Review
COVID-19 vaccines in pregnancy

https://doi.org/10.1016/j.molmed.2022.04.012Get rights and content

Highlights

  • COVID-19 during pregnancy is associated with a higher risk of stillbirth and preterm birth.

  • The current COVID-19 vaccines were not tested in pregnant women in the initial clinical trials, but information on their safety, immunogenicity, and effectiveness has been generated from observational studies.

  • No major safety concerns on the use of mainly the mRNA COVID-19 vaccines in pregnant women have been identified.

  • Pregnant women mount immune responses to COVID-19 mRNA vaccines comparable to non-pregnant counterparts.

  • Anti-SARS-CoV-2 IgG are detected in cord blood following maternal vaccination at concentrations that strongly correlated with both maternal antibody levels and the time elapsed since vaccination.

  • Vaccination of pregnant women with mRNA COVID-19 vaccines has been shown to be effective in protecting the women against disease.

COVID-19 caused by SARS-CoV-2 coronavirus has been associated with severe illness in pregnant women. Furthermore, COVID-19 during pregnancy is associated with adverse fetal outcomes including preterm labor. Pregnant women were largely excluded from initial clinical trials investigating the safety and efficacy of COVID-19 vaccines; however, they have since been included as part of the routine roll-out of these vaccines. This narrative review synthesizes the evidence on the safety, immunogenicity, and effectiveness predominantly of the mRNA COVID-19 vaccines which have been most widely used in pregnant women.

Keywords

safety
immunogenicity
transplacental transfer
antibodies

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