Department of Obstetrics and Gynecology, University of Washington, Seattle.
Seattle Children's Hospital Research Institute, Department of Pediatrics, University of Washington, Seattle.
JAMA Netw Open. 2022 Sep 1;5(9):e2230495. doi: 10.1001/jamanetworkopen.2022.30495.
COVID-19 vaccine boosters or third doses are recommended for adolescents and adults who completed their initial COVID-19 vaccine course more than 5 months prior. Minimal data are available on COVID-19 vaccine booster or third dose reactogenicity among pregnant and lactating individuals.
To describe the reactions to the booster or third dose of the COVID-19 vaccine and vaccine experiences among pregnant and lactating individuals.
DESIGN, SETTING, AND PARTICIPANTS: Beginning in October 2021, a follow-up Research Electronic Data Capture (REDCap) survey regarding a COVID-19 vaccine booster or third dose was sent to 17 504 participants in an ongoing online prospective cohort study on COVID-19 vaccines among pregnant and lactating individuals. A convenience sample of adults enrolled in the online prospective study who were pregnant, lactating, or neither pregnant nor lactating at the time of their booster or third dose was eligible for this follow-up survey; 17 014 (97.2%) completed the follow-up survey.
Receipt of a booster or third dose of the COVID-19 vaccine.
Self-reported vaccine reactions less than 24 hours after the dose.
As of April 4, 2022, 17 014 eligible participants (mean [SD] age, 33.3 [3.5] years) responded to the booster or third dose survey; of these, 2009 (11.8%) were pregnant at the time of their booster or third dose, 10 279 (60.4%) were lactating, and 4726 (27.8%) were neither pregnant nor lactating. After a COVID-19 booster or third dose, most individuals (14 074 of 17 005 [82.8%]) reported a local reaction, and 11 542 of 17 005 (67.9%) reported at least 1 systemic symptom. Compared with individuals who were neither pregnant nor lactating, pregnant participants were more likely to report any local reaction to a COVID-19 booster or third dose (adjusted odds ratio [aOR], 1.2; 95% CI, 1.0-1.4; P = .01) but less likely to report any systemic reaction (aOR, 0.7; 95% CI, 0.6-0.8; P < .001). Most pregnant (1961 of 2009 [97.6%]) and lactating (9866 of 10 277 [96.0%]) individuals reported no obstetric or lactation concerns after vaccination.
This study suggests that COVID-19 vaccine boosters or third doses were well tolerated among pregnant and lactating individuals. Data to evaluate tolerability of boosters or additional doses among pregnant and lactating individuals will be important as they are considered for these populations.
对于完成初始 COVID-19 疫苗接种超过 5 个月的青少年和成年人，建议接种 COVID-19 疫苗加强针或第三针。关于孕妇和哺乳期个人接种 COVID-19 疫苗加强针或第三针的反应性的数据很少。
描述孕妇和哺乳期个人接种 COVID-19 疫苗加强针或第三针的反应和疫苗接种体验。
设计、地点和参与者：从 2021 年 10 月开始，一项关于 COVID-19 疫苗加强针或第三针的后续研究电子数据捕获（REDCap）调查发送给了正在进行的一项关于孕妇和哺乳期个人 COVID-19 疫苗的在线前瞻性队列研究中的 17504 名参与者。在加强针或第三针时已参加在线前瞻性研究的成年人中，有资格参加这项随访调查的是怀孕、哺乳或既不怀孕也不哺乳的成年人；其中 17014 人（97.2%）完成了随访调查。
接种 COVID-19 疫苗加强针或第三针。
接种后不到 24 小时报告的疫苗反应。
截至 2022 年 4 月 4 日，17014 名符合条件的参与者（平均[标准差]年龄，33.3[3.5]岁）对加强针或第三针调查做出了回应；其中，2009 名（11.8%）在加强针或第三针时怀孕，10279 名（60.4%）在哺乳，4726 名（27.8%）既不怀孕也不哺乳。在接种 COVID-19 加强针或第三针后，大多数人（17005 人中的 14074 人[82.8%]）报告了局部反应，17005 人中的 11542 人（67.9%）报告了至少 1 种全身症状。与既不怀孕也不哺乳的个体相比，孕妇更有可能报告 COVID-19 加强针或第三针接种后的任何局部反应（调整后的优势比[aOR]，1.2；95%置信区间[CI]，1.0-1.4；P = .01），但不太可能报告任何全身反应（aOR，0.7；95% CI，0.6-0.8；P < .001）。大多数孕妇（2009 名中的 1961 名[97.6%]）和哺乳期妇女（10277 名中的 9866 名[96.0%]）报告接种疫苗后没有产科或哺乳问题。
这项研究表明，COVID-19 疫苗加强针或第三针在孕妇和哺乳期人群中耐受性良好。在考虑为这些人群接种加强针或额外剂量时，评估孕妇和哺乳期人群接种加强针或额外剂量的耐受性的数据将非常重要。
