This Practice Advisory was developed by the American College of Obstetricians and Gynecologists’ Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group in collaboration with Laura E. Riley, MD; Richard Beigi, MD; Denise J. Jamieson, MD, MPH; Brenna L. Hughes, MD, MSc; Geeta Swamy, MD; Linda O’Neal Eckert, MD; Mark Turrentine, MD; and Sarah Carroll, MPH.
Summary of Updates
This Practice Advisory provides an overview of the currently available COVID-19 vaccines and guidance for their use in pregnant, recently pregnant, lactating, and nonpregnant individuals aged 12 years and older. For guidance and recommendations for the use of these vaccines in individuals aged 11 years or younger, please visit the website of the American Academy of Pediatrics. For additional information regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and treatment, see ACOG’s Frequently Asked Questions.
This Practice Advisory has been updated to include the following:
- Preferential recommendation for the mRNA COVID-19 vaccines over the Johnson & Johnson/Janssen (J&J/Janssen) COVID-19 vaccine for the primary series and booster vaccination, including for persons who are pregnant or lactating
- Updated data on thrombosis with thrombocytopenia syndrome following J&J/Janssen COVID-19 vaccination
- New data further supporting the safety and efficacy of COVID-19 vaccination during pregnancy
- Recommendations regarding the timing of booster doses in pregnant and nonpregnant individuals for mRNA and J&J/Janssen vaccines
- The American College of Obstetricians and Gynecologists (ACOG) recommends that all eligible persons aged 12 years and older, including pregnant and lactating individuals, receive a COVID-19 vaccine or vaccine series.
- The mRNA COVID-19 vaccines are preferred over the J&J/Janssen COVID-19 vaccine for all vaccine-eligible individuals, including pregnant and lactating individuals, for primary series, primary additional doses (for immunocompromised persons), and booster vaccination.
- For patients who do not receive any COVID-19 vaccine, the discussion should be documented in the patient’s medical record. During subsequent office visits, obstetrician–gynecologists should address ongoing questions and concerns and offer vaccination again.
- Obstetrician–gynecologists and other women’s health care practitioners should lead by example by being vaccinated and encouraging eligible patients to be vaccinated as well.
- COVID-19 vaccines may be administered simultaneously with other vaccines. This includes vaccines routinely administered during pregnancy, such as influenza and Tdap.
- Moderately to severely immunocompromised people should receive a third dose of the Pfizer-BioNTech and Moderna mRNA COVID-19 vaccines at least 28 days after the completion of the initial mRNA COVID-19 vaccine series.
- All individuals aged 12 years and older who received an initial COVID-19 vaccine or vaccine series should receive a single booster dose of COVID-19 vaccine.
- Individuals who received J&J/Janssen vaccine should receive a COVID-19 booster at least 2 months following their initial vaccine.
- Individuals who received an mRNA vaccine should receive a booster 5 months following their initial vaccine series.
- ACOG recommends that pregnant and recently pregnant people up to 6 weeks postpartum receive a booster dose of COVID-19 vaccine following the completion of their initial COVID-19 vaccine or vaccine series.
- Individuals may receive any vaccine product available to them for their booster dose; they do not have to receive the same product as their initial vaccine or vaccine series; however:
- The mRNA vaccines are preferred over the J&J/Janssen COVID-19 vaccine.
- Adolescents aged 12–17 years are eligible for only the Pfizer-BioNTech COVID-19 vaccine.