Covid-19 is a highly contagious infection caused by a mutated coronavirus called SARS-CoV-2. It causes mild respiratory disease in most. However, in some, it may cause a more severe infection of the lower respiratory tract, hyper inflammation (also called cytokine storm), and other complications.
Fortunately, vaccine producers were relatively quick to react to this new challenge. As a result, there are numerous approved vaccines now, and more than 100 vaccines are under clinical trials.
Regretfully, the vaccine industry was not ready to produce vaccines at this scale. Thus, it has struggled to meet the global demand. Hence, most countries are struggling to overcome the epidemic.
Importance of vaccinating against covid-19
Some of the vaccines have a high efficacy rate of above 90%. However, coronavirus is continually evolving, mutating. Thus, the rate of breakthrough infections has risen. Delta variant of covid-19 is now widespread. There is a risk that the new omicron variant will become common soon. (This article was originally written in early December 2021). This emergence of the latest variants only highlights the importance of getting vaccinated.
It is also vital to understand that vaccines are not just to prevent covid-19 infection. They can also reduce the severity of the illness even if vaccines fail to provide complete safety. It means that even if a person gets infected after the vaccine, one is less likely to have a severe infection.
What do guidelines say about covid-19 vaccinations and pregnancy
There are multiple reasons why pregnant women often avoid covid-19 or even other vaccines. Generally, infections like covid-19 have a much lower mortality rate in young adults than older adults. It means that pregnant women are less prone to severe covid-19 infection.
Further, there are lots of worries regarding the side effects of vaccines like miscarriage, fetal abnormalities, and so on. However, there is no significant reason for these worries. There is no data indicating that covid-19 vaccines can increase the risk of any complications.
It is true that some vaccines, like those for measles or mumps, are contraindicated in pregnancy. However, there are no such contradictions for covid-19 vaccines. Thus, most experts agree that the benefits of the covid-19 vaccine outweigh any conceivable risks.
There are numerous reasons why researchers believe that pregnant women should get vaccinated. It is vital to understand that these modern vaccines are created differently from older vaccines that often contain inactivated pathogens. Instead, current vaccines produce antibodies targeting only a small part of viral antigen. These antibodies produced in response to vaccines are highly specific and are less likely to cause unforeseeable immune reactions.
At present, WHO guidelines say that women at high risk of exposure to covid-19 should get vaccinated. However, the CDC, the American College of Obstetricians and Gynaecologists, and the Society for Maternal-Fetal Medicine support the broader use of vaccines. It is because there is already some information from clinical studies regarding the safety of these vaccines in pregnant women.
How safe are covid-19 vaccines in pregnancy, and what is the evidence?
It is true that vaccines are never tested in pregnant ladies due to ethical reasons. Thus, there is always a lack of data in the initial stages. So, the question may arise: how could researchers know about the safety of the covid-19 vaccine?
Well, the reason is simple. Numerous women are working in an environment where they are at extremely high risk of exposure to the pathogen. Just take an example of healthcare workers in the US or EU. It is dominated by females. Furthermore, many of these healthcare workers are young women. CDC estimates that around 300 000 healthcare workers could be pregnant at the time of vaccination implementation. Thus, many pregnant women decided to move forward with vaccination.
Healthcare workers are not alone. Millions of women are working at places where they are at high risk of exposure to the virus, like those working in supermarkets and other businesses.
It means that there are already many pregnant women who got vaccinated while being pregnant. It also means that there is an existing way of studying the risk of vaccination. And, early data is quite encouraging. Early data from studies did not show any risk associated with vaccination in pregnancy.
Just take an example of a study done in Norway. Researchers compared the prevalence of miscarriage among vaccinated and non-vaccinated women. Vaccinated women were those who primarily got Moderna, AstraZeneca, or Pfizer jab. The study found that there was no difference between the two groups. Thus, vaccination does not increase the risk of miscarriage.
However, vaccination reduces the risk of catching covid-19 infection, thus making pregnancy safer.
Similarly, researchers in the UK studied 140 vaccinated and pregnant women (they got vaccinated during pregnancy) and compared their pregnancy outcomes with 1328 unvaccinated women. Again, vaccinated women were of different ethnicities. They did not find any increased risk of stillbirth, fetal abnormalities, or small gestational age in those vaccinated. Thus, the study concluded that covid-19 vaccines are safe in pregnancy.
Early evidence does not show any considerable risk associated with covid-19 vaccines in pregnancy. However, the benefits clearly outnumber any potential risks. Those vaccinated are considerably less likely to have a covid-19 infection. Even if they catch an infection, it would be much less severe and not pose any threat to the pregnancy.
To conclude, the early data from studies are emerging, confirming that covid-19 vaccines are highly safe for pregnant women. Furthermore, they do not pose any threat to the pregnancy. In contrast, they provide much-needed protection from infection. Thus, most professional medical associations are now recommending covid-19 vaccine in pregnancy.
Author: Dr Preet Pal S.B.
Dr. Preet Pal S.B. is a physician (M.D. Medicine) specialising in diabetes (Fellowship in Diabetes). He is especially interested in metabolic disorders, neurodegenerative disorders, maternal and child health. Dr. Preet Pal S.B. is a lifetime member of the Indian Medical Association.
In addition, he has extensive experience working in medical research in the pharmaceutical and biotech industry, which has provided him with a greater insight into what works in healthcare. It also gives him the ability to understand the quality of evidence in healthcare better.
Dr. Preet Pal S.B.is also a prolific writer and loves sharing his knowledge and experiences.