COVID-19 Vaccine policies and recommendations for pregnant and lactating people worldwide.

Timeline of Evidence and Recommendations

The timeline below shows the distribution of national COVID-19 vaccine policies for pregnancy or lactation from March 13, 2021, to present day, color-coded according to COMIT score. Superimposed black lines indicate the publication dates of: (1) evidence of SARS-CoV-2 risk in pregnancy; (2) COVID-19 vaccine safety and effectiveness and newborn outcome research; and (3) WHO/SAGE COVID-19 vaccine recommendations. Detailed information on the research findings or recommendations can be found in the table below.
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Showing all dates (select a range on the above graph to filter the list)
Items shown: 72
Date (Click to sort descending) Category (Click to sort ascending) Title/Author (Click to clear sorting) Findings (Click to clear sorting)
2020-06-26
Risk of SARS-CoV2 In Pregnancy
Pregnant women might be at an increased risk for severe COVID-19 illness; Among reproductive-age women with SARS-CoV-2 infection, pregnancy was associated with hospitalization and increased risk for intensive care unit admission, and receipt of mechanical ventilation, but not with death.
2020-09-01
Risk of SARS-CoV2 In Pregnancy
Pregnant and recently pregnant women with covid-19 diagnosed in hospital are less likely to manifest symptoms of fever and myalgia than non-pregnant women of reproductive age and might be at increased risk of admission to an intensive care unit; Risk factors for severe covid-19 in pregnancy include increasing maternal age, high body mass index, and pre-existing comorbidities; Pregnant women with covid-19 are more likely to experience preterm birth and their neonates are more likely to be admitted to a neonatal unit.
2020-11-06
Risk of SARS-CoV2 In Pregnancy
Among 3,912 infants with known gestational age born to women with SARS-CoV-2 infection, 12.9% were preterm (<37 weeks), higher than a national estimate of 10.2%. Among 610 (21.3%) infants with testing results, 2.6% had positive SARS-CoV-2 results, primarily those born to women with infection at delivery.
2020-11-06
Risk of SARS-CoV2 In Pregnancy
Risk of severe COVID-19-associated illness including death; among 400,000 women aged 15-44 with symptomatic COVID-19, intensive care unit admission, invasive ventilation, extracorporeal membrane oxygenation, and death were more likely in pregnant women than in nonpregnant women.
2020-12-17
Vaccine Safety / Effectiveness / Newborn Outcomes
No effects on female reproduction, fetal/embryonal development, or postnatal development.
2020-12-21
Vaccine Safety / Effectiveness / Newborn Outcomes
No vaccine-related effects on female fertility, pregnancy, or embryo-fetal or postnatal development.
2021-01-08
WHO / SAGE Recommendations
Pfizer recommended (1) for lactating persons and not recommended but with exceptions (elevated risk of exposure & serious disease) (4) for pregnant persons.
2021-01-08
WHO / SAGE Recommendations
Pfizer permitted (2) for lactating persons and not recommended but with exceptions (elevated risk of exposure) (4) for pregnant persons.
2021-01-21
Vaccine Safety / Effectiveness / Newborn Outcomes
Preliminary DART show no adverse effects in reproductive toxicity.
2021-01-25
WHO / SAGE Recommendations
Moderna recommended (1) for lactating persons and not recommended but with exceptions (elevated risk of exposure & serious disease) (4) for pregnant persons.
2021-01-29
WHO / SAGE Recommendations
Moderna permitted (2) for lactating persons and permitted with qualifications (elevated risk of exposure & serious disease) (3) for pregnant persons.
2021-02-10
WHO / SAGE Recommendations
AstraZeneca recommended (1) for lactating persons and permitted with qualifications (elevated risk of exposure & serious disease) (3) for pregnant persons.
2021-02-23
Risk of SARS-CoV2 In Pregnancy
The data presented support strong guidance for enhanced precautions to prevent SARS-CoV-2 infection in pregnancy, particularly in the context of increased risks of preterm delivery and maternal mortality, and for priority vaccination of pregnant women and women planning pregnancy.
2021-03-17
WHO / SAGE Recommendations
Janssen recommended (1) for lactating persons and permitted with qualifications (elevated risk of exposure & serious disease) (3) for pregnant persons.
2021-03-17
WHO / SAGE Recommendations
AstraZeneca permitted (2) for lactating persons and permitted with qualifications (elevated risk of exposure & serious disease) (3) for pregnant persons.
2021-03-25
Vaccine Safety / Effectiveness / Newborn Outcomes
Coronavirus disease 2019 messenger RNA vaccines generated robust humoral immunity in pregnant and lactating women, with immunogenicity and reactogenicity similar to that observed in nonpregnant women. Vaccine-induced immune responses were statistically significantly greater than the response to natural infection. Immune transfer to neonates occurred via placenta and breastmilk.
