HealthyChildren.org is the official parenting website for AAP. AAP recommends those 5 years and older who do not have any thing that pose a threat to their well-being receive COVID-19 vaccine. Clinical trials and safety measures are on-going with this age group. Children who were infected with SARS-CoV-2 should receive COVID-19 vaccination.

• All who are eligible should receive the COVID-19 vaccination, this includes those who are pregnant and lactating. • COVID-19 vaccine can be taken at the same time as other vaccinations. • “Moderately to severely immunocompromised individuals (i.e., people who have undergone solid organ transplantation or have been diagnosed with conditions that are considered to have an equivalent level of immunocompromise) should receive an additional dose (i.e., an additional primary dose) of COVID-19 vaccine after their initial vaccine or vaccine series. The additional dose should be administered four weeks after the completion of the initial COVID-19 vaccine or vaccine series. For mRNA vaccines, this means immunocompromised individuals need a 3-dose primary series. For J&J/Janssen vaccine, immunocompromised individuals need a 2-dose primary series with the second dose being an mRNA vaccine.” https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care() • All those who have completed the initial series of COVID-19 vaccine should receive the booster. • Discussing precautions with your healthcare provider will help. Letting them know if you had any allergic reaction to other vaccinations would help them in the discussion about obtaining COVID-19 vaccine. • “ACOG strongly recommends that pregnant individuals be vaccinated against COVID-19.” https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care() • According to ACOG there is no proof of undesirable consequences on the pregnant individual or the fetus when the COVID-19 vaccine is received. • According to ACOG although pregnant individuals were not involved in COVID-19 trials, they were able to track those who received the vaccination. No adverse effects has taken place and they also watched for the safety of the vaccination. There is a study going now to watch for the safety. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/() • https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care()

Pregnant women should be offered the vaccine, and that is not just my opinion, that's the opinion of the American College of Gynecology and that's the opinion of the Society for Maternal-Fetal Medicine. These are experts and taking care of pregnant mothers, and they believe that women should be offered these vaccines. They really want to protect pregnant women from having severe outcomes from COVID. Pregnant women are at increased risk for bad outcomes when they get COVID and even if they're healthy, the pregnancy itself makes them susceptible to some of the complications of COVID. So pregnant women are more likely to have severe COVID and more likely to be hospitalized, and any severe illness in pregnancy increases the risk to the outcome of the pregnancy. Now we have registries of women who did choose to take the vaccine, because theoretically there's no reason it would be harmful for them to do so. We have some data that shows they haven't had any increased risk of bad outcomes from their pregnancies. Their babies have been just as healthy as their counterparts who weren't vaccinated. But looking at the transfer of immunity to their babies, there are some early signs from studies that have been conducted that are small, that show those antibodies do get transferred across the placenta to the baby. So Pfizer is enrolling about 4,000 women in a large study looking at the immunity that babies get when they're too young to be vaccinated. They could still get enough benefit from their mother being vaccinated to protect them from COVID in infancy. So it's still a question that's being answered. There are some very promising, early results. There's absolutely no sign that it's any concern for breastfeeding mothers to take the vaccine. Perfectly safe for you to breastfeed after you've been vaccinated. Antibodies are detected in breast milk. Now, what we don’t know is how well those antibodies get absorbed by the baby, and if they end up being protective or not. There's two ways that the baby could be getting antibodies from their mom. They could get it through the bloodstream, which we think is probably a pretty efficient way to immunize the baby, or they could get it through breast milk. Pregnant women are sometimes confused by all of this understandably, and I would encourage them to talk with their ob/gyn, talk with their primary care provider who's taking care of them in their pregnancy and can advise them about the pros and cons of being vaccinated, and generally they're going to find reassurance there. https://www.mayoclinic.org/coronavirus-covid-19/vaccine-if-pregnant() https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care() https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/() https://www.hhs.gov/immunization/get-vaccinated/for-parents/five-reasons/index.html()

Immunizations are one of the greatest public health achievements, preventing tens of thousands of deaths, millions of cases of disease, and saving billions of dollars per decade. Immunizations are a safe, effective way to protect children from disease, including some cancers, as well as hospitalization, disability, and death. It is especially important during a pandemic or other public health emergency to maintain routine immunizations to prevent further outbreaks. Pediatricians play a crucial role in immunizing children and are a trusted source for vaccine information. Vaccine conversations with parents should begin as early as possible – at prenatal visits/interviews ideally – as families often make immunization decisions during pregnancy through the first 2 months of baby’s life.

The American Academy of Pediatrics strongly recommends immunizations as the safest and most cost-effective way of preventing disease, disability, and death. The AAP calls for the on-time, routine immunization of all children and adolescents according to its policy, Recommended Immunization Schedules for Children and Adolescents Aged 18 Years or Younger, United States, 2022. The AAP Red Book serves as policy of the AAP and is written by the AAP Committee on Infectious Diseases. Chapter 1 of the Red Book focuses on Immunizations. Chapter 3 includes Summaries of Infectious Diseases, including those prevented by routine immunization. The AAP supports regulations and laws requiring immunizations to attend child care and school, with exemptions for specific immunizations only when medically contraindicated for an individual child. The AAP views nonmedical exemptions to school-required immunizations as inappropriate for individual, public health, and ethical reasons and advocates for their elimination. More is available in the policy statement, Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance. To support routine and on-time vaccination of adolescents, the AAP has issued the clinical report, The Need to Optimize Adolescent Immunization, which reminds pediatricians that every visit is an opportunity to vaccinate. https://www.aap.org/en/patient-care/immunizations/()

https://ivaccinate.org/()

https://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf()