From the start of this pandemic, it is found that many pregnant women were affected by covid 19. Even many of those cases turned fatal. When the first covid 19 vaccine came, we all know it was not recommended to vaccinate the pregnant women. Because there were no trial reports available about the effect of covid vaccine in pregnant women. So there was a fear of harm to both mother and baby. But a few months already passed, researches are still going on. Now many countries such as United Kingdom, United States of America, Canada, India, Australia, Singapore, Israel have given emergency approval to vaccinate pregnant woman with covid 19 vaccines. In this article we will discuss the reasons, effects, trial results and many more. Lets have a look
Why covid 19 vaccine is recommended for pregnant woman?
- Data from different countries suggest that pregnant women are at increased risk for developing severe illness due to covid 19. Though pregnancy does not increase the risk to get infected with covid 19, but once they are infected then covid 19 may give increased chance of fatal outcome as compared to non-pregnant women.
- Data shows that pregnant women who are infected with covid 19 have an increased risk for preterm birth. Once infected, there is an increased risk of other adverse pregnancy outcomes such as a higher chance of death of baby in the womb.
- Mostly pregnant women are asymptomatic or many have mild illness, but sudden deterioration may occur that is risky both for mother and baby in the womb.
- WHO recommended to vaccinate pregnant women when the benefits of vaccination are more than the potential risks. So pregnant women who are at high risk of coronavirus exposure should take the vaccine. Also pregnant women who have comorbidities are in high risk group to get severe covid 19 illness, so should take the vaccine to avoid a fatal outcome.
Here it is important to note that pregnant women should take all the protective measures to prevent themselves from getting infected with covid 19. Getting vaccinated is such a preventive measure.
Who are at higher risk of getting infected with covid 19?
Though anyone can get infected with covid 19 if does not take preventive measures, but some people are at higher risk for getting the infection such as
- People who are healthcare workers or frontline workers. They are more exposed to coronavirus than general people. So their chances of getting infected with covid 19 are more.
- Community with a high rate or increasing rate of covid 19 infections, so people in this community are at increased risk to get the infection.
- People who are frequently exposed to outside people.
- People who can not maintain social distancing when living in a crowded household. Also when people in a crowded household can not use a separate bathroom and other preventive measures.
How does covid 19 affect the health of the pregnant woman?
Data shows that more than 90 percent of the pregnant woman with covid 19 recover without hospitalization, but rapid deterioration may occur in few cases. If sudden deterioration occurs then it may lead to a fatal outcome.
Pregnant women who are symptomatic when infected with covid 19 are at increased risk of severe illness and death.
Pregnant women with symptomatic covid 19 are also at increased risk of fatal pregnancy outcomes such as premature birth, admission to ICU, requirement of ventilator, special equipment for breathing or illness that leads to death, etc. Pregnant women without covid 19 are free from all these risky outcomes.
How does covid 19 infection of pregnant woman affect the baby?
Data shows that more than 95 percent of the newborn of covid 19 positive mothers are in good condition at birth. But covid 19 during pregnancy increase the chances of premature birth, increases the possibility of hospitalization of the newborn, and even there is increased chance of death of the newborn baby.
Which pregnant women are at higher risk of developing complications after covid 19 infection?
Several risk factors promote developing complications after covid 19 infection during pregnancy. These risk factors are
- Pre-existing co-morbidities (such as diabetes, hypertension, etc), higher maternal age, obesity are risk factors for severe illness of covid 19 during pregnancy.
- Pregnant women with high-risk conditions such as diabetes, chronic respiratory conditions (example- COPD, Asthma, Cystic Fibrosis), Sickle cell disease, Organ transplant patient, patient on dialysis or advanced chronic kidney disease, heart disease, patient on immunosuppressive medications ( immunosuppressive medication weakens the immunity), etc.
If a pregnant woman has already had covid 19, when should she be vaccinated?
If a woman is infected or got infected with covid 19 infection during pregnancy, then she should receive the covid 19 vaccine soon after the delivery.
Are there any side effects of the covid 19 vaccines that can either harm the pregnant woman or her foetus?
Covid 19 vaccines that are available are safe to use. Vaccination will protect pregnant women from covid 19 illness like other persons.
As per reports to date, experts believe that covid 19 vaccines that are available to use, are unlikely to pose a risk to pregnant women and the baby in the womb.
The vaccine may have mild side effects. After getting the covid vaccine, one may have a mild fever, pain at the injection site, or feeling unwell for the next 1-3 days.
The long-term harmful effects or adverse effects and safety of the covid vaccine for the baby in the womb are not established to date.
