The COVID-19 vaccine in pregnancy: risks benefits and recommendations

STAFFORD, Irene A.; PARCHEM, Jacqueline G.; SIBAI, Baha M.

The 2019 Coronavirus (COVID-19) has caused over two-million deaths worldwide, with over 412,000 deaths reported in Unites States. To date, at least 57,786 pregnant women in the US have been infected and 71 have died1-4. Although pregnant women are at higher risk for severe COVID-19 related illness, clinical trials for the available vaccines excluded pregnant and lactating women. The safety and efficacy of the vaccines for pregnant women, the fetus and the newborn remain unknown. A review of maternal and neonatal COVID-19 morbidity and mortality data along with perinatal vaccine safety considerations are presented to assist providers with shared decision-making regarding vaccine administration for this group, including the health care worker who is pregnant, lactating or considering pregnancy. The COVID-19 vaccine should be offered to pregnant women after discussing lack of safety data, with preferential administration for those at highest risk for severe infection, until safety and efficacy of these novel vaccines are validated.