Immunity and COVID-19 vaccines in pregnancy – precautions and risks

Symptomatic coronavirus disease (COVID-19) during pregnancy represent a high-risk situation for maternal complications, including respiratory distress, pneumonia and even death. Pregnancy represents a unique adaptative immunological and hormonal state at the inflammatory response. At this time, global immunization is a promising way to stop this pandemic. Since early December 2020, more than 150 vaccine candidates in various stages of development and research are communicated. In Romania, there are four vaccines authorized by the European Medicines Agency (EMA): Pfizer–BioNTech, Moderna, Oxford– AstraZeneca and Johnson & Johnson. However, many people are reluctant to take the COVID-19 vaccine, including false beliefs about this use during pregnancy. Herein, we present the current state of knowledge about immunity and COVID-19 vaccines during pregnancy based on reported cases from medical literature. Most of them are reported from healthcare pregnant women in COVID-19 facilities or in women in the first trimester of pregnancy who did not know they were pregnant at the time of vaccination. The Eudravigilance from European Medicines Agency (EMA) constantly monitors any side effects after a vaccine. COVID-19 vaccination during pregnancy is proving to be as safe and effective as in the general population. Because COVID-19 vaccines have been observed in association with a higher rate of miscarriage in early pregnancy, it should be used with caution in the first trimester. Vaccination before planning a pregnancy in order to gain immunity at the time of conception is recommended.

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