evidence: In a research letter published in April 2022, investigators evaluated the association between COVID-19 vaccination during early pregnancy and risk of major fetal structural anomalies identified on ultrasonography. Of 2622 patients who received at least 1 dose of COVID-19 vaccine, 1149 (43.8%) were vaccinated within the teratogenic window. Results of this analysis found that vaccination within the teratogenic window was not associated with presence of a congenital anomaly identified on ultrasonography (Ruderman 2022). [...] There is no evidence of adverse maternal or fetal effects from vaccinating pregnant individuals with COVID-19 vaccine, and a growing body of data demonstrate the safety of such use (Ciapponi 2021, Ciapponi 2023, Wainstock 2021, Kachikis 2021, Magnus 2021, Fu 2021, Ruderman 2022). Therefore, individuals who are or will be pregnant should receive the COVID-19 vaccine. Emerging data indicate that vaccine-induced antibodies cross the placenta, but the degree of protection these antibodies provide to the neonate is unknown (Yang 2022). In a recent case-control study from 20 pediatric hospitals, CDC found that COVID-19 vaccination during pregnancy reduced the risk of infant hospitalization with COVID-19 by 61%, suggesting that COVID-19 vaccination during pregnancy might also help protect babies. These findings emphasize the importance of COVID-19 vaccination during pregnancy to protect pregnant people and their babies from COVID-19 (Halasa 2022). Vaccination may occur in any trimester and emphasis should be on vaccine receipt as soon as possible to maximize maternal and fetal health.