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Review
. 2022 Aug;227(2):136-147.
doi: 10.1016/j.ajog.2022.05.020. Epub 2022 May 11.

COVID-19 vaccination in pregnancy

Erkan Kalafat  1 , Paul Heath  2 , Smriti Prasad  3 , Pat O Brien  4 , Asma Khalil  5
Affiliations
Review

COVID-19 vaccination in pregnancy

Erkan Kalafat et al. Am J Obstet Gynecol. 2022 Aug.

Abstract

Despite a recent endorsement from official and professional bodies unequivocally recommending COVID-19 vaccination, vaccine hesitancy among pregnant people remains high. The accumulated evidence demonstrates that pregnant people are a special risk group for COVID-19, with an increased risk of intensive care unit admission, extracorporeal membranous oxygenation requirement, preterm birth, and perinatal death. These risks are further increased with some variants of concern, and vaccination of pregnant people reduces the COVID-19-related increase in maternal or fetal morbidity. Data from more than 180,000 vaccinated persons show that immunization against COVID-19 with an mRNA vaccine is safe for pregnant people. Many observational studies comparing perinatal outcomes between vaccinated and unvaccinated pregnant people have had reassuring findings and did not demonstrate harmful effects on pregnancy or the newborn. Immunization with mRNA vaccines does not increase the risk of miscarriage, preterm delivery, low birthweight, maternal or neonatal intensive care unit admission, fetal death, fetal abnormality, or pulmonary embolism. Moreover, observational data corroborate the findings of randomized trials that mRNA vaccination is highly effective at preventing severe SARS-CoV-2 infection in pregnant people, emphasizing that the potential maternal and fetal benefits of vaccination greatly outweigh the potential risks of vaccination. Ensuring pregnant people have unrestricted access to COVID-19 vaccination should be a priority in every country worldwide.

Keywords: COVID-19; SARS-CoV-2; antibodies; immunogenicity; maternal immunization; pandemic; pregnancy; reactogenicity; side effects; vaccine.

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Figures

Figure
Figure
Policy positions of countries around the globe during the pandemic The figure was created using data and graphics from the COVID-19 maternal immunization tracker website (https://comitglobal.org/explore/public-health-authorities/pregnancy). Kalafat. COVID-19 vaccination in pregnancy. Am J Obstet Gynecol 2022.
See this image and copyright information in PMC

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