Although major reductions in maternal and child mortality were achieved in the Millennium Development Goals era, progress must be accelerated to meet Sustainable Development Goals health targets by 2030.

Pregnant women and their babies are among the populations most vulnerable to untoward health outcomes. Yet current standards for evaluating health interventions cannot be met during pregnancy because of lack of adequate evidence.

It is a critical time to formulate an organized and comprehensive approach to monitoring safety of maternal immunizations in low- and middle-income countries and thereby track safety and effectiveness to ensure program success and public confidence.

A recent analysis reported that most vaccine pharmacovigilance systems in low- and middle-income countries consist of spontaneous (passive) adverse event reporting. Thus, LMICs need effective active surveillance approaches, such as pregnancy registries.

The COVAX Maternal Immunization Work Group (WG) was established with the goal of developing a report that identifies and provides recommendations on COVID-19 candidate vaccine(s) for potential use in pregnant women.

Our study’s main objective was to identify existing perinatal data collection systems in low- and middle-income countries that collect individual information on maternal and neonatal health outcomes and could be developed to inform active safety surveillance of novel vaccines for use during pregnancy.

We conducted an overview of systematic reviews (SRs) summarizing the best evidence regarding the effect of COVID-19 on maternal and child health following Cochrane methods and PRISMA statement for reporting.

Excluding pregnant women from studies on vaccination in order to provide protection from theoretical risks is not warranted and can prevent this population from potentially beneficial inmunizations.