Vaccinations against covid-19 and pregnancy

Anna Janusz, MD: Vaccinations against COVID-19 during pregnancy, lactation and during pregnancy efforts – recommendations of the American College of Obstetricians and Gynecologists (ACOG) from December 2020

Pregnant women

• Pregnant women should not be denied vaccination against COVID-19.
  Currently, we do not have data from clinical trials on the safety of COVID-19 vaccine use in pregnant women, but there are also no data to suggest that this vaccination should be contraindicated in pregnant women. In preclinical Developmental and Reproductive Toxicity (DART) studies performed in animal models by the manufacturers of both vaccines, no alarming safety signals were observed in this area.
• Pregnant women should be able to make their own decision to vaccinate against COVID-19 and receive support regardless of the decision taken.
• Pregnant women considering vaccination against COVID-19 should have access to up-to-date information on the safety and efficacy of vaccines, including information that is currently not available.
• Talking to the doctor about the COVID-19 immunization can help a pregnant woman make a decision about immunization.

Currently, there are no preferences regarding the choice of preparation for vaccination against COVID-19 in pregnant women (Pfizer-BioNtech, Moderna vaccine).

The interval between vaccination against COVID-19 and vaccination with other agents (e.g. against diphtheria, tetanus and pertussis) should be ≥14 days.

Breastfeeding women

• Vaccination against COVID-19 should be offered to lactating women.
• There is no need for women who have been vaccinated against COVID-19 to stop or avoid breastfeeding.

Women planning pregnancy

• Vaccination against COVID-19 is recommended for women trying to become pregnant or planning to become pregnant.
• Given the mechanism of action and the safety profile of the vaccines in non-pregnant individuals, COVID-19 mRNA vaccines are not considered to increase the risk of infertility.
• It is not necessary to delay pregnancy after vaccination against COVID-19.
• If a woman becomes pregnant after receiving the first dose of vaccine, the second dose should be administered as indicated.
• A pregnancy test should not be required prior to administration of any EUA approved COVID-19 vaccine (Emergency Use Authorization, EUA).

Reference:

• https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/vaccinating-pregnant-and-lactating-patients-against-covid-19
• https://www.mp.pl/szczepienia/artykuly/wytyczne/255665,szczepienie-przeciwko-covid-19-kobiet-w-ciazy-i-karmiacych-piersia