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We do not yet have data from clinical trials on the safety of vaccination against COVID-19 in pregnant women, but we also do not have data that it should be contraindicated in pregnant women. Therefore, these vaccinations should not be denied to them, believes Jacek Tulimowski, MD, PhD, obstetrician and gynecologist.
- Jacek Tulimowski, MD, PhD: in favor of vaccination against COVID-19 in pregnant women is the fact that those who become ill may be more at risk of a severe course of this disease
- The doctor adds, however, that the decision to vaccinate each woman is an individual matter
- Clinical trials on the safety of vaccination against COVID-19 in pregnant women are still underway, but, as Dr. Tulimowski points out, nothing disturbing has been observed in them.
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The specialist spoke about this during the online conference “Women’s health during the COVID-19 pandemic” organized by the Fundacja im. Maciej Hilgier. He stressed that vaccination against the SARS-CoV-2 coronavirus in pregnant women is an individual decision. Such a decision requires weighing up all the benefits and possible risks. He referred to the opinion of the Center for Disease Control (CDC) in Atlanta, the American College of Obstetricians and Gynecologists (ACOG) and the Polish Society for Reproductive Medicine and Embryology.
Pregnant women more at risk of severe COVID-19
Dr. Jacek Tulimowski, MD, PhD is the editor-in-chief of the “Nowy Gynecological Gynecological Office” magazine. She points out that the arguments in favor of immunizing pregnant women against COVID-19 are that those who become ill may be at greater risk of suffering from the severe course of the disease. They more often require hospitalization in the intensive care unit and undergo mechanical respiratory support, including the use of ECMO (extracorporeal blood oxidation).
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According to the American College of Obstetricians and Gynecologists, vaccination against COVID-19 should not be specifically denied to pregnant women in priority vaccination groups. The opinion of the Joint Committee on Vaccination and Immunisation (JCVI) is similar.
These are mainly pregnant women who are medical, social or social workers, as they are more likely to be infected with the coronavirus. This group also includes those who suffer from comorbidities that make COVID-19 more severe. These are mainly chronic respiratory diseases (eg Chronic Obstructive Pulmonary Disease), cystic fibrosis, severe asthma, chronic cardiovascular disease, as well as diabetes, liver disease and epilepsy.
Vaccines for pregnant women: research is ongoing
There are no data from clinical trials on the safety of vaccination against COVID-19 in pregnant women yet. Such research is still being conducted. So far, the results of preclinical animal tests on developmental and reproductive toxicity are known. “In these studies, nothing disturbing was observed in terms of reproduction, fetal development and postnatal development of the offspring” – noted Dr. Jacek Tulimowski.
- Pregnant women suffer from COVID-19 more often than the rest of the population. Even by 70 percent.
In his opinion, pregnant women should therefore be able to decide whether to vaccinate. To facilitate this, they should be informed of the latest data on vaccine safety and efficacy. According to JCVI, there is no known risk of giving pregnant women “non-live” vaccines during pregnancy, and such vaccines are currently available against COVID-19. The Committee is not recommending only routine vaccinations.
The specialist also refers to the opinion of the Polish Society of Reproductive Medicine and Embryology, which indicates that there are no data on the impact of vaccination on eggs, sperm, embryo implantation or in the early stages of pregnancy. It only makes sense to postpone assisted reproductive techniques.
What happens if a woman becomes pregnant after the first dose of the vaccine?
Dr. Jacek Tulimowski suggests that in women of childbearing age, it is not necessary to undergo a pregnancy test before receiving the COVID-19 vaccine. “If a woman becomes pregnant after receiving the first dose of the vaccine, then the second dose should be administered according to the manufacturer’s requirements,” he adds. This may be relevant for a preparation such as AstraZeneca, where a second dose should be given 12 weeks later.
The specialist emphasizes that, at least for the time being, there are no preferences regarding the choice of the preparation in pregnant women. Only due to the registration requirements of these vaccines, in the case of women aged 16-17 years, the Pfizer / BioNTech preparation should be selected. He also admits that pregnant women, as well as others, may experience side effects such as injection site reaction, muscle pain, joint pain, chills and headache, and fatigue. In case of fever, paracetamol is recommended.
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Both doses should be administered with the same vaccine. The interval between vaccination against COVID-19 and other vaccines, e.g. against diphtheria, tetanus or pertussis, should be at least two weeks (to minimize the risk of overlapping possible vaccination reactions).
In his opinion, vaccination should be offered to lactating women, on the same basis as to people with priority for vaccination due to the greater risk of COVID-19 disease. He cites the opinion of the US Centers for Disease Control (CDC), which indicates that nursing women are in the priority group of these vaccinations. Also in these women there is no evidence of a risk from the use of “non-live” vaccines during breastfeeding.
The specialist reminded that in the UK, apart from clinical trials, urgent work is being carried out on a registry that will collect data on vaccination against COVID-19 among pregnant women. Recently published preliminary observations in Israel and the USA show that antibodies generated in the body of women vaccinated with the Pfizer or Moderna mRNA preparation cross the placenta into the body of the fetus. A breastfeeding mother passes them on to her baby also after birth. “It is a prophylactic effect for both mother and child” – emphasizes Dr. Jacek Tulimowski.
Author: Zbigniew Wojtasiński
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