Population: All who are pregnant.
Organization
ACOG 2023
Screening Recommendations
–Recommend that all pregnant individuals receive a COVID-19 vaccine series, including a bivalent mRNA COVID-19 vaccine booster.
–Explain expected side effects during vaccine counseling, including those that are a normal immune reaction and part of developing antibodies to protect against COVID-19.
–Counsel pregnant and lactating patients to take acetaminophen if they have a fever after vaccination, as it is safe to take and does not affect antibody levels.
–Recommend bivalent mRNA COVID-19 booster at least 2 mo following their last primary dose or monovalent booster to all pregnant and recently pregnant (up to 6 wk postpartum) patients, due to waning immunity in pregnancy, and the potential for severe illness and death from SARS-CoV-2 during pregnancy.
–Recommend Novavax’s monovalent COVID-19 vaccine as a booster to those individuals aged 18 and older who cannot or will not receive a bivalent mRNA COVID-19 booster.
–For primary vaccination, use an mRNA or Novavax COVID-19 series rather than the J&J/Janssen vaccine.
–For patients who do not receive the vaccine, document the discussion in the medical record. At subsequent visits, address ongoing questions and concerns about vaccination and offer vaccination again.
Practice Pearls
• In multiple reproductive developmental toxicity studies in animals, there have been no vaccine-related adverse effects on fertility, fetal, or postnatal development.
• Booster vaccination may occur in any trimester, and the emphasis should be on early administration to maximize maternal and fetal health.
• Vaccination with any product continues to be safer than remaining unvaccinated.
Source
–ACOG Clinical Practice Advisory. COVID-19 Vaccination Considerations for Obstetric-Gynecologic Care. 2020 (last updated January 2023).