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A narrative review of COVID-19 vaccination in pregnancy and breastfeeding

Journal of Perinatology volume 44, pages 12–19 (2024)Cite this article

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Abstract

The Coronavirus pandemic has affected millions of people due to the spread of the Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) virus. Pregnant individuals and infants are most vulnerable given the increased risk of developing severe complications from SARS-CoV-2 infection. Recently, COVID-19 vaccination is recommended for pregnant women and infants starting at 6 months of age to prevent disease contraction and minimize disease severity. We conducted a review of the literature on COVID-19 vaccination to discuss vaccine safety and efficacy, immunity after maternal vaccination, transplacental transfer and persistence of antibodies, and public health implications. Current evidence supports the safety and efficacy of vaccination during pregnancy. Maternal vaccination provides greater antibody persistence in infants compared to immunity from natural infection. Furthermore, vaccination has demonstrated an increased rate of passive antibody transfer through the placenta and breast milk. Public health interventions are important in achieving herd immunity and ultimately ending the pandemic.

Impact

  • This article highlights the benefits of COVID-19 vaccination during pregnancy with a review of the data describing safety and efficacy, passive and active immunity after maternal immunization, trans-placental transfer and persistence of protective antibodies, and public health implications. With this information, healthcare providers can provide up-to-date knowledge to their pregnant patients to help them form an informed decision on vaccination and combat vaccine hesitancy.

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Fig. 1: COVID-19 Vaccination schedule for non-immunocompromised pregnant people.
Fig. 2: Factors Contributing to Vaccination Decision- Making and Hesitancy in Pregnant/Lactating Indviduals.
Fig. 3: Timeline of COVID-19 vaccine development.

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Authors and Affiliations

  1. Chobanian & Avedisian School of Medicine, Boston, MA, US

    Jean L. Devera & Yunisse Gonzalez

  2. Division of Pediatrics Infectious Disease, Department of Pediatrics, Boston Medical Center, Boston, MA, US

    Vishakha Sabharwal

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  2. Yunisse Gonzalez
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JLD, YS and VS conceptualized the article, helped write the manuscript.

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Correspondence to Vishakha Sabharwal.

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Devera, J.L., Gonzalez, Y. & Sabharwal, V. A narrative review of COVID-19 vaccination in pregnancy and breastfeeding. J Perinatol 44, 12–19 (2024). https://doi.org/10.1038/s41372-023-01734-0

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