The American College of Obstetrics and Gynecologists (ACOG) recommends that COVID-19 vaccines should not be withheld from pregnant individuals who meet criteria for vaccination based on recommended priority groups. The recommendation is the same for lactating women.
After the Advisory Committee on Immunization Practices (ACIP) issues its interim recommendation on Dec. 12, 2020, for the use of the Pfizer-BioNTech COVID-19 vaccine in persons aged ≥16 years for the prevention of COVID-19 illness (following the emergency use determination), ACOG issued its recommendation that the vaccine should not be withheld from pregnant or lactating women.
The statement says, “The mRNA vaccines are not live virus vaccines, nor do they use an adjuvant to enhance vaccine efficacy. These vaccines do not enter the nucleus and do not alter human DNA in vaccine recipients. As a result, mRNA vaccines cannot cause any genetic changes.”
COVID-19 INFECTION RISK IN PREGNANCY
In its practice advisory issued Dec. 13, 2020, ACOG noted the following:
“Symptomatic pregnant patients with COVID-19 are at increased risk of more severe illness compared with nonpregnant peers (Ellington MMWR 2020, Collin 2020, Delahoy MMWR 2020, Panagiotakopoulos MMWR 2020, Zambrano MMWR 2020). Although the absolute risk for severe COVID-19 is low, these data indicate an increased risk of ICU admission, need for mechanical ventilation and ventilatory support (ECMO), and death reported in pregnant women with symptomatic COVID-19 infection, when compared with symptomatic non-pregnant women (Zambrano MMWR 2020). Pregnant patients with comorbidities such as obesity and diabetes may be at an even higher risk of severe illness consistent with the general population with similar comorbidities (Ellington MMWR 2020, Panagiotakopoulos MMWR 2020, Knight 2020, Zambrano MMWR 2020). Given the growing evidence, CDC has included pregnancy as a factor that leads to increased risk for severe COVID-19 illness (CDC). Similar to the general population, Black and Hispanic individuals who are pregnant appear to have disproportionately higher prevalence of COVID-19 infection and death (Ellington MMWR 2020, Moore MMWR 2020, Zambrano MMWR 2020). Further, risk (Zambrano MMWR 2020) of ICU admission was higher for pregnant Asian and Native Hawaiian/Pacific Islander individuals. These disparities are due to a range of social and structural factors including disparities in socioeconomic status, access to care, rates of chronic conditions, occupational exposure, systemic racism, and historic and continued inequities in the health care system.
The report states that ACOG will follow up with additional information as it becomes available.