COVID-19 vaccines in pregnancy

Abstract

As of December 1, 2020, nearly 64 million people have been infected with COVID-19 worldwide with nearly 1.5 million global deaths. The impact of this virus has continued to overwhelm hospital infrastructure and demanded remodeling of healthcare systems. With rising concerns for a third, and possibly the largest, wave of infected individuals, national leaders are continuing to seek avenues by which we can further limit disease transmission and prevent infection with the use of vaccination. To our knowledge, no clinical trial evaluating vaccines to prevent COVID-19 has included pregnant women. By December 2020, it’s anticipated that the FDA will approve at least one or two mRNA-based COVID-19 vaccine under emergency use authorization (EUA) based on Phase 3 clinical trial efficacy data. Both Pfizer and Moderna have manufactured mRNA-based vaccines with 95% and 94.1% efficacy against COVID-19. [1, 2] AstraZeneca has manufactured a vaccine using a viral-vector demonstrating early efficacy as well and this next generation platform has previously been utilized with the Ebola vaccine and safely administered during pregnancy with an acceptable safety profile [3]. Approval of these vaccines will have a tremendous impact on the ongoing pandemic, yet there remains a lack of data for use of COVID-19 vaccine in pregnant women. In this article we seek to discuss the available data regarding treatment and prevention of COVID-19 in pregnancy and address the growing questions regarding how best to approach vaccine access and administration in the pregnant population.