COVID-19 VACCINATION FOR PREGNANT WOMEN.
l INTRODUCTION
COVID-19 infection in pregnant women may result in rapid
health deterioration,
including the foetus. On the basis of the recommendations from National
Technical Advisory Group on Immunization (NTAGI), a pregnant woman will have
the choice to take the vaccination after she is given detailed
information regarding the associated risks. COVID-19 positive
pregnant women are more
likely to require intensive care as compared to their non-pregnant counterparts. With
respect to the current
situation of the SARS-CoV-2 pandemic, experts have suggested that the COVID-19
vaccine may be offered to pregnant
women if no contraindications exist. The motive is to weigh risk versus benefit on an individualized basis, such that a pregnant woman can make an informed decision.
l Preparing for COVID-19 vaccination of
pregnant women
The
preparatory steps include :-
1. Orientation and Capacity Building
Orientation of programme staff
2. Counseling pregnant women for COVID
Vaccination.
3. Vaccination of Pregnant Women.
4. Adverse Events following Vaccination/AEFI
(Obstetrician and
gynecologist, pediatrician or neonatologist are to be included in AEFI committees and
also to be sensitized on
Covid-19 vaccination of pregnant women; all the medical officers, private practitioners and
frontline health workers are
to be trained on their specific
roles in surveillance of AEFI related to Covid-19 vaccination of
pregnant women).
5. Monitoring by State Task forces (STF)
and District
Task Forces (DTF) / Urban Task Forces (UTF), as for current vaccination for COVID.
l SOME
IMPORTANT QUESTIONS :-
1. Why is COVID 19 vaccine being
recommended for pregnant women?
ü
Pregnancy
does not increase the risk to COVID-19 infection, but current evidence indicates that pregnant women are at an increased
risk for severe illness from COVID-19 compared to non-pregnant women in case
they get infected. - Additionally, pregnant women with COVID-19 are at
increased risk for preterm birth and might have an increased risk of other
adverse pregnancy outcomes including higher chances of neonatal morbidity2 -
Most pregnant women will be asymptomatic or have mild disease, BUT their health
may deteriorate rapidly and that might affect the foetal outcome. - It is
important that they take all precautions to protect themselves from acquiring
COVID-19, including taking vaccination against COVID-19. - WHO recommends
vaccination in pregnant women when the benefits of vaccination to the pregnant
woman outweigh the potential risks, such as pregnant women at high risk of
exposure to COVID-19andpregnant women with comorbidities that place them in a
high-risk group for severe COVID-19 disease. - It is therefore advised that a
pregnant woman should take COVID-19 vaccine.
2. How does COVID 19 affect the health of
the pregnant woman?
ü
Although
most (>90 percent) infected pregnant women recover without need for
hospitalization, rapid deterioration in health may occur in a few. -
Symptomatic pregnant women appear to be at increased risk of severe disease
& death. - Compared with pregnant women without COVID-19, those with
symptomatic COVID19 are at increased risk of adverse pregnancy outcomes,
including admission to the ICU, iatrogenic preterm birth, pre-eclampsia-like
symptoms, Caesarean section and death
3. How does COVID 19 infection of
pregnant women affect the baby?
ü Most (over 95 percent) of newborns of
COVID-19 positive mothers have been in good condition at birth. - However,
Covid-19 in pregnancy increases the chances of preterm birth, increasing the
possibility of hospitalization for the neonate and in some cases even death. 5.
Which pregnant women are at higher risk of developing complications after COVID 19 infection? Risk
factors for developing complications after COVID 19 infection during pregnancy are: -
Pre-existing comorbidities, advanced maternal age, and high body mass index are
risk factors for severe COVID -19 in pregnancy. Pregnant women with certain high-risk
conditions have greater risk of severe illness from COVID-19 such as
Pre-existing medical conditions e.g. Diabetes Organ transplant recipients
Chronic respiratory conditions like COPD, Asthma, Cystic Fibrosis Homozygous
sickle cell disease.
4. If a pregnant woman has already had
COVID-19, when should she be vaccinated?
ü In case a woman has been infected with
COVID-19 infection during the current pregnancy, then she should be vaccinated
soon after the delivery.
l
REFERENCES
1. https://www.mohfw.gov.in/pdf/GuidancedocCOWIN2.pdf
2. https://www.mohfw.gov.in/pdf/COVID19VaccineOG111Chapter16.pdf
3. Wei SQ, Bilodeau-Bertrand M, Liu S,
Auger N. The impact of COVID-19 on pregnancy outcomes: a systematic review and
meta-analysis. CMAJ. 2021 Apr 19;193(16):E540-E548. doi: 10.1503/cmaj.202604.
Epub 2021 Mar 19. PMID: 33741725; PMCID: PMC8084555
4. Outcomes of Neonates Born to Mothers
with Coronavirus Disease 2019 (COVID-19) – National Neonatology Forum (NNF)
India COVID-19 Registry; early online version, Indian pediatrics.
5. SAGE guidance for the development of
evidence-based vaccination-related recommendations. Geneva: World Health
Organization;2017
(https://www.who.int/immunization/sage/Guidelines_development_recommendations.pdf,
accessed 19 April 2021).
Wonderfully explained!
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