In very rare cases (one in 1-5 lakh persons), after covid 19 vaccination, one may have some of the following symptoms within 20 days. If any of these symptoms occur, you need immediate medical help. These symptoms are
- Difficulty of breathing (Shortness of breath)
- Chest pain
- Small pinpoint bleeding or bruising in the skin beyond the injection site.
- Pain in the arm or swelling of the arm.
- Abdominal pain (may be continuous) with or without vomiting
- Seizures with no previous history
- Severe and continuous headache with no history of the previous attack of the migraine or chronic headache.
- Weakness of any particular part or side of the body
- Continuous vomiting
- Blurred vision
- Pain in eye
- Any symptoms or health conditions that are unwanted and a concern.
Are there any specific contraindications for vaccination in pregnancy?
Just like general people, a pregnant woman should avoid vaccination in the following situations
- Severe allergic reaction to the first dose of covid 19 vaccine.
- Severe allergic reactions to the vaccine or any injectable medicines, food items, etc.
- The vaccine should not be given temporarily – if diagnosed with a covid 19 infection. Vaccination should be postponed for 12 weeks from infection or 4-8 weeks from recovery.
- The vaccine also should not be given temporarily during active covid 19 infection.
- The vaccine should not be given temporarily if you are treated with anti-covid 19 monoclonal antibodies or convalescent plasma.
Always consult with your healthcare provider in the above mentioned conditions before getting the shots of the covid 19 vaccine.
How to take the decision about taking the covid 19 vaccine during pregnancy?
If you are confused to take the decision about taking the covid 19 vaccine while pregnant then you need to consider the following things
- Your potential exposure risk to coronavirus
- The risk of severe illness due to covid 19
- The benefits of covid 19 vaccination
- The limited but growing evidence about the safety of covid 19 vaccination during pregnacy.
Though there are limited data available about the safety of covid 19 vaccines for people who are pregnant, still you can receive a vaccine. You can consult with your healthcare provider before vaccination.
Recent research report shows that pregnant women who received covid 19 mRNA vaccines during their pregnancy, mostly in their third trimester, have passed antibodies to the babies in their womb. So it helped to protect their newborn after birth.
Here we should mention, even before covid 19 vaccination process started, it was found that the babies born in early pandemic time (year 2020) were naturally blessed with covid 19 antibodies.That is why no fatal newborn covid cases are registered worldwide.
Should I need to maintain all the covid 19 precautions after getting the covid 19 vaccine?
Yes, after getting the full dose of covid 19 vaccine, you still need to maintain all the covid 19 preventive measures ( such as wearing a mask, maintaining physical distancing of at least 6 feet from others, sanitizing hands with soap and water for at least 20 seconds, etc.). Also remember that if you additionally have any underlying medical conditions or if you are under any medication that can weaken your immune system, then you may not be fully protected despite having full vaccination course.
What are the global recommendations and practices on vaccination of pregnant women?
There are potential benefits and risks of the vaccine, still, International bodies have taken a positive stand on the covid 19 vaccine in pregnancy. These International bodies acknowledged that there is a lack of data in pregnancy.
WHO recommends the use of the recombinant vaccine in pregnant women. But WHO also mentions that the benefit of vaccination should be more than the potential risks of covid 19 infection. A Pregnant woman may be exposed to the covid 19 vaccine before the woman knows that she is pregnant.
WHO does not recommend to do the pregnancy testing before vaccination. WHO also does not recommend delaying pregnancy or terminating a pregnancy due to covid 19 vaccination.
International Federation of Gynecology and Obstetrics (FIGO) believes that a risk-based approach to covid 19 immunization might be of disadvantage to pregnant women.
According to The Royal College of Obstetricians and Gynecologists (RCOG), the pregnant women should be offered the covid 19 vaccine as the general population.
According to the American College of Obstetricians and Gynecologists (ACOG), pregnancy testing should not be required before receiving the covid 19 vaccine. Also, they mention that vaccine may be given to those who wish to get pregnant in the future. Women below 50 years old including pregnant women can receive any covid 19 vaccine. But all of them should be aware of the rare risk of thrombosis (clotting of blood in the blood vessel) with thrombocytopenia k(Low count of platelets) after getting the mRNA vaccines.
Takeaway:
Covid 19 illness during pregnancy may turn into fatal outcome both for mother and for baby in the womb.Getting covid 19 vaccination will prevent severe outcome of covid 19. Many countries throughout the world have given emergency approval to vaccinate pregant woman with covid 19 vaccines. You should always consult with your doctor before receiving the covid 19 vaccine. Whether to vaccinate yourself will depend on your age, physical condition, underlying any additional medical conditions, any medication you are receiving etc. The immunity your body will develop after the covid 19 vaccine will depend on these above mentioned factors. So based on your clinical condition, your doctor can assess the benefits and risks of vaccination and can guide you accordingly. Stay safe and healthy.
