ACOG: Pregnant Women Should Be Offered COVID-19 Vaccine

 An influential  physician group is advising providers to allow pregnant and lactating people who are among those prioritized for COVID-19 vaccination the chance to receive the newly released shots.

The American College of Obstetricians and Gynecologists issued a practice advisory Sunday night, just ahead of administration of the first federally approved COVID-19 vaccine – from Pfizer Inc. and BioNTech – to Americans on Monday. A Centers for Disease Control and Prevention advisory panel earlier this month recommended that health care personnel and long-term care residents should be prioritized for vaccines during that initial rollout.

However, no data is yet available on the effectiveness and safety of the vaccine in pregnant women, as they were excluded from the clinical trials of Pfizer and other companies. Some 75% of health care workers are women, and 330,000 workers are expected to be pregnant or postpartum.

In its advisory, ACOG noted the lack of data and said individuals considering a vaccine should be given that information, as well as access to information that is available on safety and efficacy. But the group says COVID-19 vaccines "should not be withheld" from those who are pregnant or lactating and meet priority criteria.

"In the interest of allowing pregnant individuals who would otherwise be considered a priority population for a vaccine approved for use … (to) make their own decisions regarding their health, ACOG recommends that pregnant individuals should be free to make their own decision in conjunction with their clinical care team," the group's practice advisory says.

Similarly, the advisory says, "theoretical concerns regarding the safety of vaccinating lactating individuals do not outweigh the potential benefits of receiving the vaccine. There is no need to avoid initiation or discontinue breastfeeding in patients who receive a COVID-19 vaccine. "

ACOG also notes the type of vaccine created by Pfizer is an mRNA vaccine, which means it doesn't carry a live virus. A vaccine from Moderna that's expected to receive similar federal approval in the coming days also is an mRNA vaccine.

"These vaccines do not enter the nucleus and do not alter human DNA in vaccine recipients. As a result, mRNA vaccines cannot cause any genetic changes," the advisory says.

ACOG says pregnant patients thinking of getting a vaccine may want to consider the level of COVID-19 positivity within their community, as well as the potential risk and severity of the disease in mothers, fetuses and newborns.

But, the advisory says, conversations with a clinician about such topics should not be required, nor should pregnancy tests be required prior to getting a vaccine. Additionally, ACOG says pregnant patients who decline vaccines "should be supported in their decision."

Based on the little data known so far, the CDC says pregnant women face an increased risk of severe COVID-19 illness and may face a heightened risk of negative pregnancy outcomes, such as preterm birth, if they become infected.