Breakdown: Is The COVID-19 Vaccine For Pregnant Women Safe Or Not?

Breakdown: Is The COVID-19 Vaccine For Pregnant Women Safe Or Not?
Breakdown: Is The COVID-19 Vaccine For Pregnant Women Safe Or Not?

Video: Breakdown: Is The COVID-19 Vaccine For Pregnant Women Safe Or Not?

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Video: COVID-19: Vaccines are safe for reproductive health | COVID-19 Special 2023, February
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COVID-19 vaccines are likely safe during pregnancy. Or not? When will we know for sure? In Russia, vaccinations against coronavirus have not yet been given to pregnant women, but in the United States they have already begun. America's leading national experts advise expectant mothers to be vaccinated with Pfizer and Moderna vaccines, because pregnancy automatically puts a woman at risk. MedAboutMe figured out what is known at the moment and whether it is worthwhile for pregnant women and those planning to think about vaccinations.

Why is there no consensus?

There are many opinions about the safety and rationality of vaccines against COVID-19, and there are even more vaccine options.

In the United States, it is believed that women should be able to decide for themselves whether they want to be vaccinated against the coronavirus. The US health agencies and medical organizations fully agree with this. And in the first couple of months after the vaccine appeared, many pregnant health workers were already vaccinated - at all gestation periods. Israel has also recently added high-risk pregnant women to its list of priority patients. But other countries, such as the UK and Russia, and with them the World Health Organization, say such advice should wait.

Why did the disagreement arise? Clinical trials of new COVID-19 vaccines have clearly ruled out pregnant women, and we do not yet have enough follow-up data to say for sure that vaccines are safe during pregnancy. Therefore, some governments and WHO are taking particular caution about permitting a vaccine for all pregnant women.

Expert commentary David Bode, Head of the Department of Obstetrics at Le Center Hospitalier Universitaire vaudois, Switzerland

US experts and many national medical groups argue that the vaccine should be offered to pregnant women in large part because there is strong evidence that gestation increases the risk of severe Covid-19 and death. Given these findings, the American Society for Reproductive Medicine goes so far as to declare the vaccine is "recommended" for women who are pregnant or planning to become pregnant. And perhaps this is reasonable.

If a patient becomes infected during pregnancy, her risk of being admitted to intensive care is about 5 percent. I do not know of a single illness that would put a 30-year-old woman at such a high risk of being admitted to an intensive care unit. In addition, if the infection occurs late in pregnancy, it also increases the risk of premature birth and the need for intensive care for the baby.

Today, there are good reasons to believe that vaccines are safe, exclude the likelihood of serious adverse events during pregnancy. There are valid animal studies and a good understanding of how vaccines work in the body. The data we collect about this is not alarming.

But we do not yet have data to support such words. Add to that the constant misinformation swirling around the COVID-19 vaccine, pregnancy and fertility. Unsurprisingly, many are confused or worried. And most organizations still do not advise all pregnant women to be vaccinated. These include the Russian Ministry of Health.

These information gaps should soon begin to fill. Numerous studies are planned or already started by vaccine manufacturers and research teams.

4 reasons "for" vaccination and explanations "against"

One of the main reasons why, despite the known risks of COVID-19 to pregnancy, not everyone recommends vaccination unequivocally is that the mode of action of RNA vector vaccines against coronavirus is quite new. We have no other approved vaccines made in this way. But now we have several key pieces of information.

These vaccines do not contain live viruses. The only vaccines that are contraindicated in pregnancy contain an attenuated live virus, such as the chickenpox (chickenpox) vaccine. Although these types of vaccines pose no danger to most people, there is a small chance that they can cross the placenta and infect the fetus. However, COVID-19 vaccines only contain fragments of genetic material called RNA and cannot provoke an infection. Coronavirus vaccines are very fragile. Once the mRNA enters the body, it likely only reaches the local muscle cells of the arm before the body destroys it. This means that it is very unlikely that it will reach the bloodstream, and even less likely that it will reach the placenta. Even if it goes this far, one of the main functions of the placenta is to be an immune barrier to the fetus, which adds another layer of protection. Although vaccines contain genetic material, it does not penetrate the nuclei of our cells, which means that it does not cause any mutations in the cells of the developing fetus.

Experts also expect that mRNA is unlikely to pass into breast milk unchanged. And even if a small amount of it is passed on to a nursing baby, they think it will be broken down by the acids in their stomach.

In addition, from March it will already be possible to inoculate with the peptide vaccine "EpiVacCorona". It contains no genetic material: the principle of action of this variant is different.

Animal studies are already underway and the results look promising. Before vaccinating pregnant people, vaccine companies collected safety data from other pregnant mammals. None of these RNA vaccine development and reproductive toxicity studies identified any safety concerns when used during pregnancy.

Rats are certainly not humans, and toxicity study results are not always equally transmitted to humans. Some of the results are similar to those of humans, and some are very different. However, they are a good starting point.

In the Pfizer and Modern vaccine trials, women of reproductive age were tested for pregnancy before each vaccination, and patients who tested positive were excluded from the studies. However, several people (12 Pfizer / BioNTech and six people who received the Moderna vaccine) became pregnant at the time of vaccination. The companies did not report any negative results in these women, although they too are still waiting for babies. The US Centers for Disease Control and Prevention also monitors pregnant women who conceive after vaccination. To be vaccinated or not?

On the one hand, there is a massive anti-vaccine movement that aggravates the situation and tends to blame vaccines for all the troubles. To the extent that Internet trolls attack women reporting COVID-19 vaccinations during pregnancy or even after a miscarriage - like Michelle Rockwell's doctor. She lost her baby, and a month after the miscarriage was vaccinated - which caused a flurry of completely illogical accusations against the vaccine manufacturers.

On the other hand, expectant mothers in the early stages have the opportunity to get vaccinated without informing doctors about their condition - at their own peril and risk. Should I do this?

There is no scientific reason to believe that pregnant women will have more adverse reactions to the vaccine or that the vaccine will put the baby at risk. At the same time, the risks of COVID-19 for pregnant women are quite high.

Fact!

A January study published in JAM Internal Medicine analyzed the results of more than 406,000 women giving birth between April and November 2020 and found higher rates of preterm birth, preeclampsia, thrombotic events (blood clotting disorders) and death in women in labor with coronavirus …

So why are experts saying that pregnant women should not get the coronavirus vaccine yet? They are waiting for additional data. With the US pregnancy vaccination campaign launched, scientists expect more data on the safety of vector vaccines. But peptide vaccines are becoming especially promising in this respect - those with the mechanism of action of which we are especially familiar.

In addition to protecting the mother during pregnancy, the researchers talk about an added bonus: the transfer of antibodies to the baby. A new study at JAM found that most women who were infected with the coronavirus during childbirth passed antibodies across the placenta, potentially helping to protect newborns. But we need data on whether the antibodies are passed on to the child after vaccination. We are waiting for the same information about the vaccination of nursing mothers and the protection of the baby's immune system. So you have to wait.

The first independent research data are planned to be received this year. Vaccine manufacturers will probably need more time: if they start recruiting volunteers now, as the largest companies plan, then the results will be clear in early 2022, and possibly even later.

Important!

Leila Adamyan, a specialist in obstetrics and gynecology at the Ministry of Health of the Russian Federation, recommends getting vaccinated against coronavirus for everyone who is preparing for pregnancy, planning conception, IVF or being treated for infertility.

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