The Vaccine Ministerial Advisory Committee (VMAC) continues to monitor the safety and effectiveness of COVID-19 vaccination during pregnancy and lactation for all vaccines included in, or considered for inclusion, in the national vaccine rollout. Although the risk is small, pregnant and postnatal women are at increased risk of severe COVID-19 disease compared to their non-pregnant counterparts. They are also at increased risk of preterm birth, and possibly other adverse obstetric outcomes. As a result of the growing body of safety evidence that supports the use of COVID-19 vaccines in pregnant women, the VMAC has recently updated its recommendations regarding administration of COVID-19 vaccines during pregnancy.
Current recommendations are as follows (updated recommendations are shown in bold):
1. COVID-19 vaccination should be offered to women who are eligible to be vaccinated during any stage of pregnancy, and during lactation. As previously recommended, both the Comirnaty® (Pfizer) vaccine or the Janssen® (J&J) vaccine can be offered. Everyone 18 years and older is now eligible to be vaccinated, and women 18 years and older should therefore be offered vaccination during any stage of pregnancy, and during breastfeeding.
2. Consideration should be given to providing vaccination to pregnant and breastfeeding women during routine antenatal and postnatal visits. Where this is not possible, health care workers should encourage pregnant and breastfeeding women to access vaccination at a nearby vaccination site.
3. Health care workers are encouraged to discuss the benefits and possible risks of COVID-19 vaccination with their patients. These discussions should include the increased risk, albeit small, of severe disease in pregnant women when compared to non-pregnant women, reassurance about the growing evidence supporting the safety of vaccines in pregnant and breastfeeding women, the strong immune response following vaccination and the benefits of immune transfer to the baby, and ongoing safety monitoring of vaccine use in pregnancy. Furthermore, that there are no known risks associated with other non-live vaccines given routinely to pregnant women.
4. COVID-19 vaccination is strongly encouraged for non-pregnant women contemplating pregnancy.