2021-03-29
WHO / SAGE Recommendations
Janssen permitted (2) for lactating persons and permitted with qualifications (elevated risk of exposure & serious disease) (3) for pregnant persons.
2021-03-30
Vaccine Safety / Effectiveness / Newborn Outcomes
Authors characterize longitudinal breast milk levels of antispike IgG/A following Pfizer-BioNTech/BNT162b2 vaccination, demonstrating sustained elevation of IgG/IgA levels. A concurrent decrease in infant respiratory illness rates suggest that maternal vaccination confers protection against infection in breastfed infants. Thus, the Pfizer-BioNTech/BNT162b2 vaccination may also confer protection against COVID-19 to breastfed infants as well.
2021-04-12
Vaccine Safety / Effectiveness / Newborn Outcomes
This study found robust secretion of SARS-CoV-2 specific IgA and IgG antibodies in breast milk for 6 weeks after vaccination. IgA secretion was evident as early as 2 weeks after vaccination followed by a spike in IgG after 4 weeks (a week after the second vaccine). Antibodies found in breast milk of these women showed strong neutralizing effects, suggesting a potential protective effect against infection in the infant.
2021-04-21
WHO / SAGE Recommendations
AstraZeneca recommended (1) for lactating persons and permitted with qualifications (elevated risk of exposure & serious disease) (3) for pregnant persons.
2021-04-21
Vaccine Safety / Effectiveness / Newborn Outcomes
Preliminary findings did not show obvious safety signals among pregnant persons who received mRNA Covid-19 vaccines.
2021-04-23
Vaccine Safety / Effectiveness / Newborn Outcomes
No adverse effect on fertility, embryo-fetal, or postnatal development.
2021-05-07
WHO / SAGE Recommendations
Sinopharm recommended (1) for lactating persons and permitted (2) for pregnant persons.
2021-05-10
WHO / SAGE Recommendations
AstraZeneca recommended (1) for lactating persons and permitted with qualifications (elevated risk of exposure & serious disease) (3) for pregnant persons.
2021-05-13
Vaccine Safety / Effectiveness / Newborn Outcomes
In this cohort study involving 103 women who received a COVID-19 mRNA vaccine, 30 of whom were pregnant and 16 of whom were lactating, immunogenicity was demonstrated in all, and vaccine-elicited antibodies were found in infant cord blood and breast milk. Pregnant and nonpregnant vaccinated women developed cross-reactive immune responses against SARS-CoV-2 variants of concern.
2021-05-19
Risk of SARS-CoV2 In Pregnancy
SARS-CoV-2 infection at the time of birth is associated with higher rates of fetal death, preterm birth, preeclampsia, and emergency cesarean delivery. There were no additional adverse neonatal outcomes, other than those related to preterm delivery. Pregnant women should be counseled regarding risks of SARS-CoV-2 infection and should be considered a priority for vaccination.
2021-05-20
Vaccine Safety / Effectiveness / Newborn Outcomes
Antenatal BNT162b2 mRNA vaccination induces a robust maternal humoral response that effectively transfers to the fetus, supporting the role of vaccination during pregnancy.
2021-05-24
WHO / SAGE Recommendations
Sinovac recommended (1) for lactating persons and permitted (2) for pregnant persons.
2021-06-15
WHO / SAGE Recommendations
Janssen recommended (1) for lactating persons and permitted with qualifications (elevated risk of exposure & serious disease) (3) for pregnant persons.
2021-06-15
WHO / SAGE Recommendations
Moderna recommended (1) for lactating persons and permitted (2) for pregnant persons.
2021-06-15
WHO / SAGE Recommendations
Pfizer recommended (1) for lactating persons and permitted (2) for pregnant persons.
2021-06-17
Vaccine Safety / Effectiveness / Newborn Outcomes
As there were no serious side effects in the children after the mothers’ vaccinations, and the presence of IgG and IgA antibodies in the breast milk was shown, the study gives further evidence on the importance of vaccination against COVID-19 in breastfeeding women. Therefore, the study may affect future recommendations for vaccination against COVID-19 in the general population of breastfeeding mothers.
2021-06-26
Risk of SARS-CoV2 In Pregnancy
COVID-19 during pregnancy is strongly associated with preeclampsia, especially among nulliparous women. This association is independent of any risk factors and preexisting conditions. COVID-19 severity does not seem to be a factor in this association.
2021-07-01
Vaccine Safety / Effectiveness / Newborn Outcomes
The findings of this study show that COVID-19 vaccination of pregnant women with the BNT162b2 mRNA vaccine seems to be safe and effective. Recommending COVID-19 vaccination of pregnant women should therefore be strongly considered in view of the maternal morbidity associated with COVID-19 in pregnancy.
