect this information, vaccination during pregnancy must be prioritized in vaccine research.

MeSH

Pregnancy, Safety, Vaccines, Covid-19 Vaccines, Vaccination, Covid-19, Centers For Disease Control And Prevention, U.S.

Cited by

• Factors influencing COVID-19 vaccination decision-making among African American and Hispanic pregnant and postpartum women in Deep South. medRxiv, 2023
• COVID-19 Vaccine Uptake and Factors Associated Among Pregnant Women in Mogadishu, Somalia. Infect Drug Resist, 2024
• Attitudes Toward COVID-19 Vaccines Among Pregnant and Recently Pregnant Individuals. JAMA Netw Open, 2024
• COVID-19 Vaccination Rates and Vaccine Hesitancy in Pregnant Women in Seven Low- and Middle-Income Countries Through May 2023: An Observational Study From the Global Network. BJOG, 2024
• Response: COVID-19 vaccination uptake among pregnant individuals. Int J Gynaecol Obstet, 2022
• Physician hesitancy to recommend COVID-19 vaccination in pregnancy as a cause of maternal deaths - Robert Brent was prescient. Birth Defects Res, 2023
• Vaccine hesitancy and knowledge regarding maternal immunization among reproductive age women in central Italy: a cross sectional study. Front Glob Womens Health, 2023
• Effectiveness and Safety of COVID-19 Vaccination During Preconceptional and Preclinical Pregnancy Period: A National Population Study. J Korean Med Sci, 2023
• In Utero Exposure to Maternal COVID-19 Vaccination and Offspring Neurodevelopment at 12 and 18 Months. JAMA Pediatr, 2024
• A scoping review of global COVID-19 vaccine hesitancy among pregnant persons. NPJ Vaccines, 2024
• Determinants of Vaccination and Willingness to Vaccinate against COVID-19 among Pregnant and Postpartum Women during the Third Wave of the Pandemic: A European Multinational Cross-Sectional Survey. Viruses, 2023
• Defining and reporting adverse events of special interest in comparative maternal vaccine studies: a systematic review. Vaccine X, 2024
• Assessing the Impact of COVID-19 Vaccination on Preterm Birth: A Systematic Review with Meta-Analysis. Vaccines (Basel), 2024
• Neonatal and maternal outcomes of mRNA versus Non-mRNA COVID-19 vaccines in pregnant patients: a systematic review and meta-analysis. Rev Bras Ginecol Obstet, 2024
• Attitudes towards vaccination against COVID-19 during pregnancy and its determinants among people of reproductive age. Hum Vaccin Immunother, 2025
• COVID-19 in Pregnancy: Knowledge about the Vaccine and the Effect of the Virus. Reliability and Results of the MAMA-19 Questionnaire. Int J Environ Res Public Health, 2022
• Factors associated with COVID-19 vaccination among pregnant women in Rio De Janeiro City, Brazil. Sci Rep, 2023
• Vaccination in pregnancy: The role of the midwife. Front Glob Womens Health, 2022
• Adverse Maternal Outcomes in Pregnant Women Affected by Severe-Critical COVID-19 Illness: Correlation with Vaccination Status in the Time of Different Viral Strains' Dominancy. Vaccines (Basel), 2022
• COVID-19 Disease in Under-5 Children: Current Status and Strategies for Prevention including Vaccination. Vaccines (Basel), 2023