The results of a recent study highlight the gaps in COVID-19 vaccination among pregnant women in the United States. Although pregnant women are at increased risk for severe illness and death from the disease, many remain unvaccinated.1

Contraceptive Technology Update asked Hilda Razzaghi, PhD, epidemiologist with the Immunization Services Division at the Centers for Disease Control and Prevention (CDC) to answer questions about the research. The transcript has been lightly edited for length and clarity.

CTU: Your study results suggest the need for improved outreach and engagement with pregnant women regarding the COVID-19 vaccine. How could OB/GYNs and family planning centers do a better job of reaching this population?

Razzaghi: We know that pregnant people are more likely to get severely ill with COVID-19, compared with non-pregnant people, and that getting a COVID-19 vaccine can help protect against severe illness. Pregnant people are eligible for and can receive a COVID-19 vaccine. When facing a decision about whether to receive a COVID-19 vaccine while pregnant, considerations might include the risk of exposure to COVID-19, risks of severe illness during pregnancy, the known benefits of vaccination, and the limited but growing evidence about the safety of COVID-19 vaccination during pregnancy. A discussion with a healthcare provider can help pregnant people make an informed decision, but this is not required prior to vaccination.

The estimates from our study provide insight on COVID-19 vaccination during pregnancy, including among specific subpopulations. The availability of data regarding safety and efficacy of COVID-19 vaccines, as well as accurate and timely information about COVID-19 vaccination to pregnant people and women of reproductive age, including those who are younger and from some racial and ethnic minority groups, is important to allow them to make a more fully informed decision about COVID-19 vaccination.

We work closely with the American College of Obstetricians and Gynecologists, the Society for Maternal-Fetal Medicine, and other professional medical organizations. These organizations have been critical in disseminating CDC guidance about COVID-19 vaccines for pregnant and breastfeeding people, as well as ensuring that healthcare providers have the resources to help counsel pregnant and reproductive-age people. We know that healthcare professionals have pregnant people and infants at the forefront and regularly provide easy-to-understand information for pregnant people and people of reproductive age to make a fully informed decision. During prenatal care and other healthcare visits, healthcare professionals can continue to inform people about COVID-19 vaccination and encourage a safe space for people to ask questions and share their concerns. The CDC and others continue working rapidly to [collect] safety and effectiveness data for pregnant people so they have as much information as possible to make these decisions. Guidance will be updated as more data are available.

CTU: Should family planning centers and other reproductive health clinics begin offering COVID-19 vaccines to patients, both before and during pregnancy? What may be a model for doing this well?

Razzaghi: COVID-19 vaccination is recommended for all people 12 years [of age] and older. On an individual level, healthcare providers are vaccine recipients’ most trusted source of information on vaccines. They play a critical role in helping vaccine recipients understand the importance of vaccination, and that COVID-19 vaccines are safe and effective. On a population level, the CDC is working with others across the federal, state, and local levels to ensure that COVID-19 vaccination is equitably distributed and easy to access.

At this time, all COVID-19 vaccines in the United States have been purchased by the government for administration exclusively by providers enrolled in the CDC COVID-19 Vaccination Program. Only healthcare professionals enrolled as vaccination providers directly through a health practice or organization can legally store, handle, and administer COVID-19 vaccines in the United States. If a provider is interested in enrolling in the CDC COVID-19 Vaccination Program, more information can be found on the CDC’s website. The CDC also offers multiple resources that might be useful when counseling a patient about COVID-19 vaccines.

REFERENCE

  1. Razzaghi H, Meghani M, Pingali C, et al. COVID-19 vaccination coverage among pregnant women during pregnancy — eight integrated health care organizations, United States, December 14, 2020-May 8, 2021. MMWR Morb Mortal Wkly Rep 2021;70:895-899.