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COVID-19 mRNA Vaccines (Moderna/Spikevax® and Pfizer/Comirnaty®)

Selected References:

  • American Academy of Pediatrics. Last updated July 2023.Breastfeeding & COVID-19: What parents need to know. Available at URL: https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Breastfeeding-During-COVID-19.aspx  
  • Academy of Breastfeeding Medicine. 2020. ABM Statement: Considerations for COVID-19 vaccination in lactation. Available at URL: https://abm.memberclicks.net/abm-statement-considerations-for-covid-19-vaccination-in-lactation 
  • American College of Obstetricians and Gynecologists. Last updated October 2024. COVID-19 vaccination considerations for obstetric-gynecologic care. Available at URL: https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care 
  • Avraham S, et al. 2022. COVID-19 vaccination and fertility treatment outcomes. Fertility and Sterility 117(6):1291-1299.  
  • Baird JK, et al. 2021. SARS-CoV-2 Antibodies Detected in Mother’s Milk Post-Vaccination. J Hum Lact. 37(3):492-498.  
  • Beharier O, et al. 2021. Efficient maternal to neonatal transfer of SARS-CoV-2 and BNT162b2 antibodies. J Clin Invest 131(13):e150319.  
  • Bentov Y, et al. 2021. Ovarian follicular function is not altered by SARS-CoV-2 infection or BNT162b2 mRNA Covid-19 vaccination. Human Reproduction 36(9):2506–2513.  
  • Bertrand K, et al. 2021. Maternal and child outcomes reported by breastfeeding women following mRNA COVID-19 vaccination. Breastfeeding Medicine 16(9).  
  • Bookstein Peretz S, et al. 2021. Short-term outcome of pregnant women vaccinated by BNT162b2 mRNA COVID-19 vaccine. Ultrasound in Obstetrics & Gynecology 58(3):450-456.  
  • Carlsen EØ, et al. 2022. Association of COVID-19 vaccination during pregnancy with incidence of SARS-CoV-2 infection in infants. JAMA Intern Med 182(8):825–831.  
  • Centers for Disease Control and Prevention, COVID-19 Vaccine Task Force. 2021. Updates from the v-safe COVID-19 vaccine pregnancy registry. Available at URL: https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-09-22/09-COVID-Olson-508.pdf  
  • Edelman A, et al. 2022. Association between menstrual cycle length and Coronavirus Disease 2019 (COVID-19) vaccination: a U.S. cohort. Obstet Gynecol Apr 1;139(4):481-489. 
  • Esteve-Palau E, et al. 2021. Quantification of specific antibodies against SARS-CoV-2 in breast milk of lactating women vaccinated with an mRNA vaccine. JAMA Netw Open 4(8):e2120575.  
  • Favre G, et al. 2025. Neurodevelopmental outcomes of infants after in utero exposure to SARS-CoV-2 or mRNA-COVID-19 vaccine compared with unexposed infants: a COVI-PREG prospective cohort study. Clin Microbiol Infect. 31(2):266-273. 
  • Fell DB, et al. 2022. Association of COVID-19 vaccination in pregnancy with adverse peripartum outcomes. JAMA 327(15):1478–1487.  
  • Fradkin MA, et al. 2024. IVF outcomes pre- and post-anti-COVID-19 vaccination – Are there differences? Reprod Biol 24(2):100879. 
  • Gonzalez D, et al. 2021. Sperm parameters before and after COVID-19 mRNA vaccination. JAMA 326(3):273–274. 
  • Gray KJ, et al. 2021. COVID-19 vaccine response in pregnant and lactating women: a cohort study. Am J Obstet Gynecol Mar 24:S0002-9378(21)00187-3.   
  • Golan Y, et al. 2021. Evaluation of messenger RNA from COVID-19 BTN162b2 and mRNA-1273 vaccines in human milk. JAMA Pediatr 175(10):1069-1071.   
  • Goldshtein I, et al. 2022. Association of BNT162b2 COVID-19 vaccination during pregnancy with neonatal and early infant outcomes. JAMA Pediatr 176(5):470-477.  
  • Halasa NB, et al. 2022. Effectiveness of maternal vaccination with mRNA COVID-19 vaccine during pregnancy against COVID-19–associated hospitalization in infants aged <6 months — 17 states, July 2021–January 2022. MMWR Morb Mortal Wkly Rep 71:264–270. 
  • Hardie I, et al. 2025. Early childhood developmental concerns following SARS-CoV-2 infection and COVID-19 vaccination during pregnancy: a Scottish population-level retrospective cohort study. Lancet Child Adolesc Health. 9(3):162-171. 
  • Havers, F. P., et al. 2024. COVID-19-Associated Hospitalizations and Maternal Vaccination Among Infants Aged <6 Months – COVID-NET, 12 States, October 2022-April 2024. MMWR. Morbidity and mortality weekly report, 73(38), 830–836.  
  • Ismail S, et al. 2024. SARS-CoV-2 antibodies and their neutralizing capacity against live virus in human milk after COVID-19 infection and vaccination: prospective cohort studies. Am J Clin Nutr 119(2):485-495. 
  • Jaswa EG, et al. 2024. In utero exposure to maternal COVID-19 vaccination and offspring neurodevelopment at 12 and 18 months. JAMA Pediatr. 178(3):258-265. 
  • Kharbanda EO, et al. 2021. Spontaneous abortion following COVID-19 vaccination during pregnancy. JAMA 326(16):1629-1631.  
  • Kharbanda EO, et al. 2024. COVID-19 vaccination in the first trimester and major structural birth defects among live births. JAMA Pediatr 1;178(8):823-829. 
