Table 1.

Impact of COVID-19 Vaccination in pregnant women.

Country	Adverse Effects	Vaccine Company	Vaccine	Article Description	Findings	Article
Israel	No adverse effects reported	Pfizer BioNTech	mRNA	Efficient transfer of neutralizing antibodies from mother to cord (Pfizer vaccine)	Results proved rapid rise in antibodies (specifically IgG and spike-specific IgG) + their effective transfer across placenta to neonate in vaccinated pregnant women; Reported Pfizer vaccine efficacy: 94%	(Beharier et al., 2021) [8]
Israel; USA	No adverse effects reported	Pfizer BioNTech	mRNA	Observational cohort study of vaccinated and unvaccinated pregnant people determining percent efficacy of the Pfizer mRNA vaccine in documented, symptomatic, and hospitalized COVID-19 groups	High vaccine effectiveness in pregnant women; Reported Pfizer vaccine efficacy: 96% against documented infection and 97% against symptomatic infection after receipt of second vaccine dose	(Dagan et al., 2021) [15]
USA	No adverse effects reported	Pfizer BioNTech	mRNA	Observational study conducted to assess the risk of spontaneous abortions (miscarriages) preconception and during first 20 weeks of gestation following receipt of specifically mRNA COVID-19 vaccines	Resulted in 12.8% risk of spontaneous abortions (SABs) indicating that there are no adverse effects of mRNA vaccination in pregnant people or the health of the fetus	(Zauche et al., 2021) [16]
Argentina; USA; UK	No adverse effects reported	Pfizer BioNTech + Moderna	mRNA	Rapid study conducted to identify the adverse effects of COVAX approved COVID-19 vaccinations on pregnant people to determine whether its administration is safe	Concluded that COVAX approved COVID-19 vaccinations are safe for use in pregnancy and pose no concerns to fetal + neonatal life	(Ciapponi et al., 2021) [17]
USA	No adverse effects reported	Moderna + Pfizer BioNTech	mRNA	Assessed immunogenicity of approved COVID-19 mRNA vaccines in pregnant + lactating women	RBD + neutralizing antibody titers higher in vaccinated groups opposed to pre vaccination; Antibodies also identified in infant cord blood indicating transplacental antibody transfer; Antibodies identified in breast milk indicating newborns protected by vaccination	(Collier et al., 2021) [18]
USA	No adverse effects reported	Moderna + Pfizer BioNTech	mRNA	Aimed to identify whether physiological + hormonal changes make pregnant patients less responsive to vaccination or induce altered immune responses	Findings suggest pregnancy promotes resistance to generating pro-inflammatory antibodies; Provides evidence that pregnant women must adhere to a strict booster vaccine schedule in order to fully mature immune response	(Atyeo et al., 2021) [19]
Israel	None found	Pfizer BioNTech	mRNA	Aimed to identify transplacental transfer of COVID-19 antibodies in vaccinated pregnant women	Concluded efficient transplacental transfer of COVID-19 IgG antibodies in pregnant women vaccinated w/ Pfizer; Also noted implications for neonatal humoral immunity	(Nir et al., 2021) [20]
USA	No adverse effects reported	Moderna + Pfizer BioNTech	mRNA	Used vaccine monitoring systems to characterize safety of mRNA COVID-19 vaccination in third trimester	No adverse effects noted; Further monitoring required to assess total outcomes following maternal vaccination	(Shimabukuro et al., 2021) [21]
UK	No adverse effects reported	AstraZeneca	Adenovirus	Nonclinical DART study to evaluate effects of Astrazeneca on fertility + reproductive system of mice + postnatal outcomes	No adverse effects; Robust immune responses in mothers and pups; Transplacental and lactational transfer of antibodies	(Stebbings et al., 2021) [22]
Israel	No adverse effects reported	Pfizer BioNTech	mRNA	Provided assessment of impact of COVID vaccination on transplacental transfer during early or late third-trimester vaccination	Vaccination in early third trimester enhances neonatal protection; Early third-trimester immunization yields higher neonatal antibody concentrations (specifically IgG types)	(Rottenstreich et al., 2022) [23]
