CDC issues ‘urgent’ COVID-19 vaccine recommendation for pregnant people and those who want to be

COVID-19 Pregnancy CDC Recommendations

I’m Pregnant. Should I get the COVID-19 vaccination?

CDC has made the official recommendation for COVID-19 vaccination for those who are pregnant, recently pregnant (including those who are lactating), who are trying to get pregnant now, or who might become pregnant in the future.4 CDC recommendations comes from professional medical organizations serving people who are pregnant, including the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine. Accumulating data to provide evidence of both the safety and effectiveness of COVID-19 vaccinations in pregnancy. CDC strongly recommends COVID-19 vaccination either before or during pregnancy, because the benefits of vaccination for both pregnant persons and their fetus/infant outweigh the known or potential risks. Getting a COVID-19 vaccine can prevent severe illness, death, and pregnancy complications related to COVID-19.

COVID-19 vaccination coverage for pregnant people remains low.

Despite recommendations for vaccination, uptake of COVID-19 vaccination by pregnant people has been lower than that of non-pregnant people.5 In addition, vaccination coverage for pregnant people differs by race and ethnicity, with vaccination coverage being lowest for non-Hispanic Black pregnant people (15.6%) as of September 18, 2021.3 Although the proportion of fully vaccinated pregnant people has increased to 31.0% (as of September 18, 2021), the majority of pregnant people remain unprotected against COVID-19, and significant disparities exist in vaccination coverage by race and ethnicity.

Pregnant and recently pregnant people with COVID-19 are at increased risk of severe illness, death, and pregnancy complications.

Pregnant and recently pregnant people with COVID-19 are at increased risk for severe illness when compared with non-pregnant people. Severe illness includes illness that requires hospitalization, intensive care unit (ICU) admission, mechanical ventilation, or extracorporeal membrane oxygenation (ECMO), or illness that results in death. Although the absolute risk is low, compared with non-pregnant symptomatic people, symptomatic pregnant people have more than a two-fold increased risk of requiring ICU admission, invasive ventilation, and ECMO, and a 70% increased risk of death.6 Pregnant people with COVID-19 are also at increased risk for preterm birth and some data suggest an increased risk for other adverse pregnancy complications and outcomes, such as preeclampsia, coagulopathy, and stillbirth, compared with pregnant people without COVID-19.7-10 Neonates born to people with COVID-19 are also at increased risk for admission to the neonatal ICU.9-11 In addition, although rare, pregnant people with COVID-19 can transmit infection to their neonates; among neonates born to women with COVID-19 during pregnancy, 1–4% of neonates tested were positive by rRT-PCR.12,13

CDC recommends urgent action to help protect pregnant people and their fetuses/infants.

CDC recommends urgent action to accelerate primary vaccination for people who are pregnant, recently pregnant (including those who are lactating), who are trying to get pregnant now, or who might become pregnant in the future. Efforts are to specifically address populations with lower vaccination coverage and use approaches to reduce racial and ethnic disparities. CDC’s recommendations ensuring tailored, culturally responsive, and linguistically appropriate communication of vaccination benefits aligns with Golden Valley Health Centers mission to serve the underserved. In addition, pregnant people should continue to follow all recommended prevention measures and should seek care immediately for any symptoms of COVID-19. Our providers take special care monitoring during pregnancy due to the risk of severe illness.

References

  1. COVID Data Tracker. Data on COVID-19 during Pregnancy: Severity of Maternal Illness. (accessed September 27, 2021)
  2. COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) (unpublished data)
  3. COVID Data Tracker. Vaccinations Among Pregnant People. (accessed September 27, 2021)
  4. CDC Interim Clinical Considerations for Use of COVID-19 Vaccines. (accessed September 27, 2021)
  5. Razzaghi H, et al. COVID-19 Vaccination Coverage Among Pregnant Women During Pregnancy — Eight Integrated Health Care Organizations, United States, December 14, 2020–May 8, 2021MMWR. 2021:70(24);895–899.
  6. Zambrano L, et al.  Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–October 3, 2020MMWR. 2020:69(44);1641–1647.
  7. Ko JY, DeSisto CL, Regina M Simeone RM, et al. Adverse Pregnancy Outcomes, Maternal Complications, and Severe Illness Among US Delivery Hospitalizations With and Without a Coronavirus Disease 2019 (COVID-19) Diagnosisexternal iconClinical Infectious Diseases. 2021;73(Supplement_1):S24–S31.
  8. Jering KS, Clagget BL, Cunningham JW, et al. Clinical Characteristics and Outcomes of Hospitalized Women Giving Birth With and Without COVID-19external icon. JAMA Intern Med. 2021;181(5):714-717. doi:10.1001/jamainternmed.2020.9241
  9. Allotey J, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysisexternal iconBMJ 2020;370:m3320. (Published 01 September 2020)
  10. Villar J, et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Studyexternal iconJAMA Pediatr. 2021;175(8):817-826. doi:10.1001/jamapediatrics.2021.1050.
  11.  Woodworth KR, et al. Birth and Infant Outcomes Following Laboratory-Confirmed SARS-CoV-2 Infection in Pregnancy — SET-NET, 16 Jurisdictions, March 29–October 14, 2020MMWR. 2020:69(44);1635–1640.
  12. Olsen EO, et al. SARS-CoV-2 infections among neonates born to women with SARS-CoV-2 infection: maternal, pregnancy and birth characteristicsexternal icon. (pre-print accessed September 27, 2021)
  13. Mullins E, Hudak ML, Banerjee J, et al. Pregnancy and neonatal outcomes of COVID-19: coreporting of common outcomes from PAN-COVID and AAP-SONPM registriesexternal iconUltrasound Obstet Gynecol. 2021;57(4):573-581. doi:10.1002/uog.23619