COVID-19 Vaccination Considerations

Topic: COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care

This Practice Advisory is intended to be an overview of currently available COVID-19 vaccines and guidance for their use in pregnant, recently pregnant, and nonpregnant individuals.

ACOG recommends that all eligible persons, including pregnant and lactating individuals, receive a COVID-19 vaccine or vaccine series. Obstetrician-gynecologists and other women’s health care practitioners should lead by example by being vaccinated and encouraging eligible patients to be vaccinated as well.

COVID-19 vaccine development and regulatory approval are rapidly progressing. Thus, information and recommendations will evolve as more data are collected about these vaccines and their use in specific populations. This Practice Advisory is intended to be an overview of currently available COVID-19 vaccines and guidance for their use in pregnant, recently pregnant, and nonpregnant individuals.

  • The U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the following vaccines:
    • Pfizer-BioNtech mRNA vaccine (BNT162b2): for use in individuals age 12 years and older as a 2-dose regimen given 3 weeks (21 days) apart.
    • Moderna mRNA-1273 vaccine: for use in individuals age 18 and older as a 2-dose regimen given 1 month (28 days) apart.
    • Janssen Biotech, Inc. (Johnson & Johnson) Ad26.COV2.S vaccine: for use in individuals age 18 and older as a single dose regimen.
  • After an explicit, evidence-based review of all available data, the Advisory Committee on Immunization Practices (ACIP) has issued interim recommendations for use of the Pfizer-BioNTech COVID-19 vaccine in persons aged ≥12 years for the prevention of COVID-19 (CDC 2021), the use of the Moderna-1273 COVID-19 vaccine in persons aged ≥ 18 years (CDC 2020), and the use of the Janssen (Johnson & Johnson) COVID-19 vaccine in persons aged ≥ 18 years (CDC 2021).
  • ACOG strongly recommends that all eligible persons receive a COVID-19 vaccine or vaccine series. Obstetrician-gynecologists and other women’s health care practitioners should lead by example by being vaccinated and encouraging eligible patients to be vaccinated as well.
  • ACOG recommends that pregnant individuals be vaccinated against COVID-19.
  • ACOG recommends that lactating individuals be vaccinated against COVID-19.
    While a conversation with a clinician may be helpful, it is not a requirement prior to vaccination, as this may cause unnecessary barriers to access.
  • Similar to their non-pregnant peers, vaccination of pregnant individuals with a COVID-19 vaccine may occur in any setting authorized to administer these vaccines. This includes any clinical setting and non-clinical community-based vaccination sites such as schools, community centers, and other mass vaccination locations.
  • Pregnancy testing is not a requirement prior to receiving any EUA-approved COVID-19 vaccine.
  • Claims linking COVID-19 vaccines to infertility are unfounded and have no scientific evidence supporting them. ACOG recommends vaccination for all eligible people who may consider future pregnancy.

Topic Discussed: COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care

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