. 2021 Aug 30;99(10):739–746. doi: 10.2471/BLT.21.286644

Table 1. Summary of recommendations from peak medical organizations, government and immunization technical advisory groups about COVID-19 vaccination for pregnant and lactating women.

Society or organization	Specific patient populations
Society or organization	Planning pregnancy	Pregnant	Breastfeeding
Centers for Disease Control and Prevention¹³	“…can receive a COVID-19 vaccine” “…no evidence that… COVID-19 vaccines cause female or male fertility problems” “…does not recommend routine pregnancy testing” “…do not need to avoid pregnancy after”	“If you are pregnant, you can receive a COVID-19 vaccine” “…these vaccines... are unlikely to pose a risk for people who are pregnant” “…early data… did not identify any safety concerns for pregnant people who were vaccinated or their babies” “COVID-19 vaccines and other vaccines may now be administered without regard to timing”	“…lactating people can receive a COVID-19 vaccine” “COVID-19 vaccines are thought not to be a risk to lactating people or their breastfeeding babies”
American College of Obstetricians and Gynecologists⁹	“…claims linking COVID-19 vaccines to infertility are unfounded and have no scientific evidence supporting them” “…recommends vaccination for all eligible people who may consider future pregnancy”	“…recommends that pregnant individuals have access to COVID-19 vaccines”	“COVID-19 vaccines should be offered to lactating individuals similar to non-lactating individuals” “There is no need to avoid initiation or discontinue breastfeeding”
European Society of Human Reproduction and Embryology¹⁴	“…lack of information on the possible effect… on assisted reproduction treatment or future pregnancy” “…prudent to postpone the start of assisted reproduction”	“…should be informed about the lack of long-term human studies… but should not be excluded from vaccination programmes.” Decision should be made “after considering the benefits and risks”	NR
World Health Organization¹⁵	“WHO does not recommend pregnancy testing prior to vaccination.” “WHO does not recommend delaying pregnancy”	“…may receive the vaccine if the benefit of vaccinating a pregnant woman outweighs the potential vaccine risks.” “…pregnant women at high risk… may be vaccinated”	“Vaccination can be offered to breastfeeding women if they are part of a group prioritized for vaccination” “WHO does not recommend discontinuation of breastfeeding after vaccination”
Royal College of Obstetricians and Gynaecologists⁸	“…do not need to avoid pregnancy after vaccination” “…no evidence to suggest that COVID-19 vaccines will affect fertility”	“…benefits and risks… should be discussed on an individual basis” “…while there is no known risk associated with giving other non-live vaccines to pregnant women, there are no specific data as yet about the safety of COVID-19 vaccination in pregnancy”	“You should not stop breastfeeding in order to be vaccinated against COVID-19”
Australian Technical Advisory Group on Immunisation¹⁶	“You do not need to avoid becoming pregnant before or after vaccination. You are not required to have a pregnancy test before getting vaccinated”	“…do not routinely recommend COVID-19 vaccine in pregnancy” “…can consider it if the potential benefits of vaccination outweigh any potential risks”	“…can receive the COVID vaccine at any time, and do not need to stop breastfeeding after vaccination”
Royal Australian and New Zealand College of Obstetricians and Gynaecologists⁷	“…no evidence that women who become pregnant after receiving the vaccine are at increased risk of teratogenicity, miscarriage or maternal illness. Pregnancy need not be delayed after receiving the vaccine”	“While Royal Australian and New Zealand College of Obstetricians and Gynaecologists does not recommend routine universal vaccination in the setting of low community transmission, all pregnant women should receive information” “Women with risk factors advised to consider vaccination”	“…no data on the safety of COVID-19 vaccines in lactating women or on the effects of inactivated vector-based vaccines or mRNA vaccines on the breastfed infant or on milk production/excretion. These vaccines are not thought to be a risk to the breastfeeding infant”
Immunisation Advisory Centre, New Zealand¹⁷	“Routine pregnancy testing before COVID-19 vaccination is not recommended and those who are trying to become pregnant do not need to avoid pregnancy after receiving a COVID vaccine”	“Women who are pregnant and at risk of exposure to SARS-CoV-2 virus can receive a COVID-19 vaccine at any stage of pregnancy. For those at low risk of exposure, it is recommended to delay vaccination until after birth”	“Breastfeeding women can receive a COVID-19 vaccine. There are no safety concerns for a breastfeeding woman or her infant associated with having this COVID-19 vaccine”
Joint Committee on Vaccination and Immunisation¹⁰	“…can be vaccinated with a suitable product for their age and clinical risk group”	“…available data do not indicate any harm to pregnancy” “…should be offered vaccination at the same time as non-pregnant women, based on their age and clinical risk group”	“…no known risk associated with giving non-live vaccines whilst breastfeeding” “…may be offered any suitable COVID-19 vaccine” “…should be informed about the absence of full safety data for the vaccine in breastfeeding”
Ministry of Health, Israel¹⁸	“…recommended that women who are planning a pregnancy or who are undergoing fertility treatments complete the two vaccine doses before the beginning of the pregnancy”	“…recommend vaccinating pregnant women who are considered as being at high-risk” “It is our recommendation to vaccinate all pregnant women in their second or third trimester”	“It is recommended to vaccinate breastfeeding women”
Public Health England¹⁹	“…no need to avoid pregnancy after COVID-19 vaccination”	“…pregnant women should be offered COVID-19 vaccines at the same time as people of the same age or risk group”	“…not thought to be a risk to the breastfeeding infant, and the benefits of breastfeeding are well known”
National Advisory Committee on Immunisation, Canada¹¹	NR	“…preferentially recommends that a complete vaccine series with an mRNA COVID19 vaccine should be offered”	“…individuals should continue to breastfeed after vaccination”
Society of Obstetricians and Gynaecologists of Canada⁶	“……should not be counselled to terminate pregnancy based on having received the vaccine” “…not known whether an individual should delay pregnancy following receipt of the vaccine and a risk–benefit discussion for those planning pregnancy should occur”	“Women who are pregnant or breastfeeding should be offered vaccination at any time during pregnancy if they are eligible”	“Women who are pregnant or breastfeeding should be offered vaccination at any time during pregnancy if they are eligible”

NR: not reported.

Note: These recommendations are those published up to 16 June 2021. These recommendations may have changed since preparation of this article. Notably, the Australian Technical Advisory Group on Immunisation and Royal Australian and New Zealand College of Obstetricians and Gynaecologists recommendations were changed on 9 June 2021 (the updated statement is shown in Box 1).