Covid-19 vaccination in pregnancy

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.

COVID-19 in Pregnancy: Knowledge about the Vaccine and the Effect of the Virus. Reliability and Results of the MAMA-19 Questionnaire

“…The results that older age, higher education and higher income were associated with higher acceptance of COVID-19 vaccination are in agreement with several studies [ 35 , 36 , 37 ].…”

“…The study was carried out in only one Teaching Hospital of the biggest metropolis of central Italy, and it might be interesting to propose the same questionnaire in other contexts: hospitals in the suburbs, smaller towns and different Italian regions. In these realities, the results may have been less optimistic given that two of the discriminating factors of knowledge are education level and income [ 36 , 38 ].…”

Response: COVID‐19 vaccination uptake among pregnant individuals

“…In such circumstances, this population‐based cross‐sectional study provided valuable information to help delineate a strategic plan to optimize vaccine uptake and coverage among pregnant individuals. Likewise, previous reports have used similar study designs, as mentioned in the reviews by Kalafat et al 2 and Badell et al 3 Otherwise; we agree with Drs Sriwijitalai and Wiwanitkit that cross‐sectional studies are subject to several limitations, and that future prospective longitudinal studies may overcome such constraints while allowing the analysis and evaluation of additional variables of interest such as changes in the intensity of the COVID‐19 pandemic and factors associated with vaccine hesitancy in any given timeframe.…”

COVID-19 Vaccine During Pregnancy and Perinatal Outcomes

“…Another published study investigating the relationship between COVID-19 vaccination in pregnancy and adverse perinatal outcomes showed no increase in the rate of NICU admission or low Apgar score (24) . Another recent review did not show any relationship between COVID-19 vaccination and adverse perinatal outcomes (25) . Regarding the gestational age and birth weight in women who received the COVID-19 vaccine during pregnancy, our study revealed that the average gestational age of unvaccinated women was longer than that of vaccinated women.…”