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The CDC is now urging that pregnant people get vaccinated against COVID, citing new safety data, according to updated recommendations released Wednesday.

The agency, citing an analysis of data in the v-safe pregnancy registry, concluded that the shots are safe for people who are pregnant or plan to be pregnant. According to the CDC, “scientists did not find an increased risk for miscarriage among people who received an mRNA COVID-19 vaccine before 20 weeks of pregnancy.” The agency also said available safety data found no additional risk to people vaccinated later in pregnancy, or to their babies. 

The agency’s decision to strengthen its recommendations comes after months of ambiguous language that came short of formally advising pregnant people to get the shot due to a lack of safety data. The issue was magnified in late January when the CDC and World Health Organization appeared to differ in their guidance for pregnant people. 

The organizations argued at the time that their guidance was the same, and that the issue came down to nuances in how they projected confidence while acknowledging there wasn’t enough data to make a full recommendation. The missing data was a result of pregnant women not included in the clinical trials for the vaccines.  

Sascha Ellington, lead of the CDC’s emergency preparedness and response team within the division of reproductive health, said pregnant people should not be immediately excluded from clinical trials so that there isn’t an absence of data. 

“We hope this is a lesson for future vaccine trials and I know the manufacturers are doing studies now on vaccination in pregnancy but, you know, really missed the mark to get that information and data pre-authorization,” she said. 

Ellington said the agency’s “less than enthusiastic” guidance coupled with heightened hesitancy towards new medications could be contributing to the “surprisingly low” vaccination rate among pregnant people. According to CDC data, only 23% of pregnant women have received at least one dose of the shot. That would rank last when compared to any of the eligible age groups. 

The CDC’s update comes nearly two weeks after the American College of Obstetricians and Gynecologists released their own updated recommendations that all pregnant and lactating individuals receive a COVID vaccine. In a statement to CBS News, ACOG President Dr. J. Martin Tucker said the organization “continues to work with the CDC to help ensure that pregnant and lactating people feel confident in the safety and protective value of the COVID-19 vaccines.”