Abstract

Safety and effectiveness of COVID-19 vaccines during pregnancy is a particular concern affecting vaccination uptake by this vulnerable group. Here we evaluated evidence from 23 studies including 117,552 COVID-19 vaccinated pregnant people, almost exclusively with mRNA vaccines. We show that the effectiveness of mRNA vaccination against RT-PCR confirmed SARS-CoV-2 infection 7 days after second dose was 89.5% (95% CI 69.0-96.4%, 18,828 vaccinated pregnant people, I2 = 73.9%). The risk of stillbirth was significantly lower in the vaccinated cohort by 15% (pooled OR 0.85; 95% CI 0.73-0.99, 66,067 vaccinated vs. 424,624 unvaccinated, I2 = 93.9%). There was no evidence of a higher risk of adverse outcomes including miscarriage, earlier gestation at birth, placental abruption, pulmonary embolism, postpartum haemorrhage, maternal death, intensive care unit admission, lower birthweight Z-score, or neonatal intensive care unit admission (p > 0.05 for all). COVID-19 mRNA vaccination in pregnancy appears to be safe and is associated with a reduction in stillbirth.

  • Pregnant women
  • Vaccine/vaccination
  • Efficacy/effectiveness
  • Safety
  • Administration
  • COVID-19