2021-07-12
Vaccine Safety / Effectiveness / Newborn Outcomes
Among pregnant women, receipt of the BNT162b2 vaccine was associated with a lower risk of incident SARS-CoV-2 infection.
2021-07-23
Vaccine Safety / Effectiveness / Newborn Outcomes
Authors observed significantly elevated levels of SARS-CoV-2 specific IgG and IgA antibodies in human milk beginning approximately 7 days after the initial vaccine dose, with an IgG-dominant response. Maternal vaccination results in SARS-CoV-2 specific immunoglobulins in human milk that may be protective for infants.
2021-07-30
WHO / SAGE Recommendations
AstraZeneca recommended (1) for lactating persons and permitted with qualifications (elevated risk of exposure & serious disease) (3) for pregnant persons.
2021-08-09
Vaccine Safety / Effectiveness / Newborn Outcomes
When compared to the expected range of SABs in recognized pregnancies, these data suggest receipt of an mRNA COVID-19 vaccine preconception or during pregnancy is not associated with an increased risk of SAB. These findings add to accumulating evidence that mRNA COVID-19 vaccines during pregnancy are safe.
2021-08-09
Vaccine Safety / Effectiveness / Newborn Outcomes
This study has contributed to the body of evidence that having COVID-19 vaccination in pregnancy does not alter perinatal outcomes.
2021-08-12
WHO / SAGE Recommendations
Vaccination recommended in lactating persons (Pfizer, Moderna, AstraZeneca, Janssen, Sinopharm, Sinovac).
2021-08-20
Vaccine Safety / Effectiveness / Newborn Outcomes
In this birth cohort, vaccinated pregnant women were less likely than unvaccinated pregnant patients to experience COVID-19 infection, and COVID-19 vaccination during pregnancy was not associated with increased pregnancy or delivery complications {late pregnancy vaccination}.
2021-09-07
Vaccine Safety / Effectiveness / Newborn Outcomes
The results of this study indicate that the BNT162b2 mRNA COVID-19 vaccine is highly effective in pregnant women for the variants circulating in Israel at the time of the study, with vaccine effectiveness that was comparable to that estimated in the general population.
2021-09-08
Vaccine Safety / Effectiveness / Newborn Outcomes
Among women with spontaneous abortions, the odds of COVID-19 vaccine exposure were not increased in the prior 28 days compared with women with ongoing pregnancies.
2021-09-08
Vaccine Safety / Effectiveness / Newborn Outcomes
Findings suggest that the risk of spontaneous abortion after mRNA Covid-19 vaccination either before conception or during pregnancy is consistent with the expected risk of spontaneous abortion; these findings add to the accumulating evidence about the safety of mRNA Covid-19 vaccination in pregnancy.
2021-09-17
Vaccine Safety / Effectiveness / Newborn Outcomes
All women showed immunity after vaccination with positive antibodies for IgM, IgA and IgG antibodies. The dominant serum antibody response was IgG. Modest levels of antibodies in breastmilk of lactating mothers were observed in this study, especially IgG in 42.9%.
2021-09-18
Vaccine Safety / Effectiveness / Newborn Outcomes
The study demonstrated the efficient transfer of SARS-CoV-2 immunoglobulin G across the placenta in women, vaccinated with the BNT162b2 messenger RNA vaccine during pregnancy, to their neonates, with a positive correlation between maternal serum and cord blood antibody concentrations. In addition to maternal protection against COVID-19, the vaccine may also provide neonatal humoral immunity.
2021-10-13
Vaccine Safety / Effectiveness / Newborn Outcomes
study shows an association between SARS-CoV-2 vaccination and lower odds of severe or critical COVID-19 and COVID-19 of any severity in pregnant patients during the Delta variant–predominant fourth surge of SARS-CoV-2.
2021-10-21
WHO / SAGE Recommendations
Sinovac recommended (1) for lactating persons and permitted (2) for pregnant persons.
2021-10-28
WHO / SAGE Recommendations
Sinopharm recommended (1) for lactating persons and permitted (2) for pregnant persons.
2021-11-03
WHO / SAGE Recommendations
Bharat recommended (1) for lactating persons and permitted (2) for pregnant persons.
2021-11-18
Vaccine Safety / Effectiveness / Newborn Outcomes
Study found no evidence of an increased risk for early pregnancy loss after Covid-19 vaccination and adds to the findings from other reports supporting Covid-19 vaccination during pregnancy.
2021-11-19
WHO / SAGE Recommendations
Moderna recommended (1) for lactating persons and recommended (1) for pregnant persons.
