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CDC Strongly Recommends COVID Vaccine in Pregnancy

— New data in hand, agency strengthens its recommendation for pregnant people to get vaccinated

MedpageToday
A blue gloved hand holds a syringe with an out of focus pregnant woman wearing a protective mask in the background.

The CDC now that pregnant people get vaccinated against COVID-19, citing new safety data.

While the agency had previously said the vaccine could be offered during pregnancy, it vaccination "for all people 12 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future."

"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," CDC Director Rochelle Walensky, MD, said in a statement. "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."

The new CDC analysis of data from the v-safe pregnancy registry was in Research Square. It included 2,456 pregnant women who got at least one dose of an mRNA COVID-19 vaccine from preconception to before 20 weeks' gestation, and who didn't report pregnancy loss before 6 weeks.

The analysis found no increased risk of spontaneous abortion, or miscarriage, among women who had the jab. Their cumulative risk of spontaneous abortion was 14.1% (95% CI 12.1-16.1%). The typical rate of spontaneous abortion in high-income countries is 11% to 16%, CDC said.

Because the median age of the v-safe study population was higher than in reference studies, however, CDC researchers conducted age-standardized estimates, given that maternal age is a known risk factor for spontaneous abortion. The cumulative risk in that analysis fell to 12.8% (95% CI 10.8-14.8%).

In a sensitivity analysis in which all 65 people who couldn't be contacted in the 2nd trimester were assumed to have had a spontaneous abortion, cumulative risk was 18.8%, falling to 18.5% after age standardization.

"These findings add to accumulating evidence that mRNA COVID-19 vaccines during pregnancy are safe," the CDC researchers wrote.

Study limitations included the lack of a comparison group of unvaccinated pregnant people; the relatively homogeneous sample (78% non-Hispanic white, 89% healthcare workers); data collected both prospectively and retrospectively; and that all data was self-reported.

Also, the Janssen/Johnson & Johnson vaccine was not included in the analysis due to limited data, as it was authorized much later than the mRNA vaccines, the researchers noted.

Still, CDC includes the Janssen/Johnson & Johnson vaccine in its , with a caveat: "Any of the currently FDA-authorized COVID-19 vaccines can be administered to people in these groups; [the Advisory Committee on Immunization Practices] does not state a product preference. However, women aged <50 years should be aware of the rare risk of TTS [thrombosis with thrombocytopenia syndrome] after receipt of the Janssen COVID-19 vaccine and the availability of other currently FDA-authorized COVID-19 vaccines (i.e., mRNA vaccines) for which this risk has not been seen."

CDC said that earlier data from didn't raise any safety concerns for people vaccinated later in pregnancy.

The new recommendations bring CDC in line with the American College of Obstetricians and Gynecologists, which vaccination for pregnant individuals.

In its statement, CDC noted that "clinicians have seen the number of pregnant people infected with COVID-19 rise in the past several weeks."

"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 said in its statement.

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    Kristina Fiore leads ֱ’s enterprise & investigative reporting team. She’s been a medical journalist for more than a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW, and others. Send story tips to k.fiore@medpagetoday.com.