USA	No adverse effects reported	Pfizer BioNTech + Moderna	mRNA	Described maternal, neonatal, + obstetrical outcomes of women who received mRNA vaccinations	Noted no adverse effects similar to results of other literature	(Trostle et al., 2021) [24]
Israel	No adverse effects reported	Pfizer BioNTech	mRNA	Investigated association between Pfizer vaccine + pregnancy course/outcomes; Identified characteristics related to vaccination in pregnancy	Prenatal vaccination does not present adverse outcomes or newborn complications; Pfizer efficacy higher than 85% in regards to risk of symptomatic infection and transmission	(Wainstock et al., 2021) [25]
Poland	No adverse effects reported	Pfizer BioNTech	mRNA	Aimed to identify titers of specific maternal/cord antibodies against COVID-19 S-protein post antenatal vaccination along with ratio of umbilical cord + maternal antibody titers	High anti-S antibodies in cord blood suggest maternal immunization provides protection to newborns via transplacental antibody transfer; Significant cord serum antibody titer levels suggest optimal vaccination time	(Zdanowski & Wasniewski, 2021) [26]
Indonesia; USA	No adverse effects reported	Pfizer BioNTech + Moderna	mRNA	Provided greater insight into the efficacy of current COVID-19 vaccines with regards to maternal and neonatal antibody responses, transplacental transfer of antibodies, and any reported adverse effects in either the mother or infant	No severe complications reported; Very mild to moderate COVID symptoms observed after vaccination of pregnant women resulting in various local and systemic adverse events; Transplacental IgG antibody transfer of also observed when examining cord blood antibody levels; Reported Pfizer efficacy: 94.1%; Reported Moderna efficacy: 95%	(Pratama et al., 2022) [27]
USA	No adverse effects reported	Pfizer-BioNTech + Moderna	mRNA	Aimed to illustrate the effectiveness of 2-dose maternal COVID-19 vaccination during pregnancy and its subsequent implications for the developing neonate	Maternal antibodies detected in maternal sera at delivery along with breast milk and infant sera suggesting that maternal COVID-19 vaccination during pregnancy may protect infants aged 6 months or less from severe SARS-CoV-2 infection	(Halasa et al., 2022) [28]
USA	No adverse effects reported	Pfizer BioNTech + Moderna + Johnson & Johnson	mRNA	To provide greater insight into the maternal antibody response and transplacental antibody transfer through the umbilical cord with regards to the vaccine administered to the pregnant woman and the trimester of vaccination	Confirmed presence of maternal IgG and anti-S spike antibodies in the developing newborn following transplacental antibody transfer; Spike-specific antibodies significantly higher in concentration in cord blood after administering Moderna or Pfizer vaccines versus cord blood after J & J vaccine	(Atyeo et al., 2022) [29]
USA	No adverse effects reported	Pfizer BioNTech + Moderna + Johnson & Johnson	mRNA	Focused on characterizing the persistence of vaccine-induced anti-S IgG antibodies in infants born to vaccinated mothers with comparison to infants born to mothers with natural SARS-CoV-2 infection	High anti-S antibodies for 6-month old infants born to COVID-vaccinated mothers compared to infants born to mothers with natural SARS-CoV-2 infection; Findings suggest maternal immunization provides protection to newborns via transplacental antibody transfer	(Shook et al., 2022) [30]
USA	No adverse effects reported	Pfizer BioNTech + Moderna	mRNA	Focused on characterizing SARS-CoV-2 and COVID-19 vaccine-induced binding and neutralizing antibodies in maternal and cord blood	COVID-19 vaccinated pregnant women raised higher binding and neutralizing antibodies than in all SARS-CoV-2 infected pregnant women	(Dude et al., 2023) [31]