Vaccines for pregnant women - Issues and concerns

The story: India's vaccination story began in January 2021, and despite all the hiccups, is progressing to the eventual goal of vaccinating all adults

Vaccines for pregnant women - Issues and concerns

---

• The story: India's vaccination story began in January 2021, and despite all the hiccups, is progressing to the eventual goal of vaccinating all adults. Now, pregnant women are eligible for vaccination against Covid-19.
• What guidelines say: The Health Ministry announced that pregnant women were eligible for Covid-19 vaccination, at any time of the pregnancy. Guidelines were released detailing the risks, the benefits, and likely side effects of vaccination.

1. Experts are of the view that the benefits of vaccination for pregnant women outweigh the potential risks.
2. Four reasons: (i) Current evidence indicates that pregnant women are at an increased risk of severe illness from Covid-19 compared to non-pregnant women in case they get infected. (ii) Pregnant women with Covid-19 are at higher risk for preterm birth and may have a higher risk of other adverse pregnancy outcomes, including neonatal morbidity. (iii) While most pregnant women will be asymptomatic or have mild disease, their health “may deteriorate rapidly and that might affect the foetal outcome”. (iv) The World Health Organization recommendation for vaccination in pregnant women is when the benefits outweigh the potential risks for groups “… such as pregnant women at high risk of exposure to Covid-19 and pregnant women with co-morbidities that place them in a high-risk group for severe Covid-19 disease”.

• Side effects: The Ministry underlined that Covid-19 vaccines available were safe and protect pregnant women like other individuals. The pregnant person or foetus is likely to remain unaffected. But the long-term adverse effects and safety of the vaccines for foetus and child are not established yet. Like any medicine, a vaccine may have side effects that are normally mild: mild fever, pain at injection site, or feeling unwell for 1-3 days, the guidelines say. Experts remind that a rare adverse reaction (one in 1-5 lakh) within 20 days after vaccination may happen.
• What kind of adverse reaction: The Ministry listed symptoms requiring immediate medical attention:

1. Shortness of breath
2. Chest pain
3. Pain on pressing the limbs or swelling in the limbs
4. Small pinpoint haemorrhages or bruising of the skin beyond the vaccination site
5. Persistent abdominal pain with or without vomiting
6. Seizures in the absence of previous history of seizures, with or without vomiting
7. Weakness/paralysis of limbs or any particular side of the body
8. Persistent vomiting
9. Blurred vision or pain in eyes.

• Who must avoid it: The contraindications for pregnant women are similar to those for the general population: (i) Allergic reaction to a previous dose, and (ii) Allergic reaction to vaccines or injectable therapies, pharmaceutical products, food items.
• Prior Covid cases: The Ministry recommends that such women defer vaccination for 12 weeks from infection or 4 to 8 weeks from recovery. Those who were treated with monoclonal antibodies or convalescent plasma, or have active Covid-19 infection, should also temporarily avoid vaccination. The guidelines state that the pregnancy status of women should be recorded into the adverse events following immunization (AEFI) notification form while reporting AEFI cases. All adverse events should be reported immediately to CoWIN, and all serious and severe SEFIs to the concerned Medical Officer.
• Covid-19 and foetuses: Although most infected pregnant women (>90%) recover without the need for hospitalisation, “rapid deterioration in health may occur in a few”. Compared with pregnant women without Covid-19, those with symptomatic Covid-19 are at increased risk of adverse pregnancy outcomes, including admission to the ICU, iatrogenic preterm birth, etc. Most newborns (95%) of Covid-positive mothers have been in good condition at birth. Certain categories and conditions such as diabetes, organ transplant recipients, chronic respiratory conditions, those receiving immunosuppression therapies, dialysis and congenital or acquired heart disease, too, put pregnant women at a greater risk of severe illness from Covid-19.

Join PT courses | PT Youtube | PT App | Contribute |  Testimonials