- Promote COVID-19 vaccine among people who are pregnant, lactating or who may become pregnant. Only 31% of pregnant people in the U.S. are fully vaccinated. In 2021, 97% of pregnant people hospitalized for COVID-19 illness or labor and delivery with active infection were unvaccinated. Educate patients on the safety and effectiveness of COVID-19 vaccine during pregnancy.
Background: COVID-19 Vaccine for Pregnant and Lactating People
On Sept. 29, the Centers for Disease Control and Prevention (CDC) released a Health Alert Network (HAN) advisory recommending urgent action to increase COVID-19 vaccination among people who are pregnant, recently pregnant, lactating, trying to become pregnant or who may become pregnant. CDC strongly recommends COVID-19 vaccine before or during pregnancy because the benefits of vaccine outweigh known or potential risks.
As of Sept. 27, more than 125,000 lab-confirmed COVID-19 cases are in pregnant people, including more than 22,000 hospitalizations and 161 deaths. The highest number of COVID-19-related deaths in pregnant people (n=22) in one month happened August 2021. National surveillance data shows about 97% of pregnant people hospitalized for illness or labor and delivery with active infection were unvaccinated.
In addition to the risks of severe illness and death for pregnant and recently pregnant people, they are also at increased risk for adverse pregnancy and neonatal outcomes, including preterm birth and admission of their neonate(s) to an intensive care unit (ICU). Other adverse pregnancy outcomes, like stillbirth, have been reported.
Despite the known risks of COVID-19, as of Sept. 18, 31.0% of pregnant people were fully vaccinated before or during their pregnancy. Additionally, there are racial and ethnic disparities in vaccination coverage for pregnant people.
Healthcare providers should communicate the risks of COVID-19, the benefits of vaccine, and the safety and effectiveness of COVID-19 vaccine during pregnancy. Healthcare providers should strongly recommend people who are pregnant, recently pregnant, lactating, trying to become pregnant or who may become pregnant get COVID-19 vaccine as soon as possible.
Recommendations for COVID-19 Vaccine for Pregnant and Lactating People
- Ensure all clinical staff are aware of the recommendation for vaccination of people before and during pregnancy and the serious risks of COVID-19 to pregnant and recently pregnant people and their fetuses/infants.
- Increase outreach efforts to encourage, recommend and offer vaccination to people who are pregnant, recently pregnant, lactating, trying to become pregnant or may become pregnant. A strong recommendation from a healthcare provider is a critical factor in COVID-19 vaccine acceptance and can make a meaningful difference to protect the health of pregnant and recently pregnant people and their fetuses/infants.
- For healthcare providers who see patients who are pregnant, recently pregnant, lactating, trying to become pregnant or who may become pregnant:
- Review patients’ COVID-19 vaccination status at each pre- and post-natal visit and discuss COVID-19 vaccine with those who are unvaccinated.
- Reach out to your patients with messages encouraging and recommending the critical need for vaccination.
- Remind patients that vaccine is recommended for those with prior COVID-19 infection. Studies show vaccination provides increased protection in people who have recovered from COVID-19.
- Support efforts to ensure people who get the first dose of an mRNA COVID-19 vaccine (i.e., Pfizer-BioNTech, Moderna) return for their second dose to complete the series as close as possible to the recommended interval.
- Consider a booster dose for eligible pregnant people.
- Communicate accurate information about COVID-19 vaccines and confront misinformation with evidence-based messaging from credible sources. For example, currently, no evidence shows any vaccine, including COVID-19 vaccine, causes fertility problems in women or men.
- Become a COVID-19 vaccine provider and vaccinate patients during their visit. Learn how to enroll as a COVID-19 vaccine provider.
Additional information: COVID-19 Vaccine for Pregnant and Lactating People
- Interim clinical considerations for use of COVID-19 vaccines currently approved or authorized in the U.S.
- COVID-19 vaccines while pregnant or breastfeeding.
- COVID-19 vaccines for people who would like to have a baby.
- COVID-19 among pregnant and recently pregnant people.
- COVID data tracker:
- Toolkit for pregnant people and new parents.
- Building confidence in COVID-19 vaccines.
COVID-19 vaccine resources
- Help patients access their vaccine records and explain the different ways to show vaccination status.
- EUA fact sheets for recipients and caregivers:
- COVID-19 vaccine locator, DOH.
- COVID-19 vaccine for providers
- COVID-19 vaccine provider toolkit and resources, DOH.
- COVID-19 vaccination for providers, CDC.
- Clinical considerations for COVID-19 vaccination and guidance for managing anaphylaxis, CDC.
- COVID-19 vaccine quick reference guide for healthcare professionals, CDC.
- COVID-19 vaccine training module on best practices for providers, CDC.
- Association of J&J with thrombotic thrombocytopenia after vaccination:
- J&J vaccine health alert, CDC.
- Vaccine-induced immune thrombotic thrombocytopenia frequently asked questions, American Society of Hematology (ASH).
- Diagnosis and management of vaccine-induced immune thrombotic thrombocytopenia webinar, ASH and CDC.
- April 15, 2021 Clinician Outreach and Communication Activity (COCA) call: J&J COVID-19 vaccine and cerebral venous sinus thrombosis with thrombocytopenia update for clinicians on early detection and treatment, CDC.
- Association of mRNA vaccines with myocarditis and pericarditis after vaccination:
- Information for healthcare providers: myocarditis and mRNA vaccines, DOH
- Follow-up of patients with myocarditis, consult recommendations, American Heart Association and the American College of Cardiology.
- Clinical considerations: Myocarditis and pericarditis after receipt of mRNA COVID-19 vaccines among adolescents and young adults, CDC.
- Overview of myocarditis and pericarditis, ACIP COVID-19 Vaccines Work Group, June 23, 2021, CDC.
- COVID-19 subcommittee of the World Health Organization (WHO) Global Advisory Committee on Vaccine Safety (GACVS) reviews cases of mild myocarditis reported with COVID-19 mRNA vaccines, WHO news release, May 26, 2021.
- Myocarditis and pericarditis following mRNA COVID-19 vaccination, CDC.
- Selected adverse events reported after COVID-19 vaccination, CDC.
- Myocarditis and pericarditis resources for the public, CDC.
Contacting the Health Department
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