COVID-19 Vaccine in Pregnant and Lactating Women: A Review of Existing Evidence and Practice Guidelines
Abstract
:1. Introduction
2. COVID-19 Vaccines
2.1. mRNA
2.2. Viral Vector
2.3. Recombinant Antigen Proteins
2.4. Inactivated COVID-19 Virus
3. Clinical Trials of COVID-19 Vaccine in Pregnant and Lactating Women
4. Impact of COVID-19 Vaccine in Pregnant Women
5. COVID-19 Vaccine Hesitancy
6. Impact of COVID-19 Vaccine on Fetuses and Breastfeeding Infants
7. Impact of COVID-19 Vaccine on Fertility
8. Recommendations for Health Care Providers
Special Considerations
9. Limitations
10. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Pfizer/BioNTech | Moderna | Janssen | Oxford/AstraZeneca | Sinopharm | SinoVac | |
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Target Population | Age 12 and older | Age 18 and older | ||||
Vaccine Administration | 2 doses, 21 days apart | 2 doses, 28 days apart | 1 dose | 2 doses, 8 to 12 weeks apart | 2 doses, 21 to 28 days apart | |
Efficacy | 95% | 94.1% | 72% overall and 86% against severe disease | 63.1% | 73% | 83.5% |
Side effects | Most common—injection site pain, fatigue, headache, muscle pain, joint pain, & fever | |||||
More common after the second dose | - | More common after the second dose | ||||
Rare—Severe allergic reaction Bell’s palsy, myocarditis, & pericarditis | Rare—TTS, post-vaccination syndrome, radiculitis, GBS | N/A | N/A | |||
Safety in Pregnant/Lactating women | Animal Studies—No safety concerns | Animal Studies -N/A | ||||
Human Studies—N/A |
Vaccine Type | Control/Placebo Group | Vaccine Group | ||||
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Participants | Pregnancies | Miscarriage (rate) | Participants | Pregnancies | Miscarriage (Rate) | |
Pfizer/BioNTech | 18,846 | 12 | 1 (8%) | 18,860 | 11 | 0 |
Moderna | 15,170 | 7 | 1 (14%) | 15,181 | 6 | 0 |
Janssen | 21,888 | 4 | 1 (25%) | 21,895 | 4 | 1 (25%) + 1 (25%) * |
AstraZeneca | 5,829 | 9 | 3 (33%) | 5,807 | 12 | 2 (17%) |
Pregnant and Considering Pregnancy | Breastfeeding |
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Society for Maternal-Fetal Medicine (SMFM) | |
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Academy of Breastfeeding Medicine (ABM) | |
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Food and Drug Administration (FDA) | |
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Garg, I.; Shekhar, R.; Sheikh, A.B.; Pal, S. COVID-19 Vaccine in Pregnant and Lactating Women: A Review of Existing Evidence and Practice Guidelines. Infect. Dis. Rep. 2021, 13, 685-699. https://doi.org/10.3390/idr13030064
Garg I, Shekhar R, Sheikh AB, Pal S. COVID-19 Vaccine in Pregnant and Lactating Women: A Review of Existing Evidence and Practice Guidelines. Infectious Disease Reports. 2021; 13(3):685-699. https://doi.org/10.3390/idr13030064
Chicago/Turabian StyleGarg, Ishan, Rahul Shekhar, Abu B. Sheikh, and Suman Pal. 2021. "COVID-19 Vaccine in Pregnant and Lactating Women: A Review of Existing Evidence and Practice Guidelines" Infectious Disease Reports 13, no. 3: 685-699. https://doi.org/10.3390/idr13030064