Tailor Your Outreach

• CDC recommends COVID-19 vaccination for people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future. This recommendation aligns with recommendations from the American College of Obstetrics and Gynecology (ACOG) and the Society for Maternal-Fetal Medicine (SMFM).
• Both the American College of Obstetrics and Gynecology (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) recommend that women who are pregnant or breastfeeding receive the COVID-19 vaccine.
• The best vaccine to receive is the COVID-19 vaccine made available to you first. No COVID-19 vaccine is recommended over another; however, women younger than 50 years should be made aware of the rare risk of thrombotic thrombocytopenia syndrome (TTS) after the receipt of the Johnson & Johnson/Janssen COVID-19 vaccine and the availability of other FDA-authorized COVID-19 vaccines.
• Although women who are pregnant or breastfeeding were not included in the COVID-19 vaccine clinical trials, preliminary findings from safety surveillance data did not show obvious safety signals of concern among over 30,000 pregnant persons who received mRNA COVID-19 vaccines.
• Ongoing safety monitoring of now over 170,000 people who reported they were pregnant when they received a COVID-19 vaccine has not revealed serious safety concerns.
• Research shows that women who become infected with COVID-19 virus while pregnant are at an increased risk of severe illness, including illness that results in ICU admission, mechanical ventilation, and death.
• A recent study followed eighty-four breastfeeding women over six weeks and found antibodies present in the breast milk. The study suggests a potential protective effect against COVID-19 infection in the infants.
• Although more research is needed, this study found that vaccine-induced immune response in 131 reproductive-age females was significantly greater than the response to natural infection. Another recent study followed breastfeeding women over six weeks and found antibodies present in the breast milk. These studies suggest a potential protective effect against COVID-19 infection in the infants.

Learn More

• Watch APhA’s Open Forum Webinar on Reproductive Health: The Impact of COVID-19 Disease and Vaccination to learn how you can reach patients who are pregnant, breastfeeding, or contemplating pregnancy. (Slides)
• Listen to a success story: COVID Vaccine Safety and Pregnant Women

Patient Information

• CDC’s COVID-19 Vaccines While Pregnant or Breastfeeding
• CDC’s COVID-19 Vaccines for People Who Would Like to Have a Baby

Patient Handouts

• American College of Obstetricians and Gynecologists (ACOG)’s Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients (Spanish) (Chinese) (Arabic)

• Survey data from the Kaiser Family Foundation indicates that while a majority of LGBT adults have been vaccinated as of late spring 2021, 20% of LGBT adults say they plan to wait and see how the vaccine impacts others before getting vaccinated whereas 13% of non-LGBT adults surveyed said they would wait and see.
• While vaccine acceptance is relatively high among LGBTQ+ persons, evidence shows these individuals are more likely to suffer from underlying conditions, such as HIV or substance use disorder, that can increase their risk for severe COVID-19 disease. LGBTQ+ persons are also more likely to suffer from homelessness, which can make it difficult to reach them.

Learn More

• Review HHS’s We Can Do This LGBTQ+ Community Toolkit for more information and resources to share.

Patient Handouts

• HHS’s We Can Do This COVID-19 Frequently Asked Questions for the LGBTQ+ Community

• The American Academy of Pediatrics (AAP) recommends COVID-19 vaccination for all children and adolescents 6 months and older who do not have contradictions using a COVID-19 vaccine authorized for use for their age.
• The Pfizer-BioNTech COVID-19 vaccine is currently the only vaccine that can be given to children and adolescents 5 years of age and older. Children ages 5 to 11 years require a smaller dose of the Pfizer-BioNTech COVID-19 vaccine based on the safety, tolerability, and immunogenicity profiles in children studied. The Centers for Disease Control and Prevention (CDC) recommends that children ages 5 to 11 years receive two doses (10 mcg; 0.2 mL each) of the pediatric-indicated Pfizer-BioNTech vaccine, 21 days apart. Adolescents (and adults) ages 12 years and older should receive two doses (30 mcg; 0.3 mL each) of the vaccine indicated for individuals 12 years of age and older, 21 days apart. The pediatric-indicated Pfizer-BioNTech vaccine is the same vaccine proven safe and effective in adolescents/adults. For more information about COVID-19 vaccine products, visit APhA’s Guide to COVID-19 Vaccination Schedules.
• Children and adolescents are at risk of serious complications from COVID-19 infection, including hospitalization and death, as well as long-term complications that result from infection. Although cases of myocarditis and pericarditis have been observed after vaccination in adolescents, the benefits of vaccination continue to outweigh the risks of COVID-19 infections. No cases of myocarditis or pericarditis were reported in clinical trial for children ages 5–11 years, although the study was not powered to assess the risk of myocarditis.
• Consent laws vary by state. It is important to know the consent laws in your state, so you are prepared to answer questions from teens and their parent or caregiver.

Learn More

• Review APhA’s COVID-19 Vaccination in Adolescents and Children practice resource for more information.
• Review CDC’s Stay Up to Date with COVID-19 Vaccines
• Read AAP’s Countering Vaccine Hesitancy article to learn tips for healthcare professionals.

Patient Information

• Teens for Vaccines article How can teens convince parents about the COVID-19 vaccine?

