While pregnancy puts women at higher risk of severe COVID-19, very little data are available to assess vaccine safety in pregnancy. 

Pregnant women may receive the vaccine if the benefit of vaccinating a pregnant woman outweighs the potential vaccine risks. For this reason, pregnant women at high risk of exposure to SARS-CoV-2 (e.g. health workers) or who have comorbidities which add to their risk of severe disease may be vaccinated in consultation with their health care provider.

When making a decision, you and your patient should consider the

• level of COVID-19 community transmission
• patient’s personal risk of contracting COVID-19
• risks of COVID-19 to the patient and potential risks to the fetus
• efficacy of the vaccine
• side effects of the vaccine
• lack of data about the vaccine during pregnancy

·        Vaccination can be offered to breastfeeding women if they are part of a group prioritized for vaccination. WHO does not recommend discontinuation of breastfeeding after vaccination. 

·        A lactating person who is part of a group recommended to receive a COVID-19 vaccine (e.g., healthcare personnel may choose to be vaccinated. There are no data on the safety of COVID-19 vaccines in lactating people or the effects of COVID-19 vaccines on breastfed infant or milk production/excretion. 

Yes, but vaccination should be deferred for at least 90 days after they received treatment. Based on the estimated half-life of monoclonal antibodies or convalescent plasma as part of COVID-19 treatment, as well as evidence suggesting that reinfection is uncommon in the 90 days after initial infection, delaying vaccination for 90 days is a precautionary measure until additional information becomes available, to avoid interference of the antibody treatment with vaccine-induced immune responses.

Immunocompromised individuals may receive COVID-19 vaccination if they have no contraindications to vaccination. However, they should be counseled about the

• unknown vaccine safety profile and effectiveness in immunocompromised populations
• potential for reduced immune responses
• need to continue to follow all current guidance to protect themselves against COVID-19

For persons who were vaccinated for COVID-19 while they were undergoing chemotherapy or treatment with other immunosuppressive drugs and who have since regained their immune competence, re-vaccination is not recommended at this time. 

Immunocompromised individuals may receive COVID-19 vaccination if they have no contraindications to vaccination. However, they should be counseled about the

• unknown vaccine safety profile and effectiveness in immunocompromised populations
• the potential for reduced immune responses
• need to continue to follow all current guidance to protect themselves against COVID-19

For persons who were vaccinated for COVID-19 while they were undergoing chemotherapy or treatment with other immunosuppressive drugs and who have since regained their immune competence, re-vaccination is not recommended at this time. 

·        Yes. Vaccination should be offered to eligible persons regardless of whether they have a history of prior symptomatic or asymptomatic SARS-CoV-2 infection. Data from clinical trials indicate COVID-19 vaccines can be safely administered in persons with evidence of prior SARS-CoV-2 infection.

·        Vaccination of persons with known current SARS-CoV-2 infection should be deferred until the person has recovered from acute illness (if the person had symptoms) and until criteria have been met for them to discontinue isolation.

·        This recommendation applies to any vaccine, including the first and second doses of COVID-19 vaccine. Additionally, if a person was infected within the last 90 days, they may defer vaccination until after a 90-day period or if they were treated with monoclonal antibodies or convalescent plasma within the last 90 days vaccination should be deferred.

Yes. Persons with a history of Bell’s palsy may receive COVID-19 vaccine unless they have a contraindication to vaccination. 

Yes. Persons with a history of Guillain-Barré Syndrome (GBS) may receive COVID-19 vaccine unless they have a contraindication to vaccination. With few exceptions, Advisory Committee on Immunization Practices (ACIP’s) general best practice guidelines for immunization do not include a history of GBS as a contraindication or precaution to vaccination.

https://www.cdc.gov/vaccines/covid-19/hcp/faq.html

https://www.who.int/news-room/feature-stories/detail/the-oxford-astrazeneca-covid-19-vaccine-what-you-need-to-know