Does COVID-19 vaccination in pregnancy affect toddler neurodevelopment?

Studies examining the effects of COVID-19 vaccine in pregnancy have focused on three main areas: maternal and fetal antibody production, short-term fetal and childhood safety, and overall pregnancy outcomes. Recent data support the short-term safety of the vaccine in pregnancy and also show that maternal outcomes and preterm birth are improved in people receiving the vaccine. However, little is known about neurodevelopmental outcomes of children exposed to COVID-19 mRNA vaccine during pregnancy. To examine this issue, US researchers evaluated whether there is an association between COVID-19 vaccination during or shortly before pregnancy and neurodevelopmental measures in offspring. The multicentre, prospective, cohort study of 18- to 30-month-old children was conducted at 14 centres of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network in the United States from 2024 through 2025. Women who received a COVID-19 mRNA vaccine during or within 30 days prior to pregnancy (exposed group) were matched with women who did not receive COVID-19 mRNA vaccine (unexposed group) by delivery site, delivery date, insurance status, race and ethnicity. The primary outcome was Ages and Stages Questionnaire version 3 (ASQ-3) total score; the score was deemed to be equivalent between the exposed and unexposed groups if the 90% confidence interval (CI) of the median difference was between −10 and 10. Secondary outcomes included domain-specific ASQ-3 scores, the Child Behavior Checklist, Modified Checklist for Autism in Toddlers, and Early Childhood Behavior Questionnaire scores.Key results:The study enrolled 271 exposed and 240 unexposed children. Matching on all characteristics was possible in 217 pairs;Of the 434 matched children enrolled, 59.4% were non-Hispanic white, 22.1% non-Hispanic black, 12.0% Hispanic, and 6.5% were not represented by any of the preceding racial or ethnic groups;Median age at assessment was 25.8 months; 50.9% were female;Exposed mothers were more likely to be nulliparous; their children were slightly younger at assessment and more likely to have been vaccinated against SARS-CoV-2;The primary outcome of ASQ-3 score was equivalent between the exposed and unexposed groups (255 vs 260, adjusted median difference, −3.4; 90% CI, −9.8 to 3.0);No significant differences were observed in secondary neurodevelopmental outcomes.The authors conclude that in this multicentre cohort study, ASQ-3 scores were equivalent between 18- to 30-month-old children whose mothers did or did not receive COVID-19 mRNA vaccination during or immediately prior to pregnancy. These findings provide reassurance regarding the safety of COVID-19 mRNA vaccination in pregnancy and support continued recommendations for administering COVID-19 mRNA vaccines during pregnancy.ReferenceHughes BL, Clifton RG, Metz TD, et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. SARS-CoV-2 mRNA vaccination in pregnancy and child neurodevelopment at 18 to 30 months. JAMA Pediatr 2026. Published online November 2, 2026 (accessed November 3, 2026).

Does COVID-19 vaccination in pregnancy affect toddler neurodevelopment?

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