Author reply: "The need for serial monitoring of COVID-19 vaccine uptake among pregnant and postpartum individuals".

Sir,

We agree that tracking changes in vaccination patterns over time in the peripartum period is critical. The follow up in our cohort was relatively short (6 months), and further follow up is needed. Such data may highlight how pregnancy and the postpartum period, including breastfeeding, may impact coronavirus disease 2019 (COVID‐19) vaccination relative to other less transient factors, including adverse social determinants of health, such as minority race and ethnicity, lower educational attainment and inadequate insurance coverage, as well as chronic comorbidities.

In addition to changes over time, local context matters. We agree that the relative impact of risk factors for vaccination in the peripartum period are likely to vary by regional setting. In addition to local viral dynamics, the local political milieu and social mores also impact COVID‐19 vaccine uptake. Ongoing international collaborations conducted in the peripartum period that importantly also include low‐ and‐middle‐income countries, such as INTERCOVID , and the NICHD Global Network, will be critical to understanding regional variation in COVID‐19 vaccination.

Finally, we agree that continuing to track high‐risk groups, including pregnant and lactating individuals, is critical. Pregnancy itself is a risk factor for increased COVID‐19 severity. Individuals in the peripartum period were originally excluded from COVID‐19 vaccine clinical trials, but since then, observational data have supported the safety and efficacy of vaccination in this population, and clinical trials in pregnancy are ongoing. In addition, innovative strategies to increase COVID‐19 vaccine uptake in pregnant and postpartum individuals will likely be necessary that engage community stakeholders and healthcare systems through provider dashboards and patient mobile applications.

CONFLICT OF INTERESTS

None declared. Completed disclosure of interest forms are available to view online as supporting information.

Appendix S1

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Appendix S2

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Appendix S3

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