Summary of NACI statement: Updated guidance on COVID-19 vaccines for individuals who are pregnant or breastfeeding

Publication date: September 9, 2022

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Organization: Public Health Agency of Canada

Cat.: HP40-322/2-2022E-PDF

ISBN: 978-0-660-45352-1

Pub.: 220410

Published: 2022-09-09

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Overview

With regard to a fall booster dose, NACI makes the following recommendations for people who are pregnant:

  • NACI strongly recommends that individuals who are pregnant should be offered a fall COVID-19 vaccine booster dose at any stage of pregnancy, regardless of the number of previously received booster doses. (Strong NACI Recommendation)
  • NACI recommends that COVID-19 vaccine booster doses may be offered at an interval of 6 months since a previous COVID-19 vaccine dose or SARS-CoV-2 infection. How`ever, a shorter interval of at least 3 months may be warranted to optimize protection for the pregnant person in the context of heightened epidemiological risk (including increased risk of severe outcomes in people who are pregnant). (Discretionary NACI Recommendation)
  • Individuals who are pregnant may receive all doses for which they are eligible during the course of their pregnancy.

With regard to a fall booster dose, NACI reiterates the following recommendations for people who are breastfeeding, consistent with NACI's Interim guidance on planning considerations for a fall 2022 COVID-19 vaccine booster program in Canada:

  • Individuals who are breastfeeding may be offered a fall COVID-19 vaccine booster dose, regardless of the number of booster doses previously received.
  • Individuals at increased risk of severe illness from COVID-19 who are breastfeeding should be offered a fall COVID-19 vaccine booster dose, regardless of the number of booster doses previously received.

With regard to the use of authorized bivalent Omicron-containing mRNA COVID-19 booster dose products for people who are pregnant or breastfeeding:

  • Based on data on the safety of mRNA vaccines in pregnancy, authorized bivalent Omicron-containing mRNA COVID-19 vaccines can be recommended for use in pregnant or breastfeeding individuals who do not have contraindications to the vaccine.
  • Individuals, including those who are pregnant or breastfeeding, who are recommended to receive a fall booster dose should not delay their planned vaccination in anticipation of a bivalent Omicron-containing mRNA COVID-19 vaccine. If a bivalent Omicron-containing mRNA COVID-19 vaccine is not readily available, an original mRNA COVID-19 vaccine should be offered to ensure timely protection against severe COVID-19 outcomes.

For the full statement, including supporting evidence and rationale, please see NACI Statement: Updated guidance on COVID-19 vaccines for individuals who are pregnant or breastfeeding.

For information on the interim fall booster planning considerations, including the list of individuals considered to be at increased risk of severe illness from COVID-19, please see NACI Statement: Interim guidance on planning considerations for a fall 2022 COVID-19 vaccine booster program in Canada.

For more information on the use of bivalent Omicron-containing mRNA COVID-19 vaccines as booster doses, please see NACI Statement: Recommendations on the use of bivalent Omicron-containing mRNA COVID-19 vaccines.

For more information on NACI's recommendations on the use of COVID-19 vaccines, please refer to the COVID-19 vaccine chapter in the Canadian Immunization Guide (CIG), as well as additional statements on the NACI web page.

What you need to know

For the full statement, including supporting evidence and rationale, please see NACI Statement: Updated guidance on COVID-19 vaccines for individuals who are pregnant or breastfeeding.

For more information on NACI's recommendations on the use of COVID-19 vaccines, please refer to the COVID-19 vaccine chapter in the Canadian Immunization Guide (CIG), as well as additional statements on the NACI web page.

Quotes

"The body of evidence around the use of mRNA COVID-19 vaccines in individuals who are pregnant and/or breastfeeding has grown significantly since the vaccines were first made available for use. The updated NACI guidance provides more assurance around the safety and effectiveness of mRNA COVID-19 vaccines during pregnancy and breastfeeding, as well as clarity on eligibility for, and timing of the mRNA COVID-19 booster doses. This will support individuals who are pregnant or breastfeeding as well as the healthcare professionals counselling them, so those who are pregnant or breastfeeding can protect themselves, as well as their fetuses and newborns from COVID-19 disease through immunization."

Dr. Robyn Harrison, NACI Vice-Chair

"We know that people who are pregnant are at risk for more serious outcomes from COVID-19 and that severe COVID-19 illness during pregnancy can affect newborns. Fortunately, we now have a growing body of evidence that reinforces that COVID-19 vaccination is safe and effective during pregnancy and while breastfeeding. COVID-19 vaccines provide good protection against severe disease and hospitalization for the pregnant individual and helps reduce the newborn's risk of SARS-CoV-2 infection and hospitalization due to COVID-19. We also know that receiving a COVID-19 vaccine is safe for both the individual and the newborn during any stage of pregnancy or while breastfeeding. I am grateful to NACI for reviewing the latest evidence and providing this important update to help new and prospective parents make informed and confident decisions about COVID-19 vaccination during pregnancy and while breastfeeding."

Dr. Theresa Tam, Chief Public Health Officer
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