CDC Encourages Pregnant Individuals to Get COVID-19 Vaccination

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The US Centers for Disease Control and Prevention (CDC) now recommends that pregnant and breastfeeding women get vaccinated against COVID-19, guidance based on a growing body of evidence that suggests the benefits of receiving the vaccine outweigh any known or potential risks of vaccination during pregnancy.

“CDC encourages all pregnant people or people who are thinking about becoming pregnant and those breastfeeding to get vaccinated to protect themselves from COVID-19,” said CDC Director Rochelle Walensky, MD, MPH, in an August 11, 2021 press release. “The vaccines are safe and effective, and it has never been more urgent to increase vaccinations as we face the highly transmissible Delta variant and see severe outcomes from COVID-19 among unvaccinated pregnant people,” continued Dr Walensky.

The CDC has been accumulating data to support COVID-19 vaccine safety in pregnancy through 3 monitoring systems, which have not found any safety concerns for either the individual or their baby. Adding to that data, a new analysis of one of the monitoring systems called the “v-safe COVID-19 Vaccine Pregnancy Registry” did not show an increased risk of spontaneous abortion (SAB) among pregnant, vaccinated individuals.

“Combined, these data and the known severe risks of COVID-19 during pregnancy demonstrate that the benefits of receiving a COVID-19 vaccine for pregnant people outweigh any known or potential risks,” stated the agency in the press release.

The analysis, published as a preprint in Research Square, included 2456 pregnant persons enrolled in the v-safe pregnancy registry who received at least 1 dose of an mRNA COVID-19 vaccine preconception or prior to 20 weeks’ gestation, and who did not report pregnancy loss before 6 weeks.

The cohort consisted of mostly non-Hispanic White (78.3%) persons who identified as health care personnel (88.8%), and most participants were aged 30-34 years (49.1%) or 35-39 years (28.2%), according to the analysis.

Researchers assessed participants from 6 to 19 weeks’ gestation. Among all participants, 2020 were known to be pregnant at 20 weeks’ gestation and 165 participants self-reported a SAB, of which 154 occurred prior to 14 weeks’ gestation.

Researchers found that the cumulative risk of SAB from 6-19 weeks’ gestation was 14.1% (95% confidence interval [CI], 12.1%-16.1%), which is similar to the expected rate in the general population (11%-16%).

Because the median age of the cohort was higher than in reference studies and given that maternal age is a known risk factor of SAB, CDC researchers age-standardized the estimate and the cumulative risk decreased to 12.8% (95% CI, 10.8%–14.8%).

Study limitations included the lack of a comparison group of unvaccinated pregnant persons, the relatively homogeneous sample, the data was collected prospectively and retrospectively, and all data was self-reported.

The analysis comes at an important time because in the past several weeks physicians have been observing a rise in the number of pregnant women infected with COVID-19, the CDC noted in the press release.

“The increased circulation of the highly contagious Delta variant, the low vaccine uptake among pregnant people, and the increased risk of severe illness and pregnancy complications related to COVID-19 infection among pregnant people make vaccination for this population more urgent than ever,” the agency stressed.