[Evidence summary:] What is the safety of COVID-19 vaccines in pregnancy? Are there any associated adverse events or benefits for pregnant or lactating mothers, or for the foetus? [v1.0]

Main Points 1. No unexpected pregnancy or infant outcomes have been observed related to the 96,000+ Pfizer-BioNTech or Moderna mRNA COVID-19 vaccinations administered during pregnancy in the United States, or to a similar number of Pfizer-BioNTech vaccinations administered in Israel. 2. Pregnant women and their obstetric caregivers should engage in shared decision-making in advance of vaccination to best balance the risks of vaccination with the risks of remaining unvaccinated. 3. Where the risk-benefit assessment is favourable, two doses of the mRNA vaccines Pfizer-BioNTech or Moderna should be given 28 days apart between 14 and 36 completed weeks of gestation. 4. There is no known reason for vaccine recipients to avoid breastfeeding. 5. If an individual becomes pregnant after receiving the first dose of a two-dose COVID-19 vaccine series, the second dose should be administered when indicated. Women trying to become pregnant do not need to avoid pregnancy after vaccination and there is no evidence to suggest that COVID-19 vaccines will affect fertility.