September 18, 2021), the majority of pregnant people remain unprotected against COVID-19, and
significant disparities exist in vaccination coverage by race and ethnicity.
Pregnant and recently pregnant people with COVID-19 are at increased risk of severe illness,
death, and pregnancy complications. Pregnant and recently pregnant people with COVID-19 are at
increased risk for severe illness when compared with non-pregnant people. Severe illness includes illness
that requires hospitalization, intensive care unit (ICU) admission, mechanical ventilation, or extracorporeal
membrane oxygenation (ECMO), or illness that results in death. Although the absolute risk is low,
compared with non-pregnant symptomatic people, symptomatic pregnant people have more than a two-
fold increased risk of requiring ICU admission, invasive ventilation, and ECMO, and a 70% increased risk
of death.
6
Pregnant people with COVID-19 are also at increased risk for preterm birth and some data
suggest an increased risk for other adverse pregnancy complications and outcomes, such as
preeclampsia, coagulopathy, and stillbirth, compared with pregnant people without COVID-19.
7-10
Neonates born to people with COVID-19 are also at increased risk for admission to the neonatal ICU.
9-11
In addition, although rare, pregnant people with COVID-19 can transmit infection to their neonates;
among neonates born to women with COVID-19 during pregnancy, 1–4% of neonates tested were
positive by rRT-PCR.
12,13
Recommendations
CDC recommends urgent action to help protect pregnant people and their fetuses/infants. CDC
recommends urgent action to accelerate primary vaccination for people who are pregnant, recently
pregnant (including those who are lactating), who are trying to get pregnant now, or who might become
pregnant in the future. Efforts should specifically address populations with lower vaccination coverage
and use approaches to reduce racial and ethnic disparities. CDC recommends ensuring tailored,
culturally responsive, and linguistically appropriate communication of vaccination benefits. In addition,
pregnant people should continue to follow all recommended prevention measures and should seek care
immediately for any symptoms of COVID-19. Healthcare providers should have a low threshold for
increased monitoring during pregnancy due to the risk of severe illness.
Recommendations for Public Health Jurisdictions
• Continue and increase efforts to reach and partner with communities to encourage and offer
vaccination to people who are pregnant, recently pregnant (including those who are lactating),
who are trying to get pregnant now, or who might become pregnant in the future.
• Leverage resources to promote vaccine equity: COVID-19 Vaccine Equity for Racial and Ethnic
Minority Groups.
o Include focused efforts to increase vaccination coverage in pregnancy among people
from racial and ethnic minority groups.
• Encourage healthcare providers to offer and recommend COVID-19 vaccination to their patients
and community members who are pregnant, recently pregnant (including those who are
lactating), who are trying to get pregnant now, or who might become pregnant in the future.
• Work with community partners and employers to make vaccination easily accessible for
unvaccinated populations, including those who are pregnant, recently pregnant (including those
who are lactating), who are trying to get pregnant now, or who might become pregnant in the
future.
• Continue to implement additional prevention strategies where SARS-CoV-2 transmission is high
and vaccination coverage is low, including in groups at increased risk, such as pregnant people.
• Continue to monitor community transmission and vaccination coverage levels and focus vaccine
efforts on populations with low coverage.
• Disseminate and communicate information to key partners about vaccination coverage, risks
posed by the highly transmissible Delta variant, and local transmission levels. Partner and share
messaging with programs serving pregnant and recently pregnant people.