• Homebound people are vulnerable to COVID-19 and experience unique access to care challenges. COVID-19 vaccination is a valuable strategy to protect homebound people.
• Homebound people are especially reliant on the caregivers who support them. These caregivers can help protect their own health and continue to care for the homebound individual by being vaccinated themselves.
• Pharmacists can be reimbursed for vaccine administration in the home. Pharmacists providing vaccinations to homebound individuals can be reimbursed an additional $35 for vaccine administration. Refer to APhA’s Reimbursement for Administration of COVID-19 Vaccine(s)—What We Know practice resource for more information.

Learn More

• Read CDC’s Strategies for Reaching People with Limited Access to COVID-19 Vaccines to learn steps providers can take to reach persons who need the help of another person or medical equipment such as crutches, a walker, or a wheelchair to leave their home.
• Listen to a success story: COVID-19 Vaccinations for the Homebound: Taking it on the Road
• Watch APhA’s Open Forum Webinar on At-Home Vaccinations to review factors you should consider when evaluating and planning at-home vaccination programs and how you can receive Medicare reimbursement for vaccinating patients in their homes.
• Refer to APhA’s COVID-19 Resources: Know the Facts library for information about reimbursement for providing vaccinations in the home.

• An effective outreach strategy is to partner with an organization that is already working with homeless populations in the community. These organizations have developed relationships and built trust with community members that will extend the reach of the vaccination program.
• Vaccination programs can be implemented at shelters, day programs, or food service locations, as well as in areas frequented by people experiencing unsheltered homelessness, such as encampments or similar locations. Programs that transport people experiencing homelessness to vaccination sites may be feasible, but it is important to consider the degree to which this population may be reluctant to leave their personal belongings. Taking vaccine directly to the population may be more effective.
• There is no preferred vaccine for people experiencing homelessness. The best vaccine is the first one available to the individuals in this population. It may be difficult for some people experiencing homelessness to return for a second dose. Providing a single-dose vaccine to this population may be advantageous. If a two-dose vaccine is given, it is important to partner with community groups to incorporate reminders into routine interactions and to offer multiple opportunities to receive the second dose of vaccine.
• Anyone can be vaccinated against COVID-19 regardless of immigration status or whether they can provide identification or insurance information. Some people experiencing homelessness may have difficulty providing such information or may have privacy concerns. Only the individual’s name, date of birth, sex, and address (or a note on homeless status) are required for documentation.
• Pharmacists can be reimbursed for vaccine administration provided to uninsured or underinsured individuals. Refer to APhA’s APhA’s Reimbursement for Administration of COVID-19 Vaccine(s)—What We Know practice resource for more information.

Learn More

• Review CDC’s Guidance on Management of COVID-19 in Homeless Service Sites and in Correctional and Detention Facilities
• Review key issues to consider in the Kaiser Family Foundation’s COVID-19 Risks and Vaccine Access for Individuals Experiencing Homelessness

• As you interact with members of faith-focused communities who express concerns about vaccination, listen to the words they use and ask yourself whether their concerns are along religious or theological lines or if their comments are about matters of safety and efficacy. By taking the time to learn more about each religion, you will be better prepared to respond in a meaningful way that addresses the individuals underlying concerns.
• The following paragraphs summarize a few key points each for Judaism, Christianity, and Islam. Additional information, context, and references can be found by clicking on the links at the end of this section.
• Judaism expects its believers to be proactive in maintaining health. Pikuach nefesh, acting to save a life, is a positive commandment overarching even laws for keeping the Sabbath. With contagious diseases, one’s own actions help or hinder transmitting the disease to bystanders. Jewish dietary laws (“keeping kosher”) apply to foods, not to medications. COVID-19 vaccines do not contain components of porcine origin and all COVID-19 vaccines are given by injection.
• Islam espouses principles of preventing harm (izalat al dharar yuzaal) and serving the public interest (maslahat al-ummah), each of which favor vaccination. The Qur'ān forbids consumption of several animals (e.g., “the flesh of swine”). COVID-19 vaccines do not contain components of porcine origin and medications are given special status within Islam.
• Most Christian denominations have no scriptural or canonical objection to vaccination per se. Denominations that rely on faith healing (e.g., Christian Scientists, several small sects) may view vaccination as unnecessary or even suggesting unfaithfulness to God’s will. With contagious diseases, one’s own actions help or hinder transmitting the disease to bystanders. Pope Francis recorded a video for Catholics across the Americas in 2021 to encourage COVID-19 vaccination.
• Christians, Muslims, and others may express concern over vaccines manufactured using cell lines (e.g., HEK293, PER.C6) with remote links to specific fetuses aborted several decades ago (e.g., adenovirus-vector COVID-19 vaccines from Janssen or AstraZeneca). Messenger RNA in vaccines produced by Pfizer-BioNTech and Moderna are chemically synthesized, not grown in cell culture. Those abortions were not conducted to create these cell lines. This lack of intent breaks a complicity link that could otherwise make vaccination unacceptable. There are no human cells present in the vaccines.

Learn More

• How to talk about vaccines with someone who is Jewish, when you aren’t Jewish
• How to talk about vaccines with someone who is Muslim, when you aren’t Muslim
• How to talk about vaccines with someone who is Christian, when you aren’t Christian