evidence: COVID-19 vaccination during pregnancy plays a crucial role in preventing maternal illness.1 Safety concerns are reported as 1 of the top reasons to decline COVID-19 vaccination during pregnancy.2 The exclusion of pregnant women from the initial COVID-19 vaccine trials led to information gaps regarding maternal and fetal response to vaccination. While several observational studies examined neonatal benefits via antibodies transfer across the placenta,3,4 large-scale assessments of neonatal safety are scarce. [...] Two descriptive studies provide preliminary information on neonatal outcomes after COVID-19 vaccination during pregnancy.6,7 Both studies relied on self-reported questionnaires, which may bear selection bias and respondent bias, and were characterized by small sample size, short time frame, and lack of a comparison group of unexposed neonates. One of the studies7 showed lower reactogenicity of the messenger RNA (mRNA) vaccine in pregnant women compared with nonpregnant women. This study aims to examine the association between maternal immunization during pregnancy and neonatal and early infant outcomes using a large population-based cohort. [...] Vaccination during pregnancy is common to prevent morbidity from other infectious diseases. Specifically, vaccines to prevent influenza and pertussis are recommended during pregnancy.17 The clinical data on safety and efficacy of influenza vaccination are abundant and cover both early and late gestation,18 as well as longer-term implications into early childhood.19 However, COVID-19 vaccines were not expressly studied in pregnant women and offspring prior to their availability in the United States under Emergency Use Authorization, leaving an unmet need for safety data.