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COVID-19 and Women’s Health

COVID-19 mRNA Vaccines Well Tolerated by Pregnant and Lactating Individuals

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BACKGROUND AND PURPOSE:

  • Kachikis et al. (JAMA Network Open, 2021) examined the experiences of pregnant and lactating individuals after receiving COVID-19 vaccines

METHODS:

  • Prospective cohort study
    • Primarily United States
    • Data analysis from January through March 2021
  • Participants
    • Pregnant, lactating, or planning pregnancy at the time of COVID-19 vaccination
    • Online recruitment via University of Washington COVID-19 Vaccine in Pregnancy and Lactation Registry
  • Study design
    • Self-reported
      • Demographics (including race and ethnicity) | Pregnancy | Vaccination perception
      • Outcome data including day 1 vaccine reactions: Fever | Pain at injection site | Fatigue | Myalgia | Headache | Chills

RESULTS:

  • Pregnant: 7809 | Lactating: 6815 | Planning pregnancy: 2901
    • Mean (SD) age 33.6 (3.6) years | 87.6% White
    • Vaccine received
      • Pfizer: 61.9%
      • Moderna: 37.8%
    • Two doses: 85.9%
  • Post-vaccination symptoms (most frequent)
    • Pain at injection site: 91.4%
    • Fatigue: 31.3%
  • Odds of symptoms were reduced in the pregnant cohort including fever  
    • Fever after Pfizer dose 2: OR 0.44 (95% CI, 0.38 to 0.52); P<0.001
    • Fever after Moderna dose 2: OR 0.48 (95% CI, 0.40 to 0.57); P<0.001
  • Mean (SD) maximum self-reported temperature
    • After dose 1: 38.1 (0.6) °C
    • After dose 2: 38.2 (0.6) °C
  • Symptoms reported by lactating participants
    • Interrupted breastfeeding after vaccination reported by lactating participants
      • After dose 1: 2.3%
      • After dose 2: 2.2%
    • Decreased milk supply for less than 24 hours
      • After dose 1: 5.0%
      • After dose 2: 7.2%
    • Concerns about infant
      • After dose 1: 3.0%
      • After dose 2: 4.4%

CONCLUSION:

  • COVID-19 mRNA vaccines are well tolerated by pregnant and lactating individuals
  • Pregnant, lactating, and pre-pregnancy individuals had similar vaccine reactions
    • All groups had increased reactions after dose two
  • Limitation of the study includes the use of self-reporting | Primarily healthcare workers as they had first access to vaccine
  • Further studies are ongoing to assess longer term outcomes

Learn More – Primary Sources:

Short-term Reactions Among Pregnant and Lactating Individuals in the First Wave of the COVID-19 Vaccine Rollout

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Related ObG Topics:

Vaccines in Pregnant and Lactating Women: Is Immune Response Similar to that of Non-Pregnant Patients?
mRNA COVID-19 Vaccine Safety in Pregnant Women
More Evidence that mRNA-based COVID-19 Vaccination is Effective in Pregnant Women

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