Twenty-two pregnant women died in August alone—the highest monthly toll since the pandemic began.
In the final days of September 2021, the Centers for Disease Control and Prevention issued an urgent call to a population caught between two fears — the fear of a virus and the fear of a vaccine. Twenty-two pregnant women had died from COVID-19 in a single month, the highest toll since the pandemic began, yet fewer than a third of pregnant women in the United States had chosen vaccination. The CDC, armed with data and the weight of preventable loss, stepped forward to name the imbalance plainly: the virus was the greater danger, and the evidence now demanded a response.
- August 2021 became the deadliest single month for pregnant women since the pandemic began, with 22 deaths — a number that forced the CDC to escalate from recommendation to urgent alert.
- The risk profile for pregnant women with COVID is severe: a 70% higher chance of death and more than twice the likelihood of ICU admission compared to non-pregnant women with the same infection.
- A stubborn vaccination gap persists — only 31% of pregnant women are vaccinated, even as 97% of those hospitalized with COVID during pregnancy had not received a single dose.
- The CDC directly confronted the fear driving hesitancy, presenting data from 2,500 women showing no increased miscarriage risk from Pfizer or Moderna vaccines taken before 20 weeks.
- The alert now reaches three distinct groups — those currently pregnant, those trying to conceive, and those recently postpartum — signaling that the window for protection must be treated as open at every stage.
Late September 2021 brought an unusual kind of public health communication — not a guideline update, but an urgent alert, aimed directly at pregnant women across the United States. The CDC's message was grounded in a single devastating statistic: 22 pregnant women had died from COVID-19 in August alone, the highest monthly death toll of the entire pandemic for that population.
The data surrounding those deaths painted a consistent picture. Pregnant women infected with COVID faced a 70 percent greater risk of dying than non-pregnant women with the same virus, and were more than twice as likely to need intensive care. Yet only 31 percent of pregnant women had been vaccinated — and among those hospitalized with COVID in 2021, 97 percent were unvaccinated.
To address the hesitancy driving that gap, the CDC offered a direct rebuttal to one of the most persistent fears: that vaccination could cause miscarriage. A review of 2,500 women who received Pfizer or Moderna doses before 20 weeks of pregnancy showed no elevated miscarriage risk. The agency was unambiguous — the vaccines did not threaten pregnancy.
CDC Director Rochelle Walensky urged pregnant women and those planning to conceive to consult their doctors, emphasizing that the virus itself carried documented risks of miscarriage, stillbirth, and birth complications. The alert extended to breastfeeding mothers as well, broadening the call to every stage surrounding pregnancy.
What the alert quietly acknowledged was a deeper problem: fear of the vaccine had, for many, outweighed fear of the virus — even as the virus continued to kill. The CDC was now attempting to rebalance that equation with evidence, with urgency, and with the irreducible weight of lives lost in a single month.
On a Wednesday in late September, the Centers for Disease Control and Prevention released an urgent alert aimed at a specific and vulnerable population: pregnant women. The message was direct and alarming. Twenty-two pregnant women had died from COVID-19 in August alone—the highest monthly toll since the pandemic began. The CDC was not issuing a suggestion. It was urging vaccination before pregnancy, during pregnancy, or as soon as possible after giving birth.
The numbers behind the alert were stark. Pregnant women who contracted COVID faced a 70 percent increased risk of death compared to non-pregnant women infected with the same virus. They were more than twice as likely to require intensive care. Yet despite these risks, only 31 percent of pregnant women in the United States had received a COVID vaccine. The disparity became even more glaring when the CDC examined hospital admissions: of pregnant women admitted with COVID-19 in 2021, 97 percent had not been vaccinated.
The CDC's push came with a specific reassurance aimed at one of the primary concerns keeping pregnant women from vaccination. The agency had reviewed data on 2,500 women who received at least one dose of either the Pfizer or Moderna vaccine before 20 weeks of pregnancy. None showed an increased risk of miscarriage. This finding contradicted a widespread fear that had circulated since vaccination campaigns began. The CDC was explicit: there was no evidence that the vaccines posed a risk to pregnancy.
Rochelle Walensky, the CDC director, framed the issue in personal terms. She encouraged pregnant women and those considering pregnancy to speak with their doctors about the protective benefits of vaccination—not just for themselves, but for their babies. The virus itself posed documented threats to pregnancy: miscarriage, stillbirth, and serious complications at birth. The vaccine offered protection against those outcomes.
The alert was directed at three overlapping groups: women currently pregnant, women trying to conceive, and women who had recently given birth. For those in the last category, breastfeeding mothers could also be vaccinated safely. The CDC's August guidance had already recommended vaccination for everyone 12 and older, including pregnant people, but the September alert elevated the urgency. The spike in August deaths made clear that the previous messaging had not reached enough of the population most at risk.
What remained unspoken in the alert was the gap between what the data showed and what pregnant women believed. Fear of the vaccine had proven more persuasive than fear of the virus, even as the virus killed. The CDC was now attempting to close that gap with evidence, with authority, and with the weight of 22 deaths in a single month.
Notable Quotes
I strongly encourage those who are pregnant or considering pregnancy to talk with their healthcare provider about the protective benefits of the COVID-19 vaccine to keep their babies and themselves safe.— CDC Director Rochelle Walensky
The Hearth Conversation Another angle on the story
Why did the CDC feel compelled to issue an urgent alert in September specifically? What changed?
The August death count—22 in one month—was the highest they'd seen. That's not a trend line anymore. That's a crisis moment.
But pregnant women have always been at higher risk during COVID. Why the hesitation to vaccinate?
Fear. Miscarriage is the deepest fear a pregnant woman carries. The rumor that the vaccine caused miscarriage spread faster than the data showing it didn't.
The data was available, though. The CDC had studied 2,500 women.
Yes. But data doesn't travel the way fear does. A woman hears a story from a friend, or reads something online, and that feels more real than a CDC study.
So the alert was trying to outrun the rumor?
Exactly. And to say: your doctor can help you understand this. You don't have to figure it out alone.
What about the women who were already hospitalized? The 97 percent who were unvaccinated?
They're the evidence the CDC couldn't ignore. Those women didn't choose to be part of the warning. They became it.