evidence: Women infected with covid-19 during pregnancy have a higher risk of pregnancy complications.123 Based on this evidence, and studies showing that pregnant women are at increased risk of severe disease from covid-19,34 the authorities in most countries recommend that pregnant women get vaccinated against covid-19.5678 Because pregnant women are not often included in randomised controlled trials of vaccines before marketing, evidence relating to the safety of vaccines during pregnancy relies on observational data after the introduction of vaccines. Vaccination of pregnant women against covid-19 was therefore recommended before conclusive safety data were available. Studies evaluating the safety of covid-19 vaccines among pregnant women after marketing have been reassuring, providing no evidence of an increased risk of pregnancy complications.9101112 [...] Evidence supports an increased risk of certain pregnancy complications, including preterm birth and stillbirth, among women with covid-19 infection during pregnancy.330 We did not find any evidence of an increased risk of congenital anomalies after covid-19 infection, but newer variants were not included. However, current knowledge is in line with the new viral variants becoming less harmful.37 Vaccination of pregnant women protects the women and the infants from adverse outcomes. Furthermore, we did not find any indication that vaccination against covid-19 during the first trimester increased the risk of anomalies, providing additional evidence about the safety of vaccination in pregnant women. Overall, our findings support the current recommendations to vaccinate pregnant women against covid-19.