Pregnant women are at higher risk of severe coronavirus disease 2019 (COVID-19) compared with nonpregnant women of reproductive age. During 2023-2024, the Centers for Disease Control and Prevention recommended COVID-19 vaccination for everyone aged 6 months or older, including pregnant women. Using a test-negative design, we assessed the effectiveness of 2023-2024 COVID-19 vaccines against COVID-19-associated emergency department (ED) and urgent care setting encounters among pregnant women aged 18-45 years presenting for care with COVID-19 symptoms from September 2023 to August 2024. Vaccine effectiveness against COVID-19-associated ED and urgent care encounters of one 2023-2024 COVID-19 vaccine dose was 58% (95% CI, 24-77%) among pregnant women and 37% (95% CI, 29-44%) among nonpregnant women of the same age. The 2023-2024 COVID-19 vaccines were associated with a decrease in COVID-19-associated ED and urgent care encounters among pregnant women and nonpregnant women of reproductive age.