2021-11-19
WHO / SAGE Recommendations
Pfizer recommended (1) for lactating persons and recommended (1) for pregnant persons.
2021-12-09
WHO / SAGE Recommendations
Janssen recommended (1) for lactating persons and permitted with qualifications (elevated risk of exposure & serious disease) (3) for pregnant persons.
2021-12-20
WHO / SAGE Recommendations
Novavax recommended (1) for lactating persons and permitted with qualifications (elevated risk of exposure) (3) for pregnant persons.
2021-12-28
Vaccine Safety / Effectiveness / Newborn Outcomes
Vaccination against COVID-19 before and throughout pregnancy was associated with detectable maternal anti-spike IgG levels at delivery. A complete vaccination course, prior history of SARS-CoV-2 infection, and a third-trimester booster dose were associated with the highest maternal and umbilical cord antibody levels.
2022-01-07
Vaccine Safety / Effectiveness / Newborn Outcomes
In a retrospective cohort of >40,000 pregnant women, COVID-19 vaccination during pregnancy was not associated with preterm birth or small-for-gestational-age at birth overall, stratified by trimester of vaccination, or number of vaccine doses received during pregnancy, compared with unvaccinated pregnant women.
2022-01-13
Vaccine Safety / Effectiveness / Newborn Outcomes
Severe complications known to be associated with COVID-19 in pregnancy (critical care admission and perinatal mortality) were more common in women who were unvaccinated at the time of COVID-19 diagnosis than in vaccinated pregnant women.
2022-01-21
WHO / SAGE Recommendations
Vaccination recommended in pregnancy.
2022-01-21
WHO / SAGE Recommendations
Pfizer recommended (1) for lactating persons and recommended (1) for pregnant persons.
2022-02-07
Vaccine Safety / Effectiveness / Newborn Outcomes
This study found that the majority of infants born to COVID-vaccinated mothers had persistent anti-S antibodies at 6 months compared with infants born to mothers with SARS-CoV-2 infection.
2022-02-15
WHO / SAGE Recommendations
Vaccination recommended in pregnancy (Pfizer, Moderna, AstraZeneca, Janssen, Novavax, Sinophram, Sinovac, Bharat).
2022-02-18
Vaccine Safety / Effectiveness / Newborn Outcomes
Maternal completion of a 2-dose primary mRNA COVID-19 vaccination series during pregnancy was associated with reduced risk for COVID-19 hospitalization among infants aged <6 months in a real-world evaluation at 20 U.S. pediatric hospitals during a period of Delta and Omicron variant circulation.
2022-03-15
WHO / SAGE Recommendations
Sinopharm recommended (1) for lactating persons and permitted (2) for pregnant persons.
2022-03-15
WHO / SAGE Recommendations
Sinovac recommended (1) for lactating persons and permitted (2) for pregnant persons.
2022-03-15
WHO / SAGE Recommendations
Bharat recommended (1) for lactating persons and permitted (2) for pregnant persons.
2022-03-24
Vaccine Safety / Effectiveness / Newborn Outcomes
COVID-19 vaccination during pregnancy, compared with vaccination after pregnancy and with no vaccination, was not significantly associated with increased risk of postpartum hemorrhage, chorioamnionitis, cesarean delivery, admission to neonatal intensive care unit, or low newborn 5-minute Apgar score.
2022-04-04
Vaccine Safety / Effectiveness / Newborn Outcomes
Findings suggest that COVID-19 vaccination during early pregnancy is not associated with an increased risk of fetal structural anomalies identified with ultrasonography.
2022-04-12
Vaccine Safety / Effectiveness / Newborn Outcomes
Review of reports to VAERS following COVID-19 vaccines in pregnant persons did not identify any concerning patterns of maternal or infant-fetal outcomes.
2022-05-07
Risk of SARS-CoV2 In Pregnancy
Pregnant women with covid-19 versus without covid-19 are more likely to deliver preterm and have an increased risk of maternal death and of being admitted to the intensive care unit. Their babies are more likely to be admitted to the neonatal intensive care unit.
2022-05-19
WHO / SAGE Recommendations
CanSino recommended (1) for lactating persons and permitted (2) for pregnant persons.
2022-06-06
WHO / SAGE Recommendations
Janssen recommended (1) for lactating persons and permitted (2) for pregnant persons.
COMIT: COVID-19 Maternal Immunization Tracker Johns Hopkins University Berman Institute for Bioethics and Center for Immunization Research
The COMIT policy tracker was developed with support from the Bill & Melinda Gates Foundation and Wellcome .

Citation

Berman Institute of Bioethics & Center for Immunization Research, Johns Hopkins University. Covid-19 Maternal Immunization Tracker (COMIT). www.comitglobal.org. Accessed: 4/25/2025, 9:38:09 AM.

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