FECASOG Position Statement 2026: Recommendations for Vaccination During Pregnancy in Central America

Abstract

Introduction The Central American Federation of Obstetrics and Gynecology Associations and Societies (FECASOG) developed this Position Statement with the purpose of providing regional recommendations, based on the best available scientific evidence, regarding vaccination during pregnancy (hereinafter, VDP). The document seeks to unify clinical criteria in Central America, promote the prevention of vaccine-preventable diseases, and strengthen the protection of pregnant women and newborns. Objective To provide a practical and updated guide to support healthcare professionals in recommending and administering vaccines during pregnancy, encouraging evidence-based clinical decisions adapted to the epidemiological reality of Central America. Methodology The Statement was prepared by a regional committee composed of representatives from the scientific societies of the six Central American countries, with international methodological and scientific advisory. The process included:

• Review of scientific literature and international guidelines.
• Analysis of the regional epidemiological situation.
• Evaluation of vaccine availability in each country.
• Application of a regional questionnaire to specialists.
• Discussion and consensus through an expert group.
• External review by vaccination specialists.

Vaccination Status in Central America The availability of recommended vaccines during pregnancy presents significant differences between countries. While vaccines against influenza, COVID-19, and Tdap are widely incorporated into most national programs, the Respiratory Syncytial Virus (RSV) vaccine shows a more heterogeneous implementation, mainly due to differences in availability and access. These gaps justify the need for unified regional recommendations. Barriers to Vaccination Despite solid scientific evidence on the safety and efficacy of vaccines, vaccination coverage remains lower than desired. The main identified barriers include:

• Misinformation and the circulation of fake news.
• Fear of adverse effects on the fetus.
• Low perception of risk regarding preventable diseases.
• Lack of active recommendations by healthcare personnel.
• Access barriers and differences in availability between countries.

The document emphasizes that an active recommendation from a healthcare professional constitutes the most important factor in increasing vaccine acceptance during pregnancy. Recommended Vaccines During Pregnancy Tdap Vaccine It is recommended to administer one dose during each pregnancy, preferably between weeks 27 and 36 of gestation. Its main benefits include:

• Prevention of severe pertussis (whooping cough) in infants.
• Reduction of neonatal hospitalizations and mortality.
• Transfer of maternal antibodies to the newborn.
• Excellent maternal-fetal safety profile.

Influenza Vaccine Its application is recommended during any trimester of pregnancy and during each influenza season.

• Benefits: Reduces severe illness, hospitalization, and maternal complications.
• Protection: Protects the newborn during the first months of life.
• Safety: Does not increase the risk of miscarriage, malformations, or adverse obstetric events.

COVID-19 Vaccine It is recommended for all pregnant individuals, regardless of the trimester of gestation. Evidence demonstrates that it:

• Reduces the risk of severe illness and maternal hospitalization.
• Decreases obstetric complications associated with COVID-19.
• Promotes the transfer of antibodies to the newborn.
• Presents an adequate safety profile during pregnancy and lactation.

Respiratory Syncytial Virus (RSV) Vaccine Maternal vaccination represents an innovative strategy to prevent bronchiolitis and severe respiratory disease in infants under six months of age. It is recommended to administer it between weeks 32 and 36+6 days. However, some entities, such as the WHO, indicate it starting from 28 weeks to maximize protection in countries with a high disease burden and a higher frequency of births before 32 weeks. Therefore, the indication must be individualized, considering obstetric risks and the probability of preterm birth. It is recommended to administer the RSV vaccine in each pregnancy and in accordance with current national recommendations to optimize the passive protection of each newborn. Evidence demonstrates:

• High efficacy in preventing severe respiratory disease.
• Significant reduction in hospitalizations.
• Efficient transfer of protective antibodies to the newborn.
• Favorable maternal-fetal safety profile.

Main Recommendations FECASOG recommends:

1. Incorporate vaccination as a routine part of prenatal care.
2. Promote an active recommendation by obstetrician-gynecologists and other healthcare professionals.
3. Guarantee equitable access to the recommended vaccines.
4. Strengthen continuous medical education and communication directed at the population.
5. Combat misinformation through clear, evidence-based scientific information.
6. Strengthen national and regional surveillance systems for vaccine-preventable diseases and events supposedly attributable to vaccination or immunization (ESAVI).

Conclusion VDP constitutes one of the most effective preventive interventions to simultaneously protect pregnant women and newborns against potentially serious diseases. The available scientific evidence widely supports the safety and efficacy of vaccines against influenza, COVID-19, and RSV, as well as the Tdap vaccine. Therefore, FECASOG urges Central American countries to strengthen their incorporation into prenatal care, reduce access gaps, and develop regional education and communication strategies that increase trust and acceptance of these vaccines. If you need further assistance with this text, let me know if you would like me to:

• Adjust the terminology to fit a specific English medical style (e.g., US or UK guidelines).
• Create a summary table of the vaccine recommendations for quick reference.
• Format the content into a specific file type like Markdown or Word using file generation.