  • Lipkind HS, et al. 2022. Receipt of COVID-19 vaccine during pregnancy and preterm or small-for-gestational-age at birth — Eight integrated health care organizations, United States, December 15, 2020–July 22, 2021. MMWR Morb Mortal Wkly Rep 71:26–30. 
  • Lipschuetz M, et al. 2023. Maternal third dose of BNT162b2 mRNA vaccine and risk of infant COVID-19 hospitalization. Nat Med. 10.1038/s41591-023-02270-2.  
  • Low JM, et al. 2021. Codominant IgG and IgA expression with minimal vaccine mRNA in milk of BNT162b2 vaccines. npj Vaccines 202;6:105. 
  • Magnus MC, et al. 2022. Association of SARS-CoV-2 vaccination during pregnancy with pregnancy outcomes. JAMA 327(15):1469-1477.  
  • McLaurin-Jiang S, et al. 2021. Maternal and child symptoms following COVID-19 vaccination among breastfeeding mothers. Breastfeeding Medicine 16(9).  
  • Miller ND, et al. 2024. Does the SARS-CoV-2 mRNA vaccine and its serum IgG levels affect fertility treatments and obstetric outcomes? An observational cohort study. Clin Exp Med 23;24(1):81.  
  • Morgan JA, et al. 2022. Maternal outcomes after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in vaccinated compared with unvaccinated pregnant patients. Obstet Gynecol 139:107-109.  
  • Morris RS. 2021. SARS-CoV-2 spike protein seropositivity from vaccination or infection does not cause sterility. F&S Reports 2(3):253-255.  
  • Muñoz-Gómez MJ, et al. 2024. IgG antibody levels against the SARS-CoV-2 spike protein in mother–child dyads after COVID-19 vaccination. Infection 52:813–824. 
  • Norman M, et al. 2024. Neonatal outcomes after COVID-19 vaccination in pregnancy. JAMA 6;331(5):396-407. 
  • Orvieto et al. 2021. Does mRNA SARS-C0_v-2 vaccine influence patients’ performance during IVF-ET cycle? Reprod Biol Endocrinol 19:69.   
  • Otero S, et al. 2022. Maternal antibody response and transplacental transfer following SARS-CoV-2 infection or vaccination in pregnancy. Clinical Infectious Diseases 76(2):220–228. 
  • Perez SE, et al. 2022. Human milk SARS-CoV-2 antibodies up to 6 months after vaccination. Pediatrics 148(2):e2021054260. 
  • Perl SH, et al. 2021. SARS-CoV-2–specific antibodies in breast milk after COVID-19 vaccination of breastfeeding women. JAMA 325(19):2013-2014.   
  • Piekos SN, et al. 2023. The effect of COVID-19 vaccination and booster on maternal-fetal outcomes: a retrospective cohort study. Lancet Digital Health 5(9):e594-e606. 
  • Proto A, et al. 2024. COVID-vaccines in pregnancy: maternal and neonatal response over the first 9 months after delivery. Biomolecules 14(4):435. 
  • Rosenberg-Friedman M, et al. 2021. BNT162b2 mRNA vaccine elicited antibody response in blood and milk of breastfeeding women. Nat Commun. 12(1):6222. 
  • Safrai M, et al. 2021. Stopping the misinformation: BNT162b2 COVID-19 vaccine has no negative effect on women’s fertility. Pre-print online June 1, 2021. Pre-print online June 1, 2021. DOI: https://doi.org/10.1101/2021.05.30.21258079.  
  • Safrai M, et al. 2022. The BNT162b2 mRNA Covid-19 vaccine does not impair sperm parameters. Reproductive BioMedicine 44(4):685-688.  
  • Shi W, et al. 2022. Association between time interval from COVID-19 vaccination to in vitro fertilization and pregnancy rate after fresh embryo transfer. JAMA Netw Open. 5(10):e2236609. 
  • Shimabukuro TT, et al. Preliminary findings of mRNA Covid-19 vaccine safety in pregnant persons. N Engl J Med 384:2273-2282.  
  • Sharma, A. J., et al. 2025. COVID-19 vaccination during pregnancy and birth defects: Results from the CDC COVID-19 vaccine pregnancy registry, United States 2021-2022. Birth Defects Research, 117(5), e2474.  
  • Shook LL, et al. 2022. Durability of anti-spike antibodies in infants after maternal COVID-19 vaccination or natural infection. JAMA 327(11):1087-1089.  
  • Simeone RM, et al. 2023. Effectiveness of maternal mRNA COVID-19 vaccination during pregnancy against COVID-19–associated hospitalizations in infants aged <6 months during SARS-CoV-2 Omicron predominance — 20 States, March 9, 2022–May 31, 2023. MMWR Morb Mortal Wkly Rep 72:1057–1064. 
  • Society for Maternal-Fetal Medicine. 2025. SMFM reaffirms COVID-19 vaccination recommendations during pregnancy. Available at URL: https://www.smfm.org/news/smfm-reaffirms-covid-19-vaccination-recommendations-during-pregnancy. 
  • Vesco KK, et al. Obstetric complications and birth outcomes after antenatal Coronavirus Disease 2019 (COVID-19) vaccination. Obstet Gynecol 1;143(6):794-802. 
  • Vetter-Laracy S, et al. Neonatal SARS-CoV-2 immunoglobulin G antibodies at delivery and their impact on COVID-19. Eur J Clin Microbiol Infect Dis 43(4):693-702. 
  • Youngster M, et al. 2024. The effect of COVID-19 vaccination during IVF stimulation on cycle outcomes- a retrospective cohort study. J Reprod Immunol 163:104246. 
  • Zambrano LD, et al. 2020. Update: characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status — United States, January 22–October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69:1641–1647. 
  • Zauche LH, et al. 2021. Receipt of mRNA COVID-19 vaccines and risk of spontaneous abortion. N Engl J Med 385:1533-153. 

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