The COVID-19 Pandemic has brought significant concerns for pregnant women, as they are at a higher risk of severe illness and complications from the virus. Discussing COVID-19 vaccination during pregnancy is crucial to ensure the best possible outcomes for both the mother and the developing foetus.
This blog aims to provide a comprehensive overview of the risks, vaccines, and considerations for pregnant women.
COVID-19 Risks for Pregnant Women
COVID-19 infection during pregnancy has been found to present a higher risk to both the mother (for hospitalisation, ICU admission, requiring ventilation) and the baby (premature birth, stillbirth, care in neonatal unit).
Vaccination is the best way to reduce these risks, and global surveillance data from large numbers of pregnant women have not identified any significant safety concerns with mRNA COVID-19 vaccines given at any stage of pregnancy.
COVID-19 Vaccines and Pregnancy
Two mRNA vaccines, Comirnaty (Pfizer) and Spikevax (Moderna) are available for pregnant women. Global surveillance data from large numbers of pregnant women have not identified any significant safety concerns with these vaccines at any pregnancy stage. Limited evidence exists regarding the efficacy of newer variant vaccines during pregnancy, yet safety concerns do not surpass those of the original vaccines. However, there is currently less data concerning the Novavax vaccine's use in pregnancy.
The Australian Technical Advisory Group on Immunisation (ATAGI) recommends that pregnant women be routinely offered either of these vaccines at any stage of pregnancy.
Vaccine Considerations for Pregnant Women
When considering COVID-19 vaccination during pregnancy, there are several important factors to take into account. Pregnant women should discuss their individual circumstances, potential benefits and risks, and any concerns with their healthcare provider to make an informed decision.
Timing of Vaccination During Pregnancy
Pregnant women can receive either Comirnaty or Spikevax at any stage of pregnancy. It is recommended that they discuss the best timing for the vaccine with a healthcare provider, considering individual circumstances and the potential benefits and risks of vaccination.
Discussing Concerns with Healthcare Providers
It is crucial that pregnant women or those planning a pregnancy should discuss any concerns or questions with a healthcare provider. They can help weigh the benefits and risks of vaccination and provide personalised guidance.
Some common concerns pregnant women may have include:
- Safety of the vaccine for the mother and baby
- Potential side effects of the vaccine
- Effectiveness of the vaccine during pregnancy
- Timing of vaccination in relation to other prenatal care
Healthcare providers can address these concerns and provide evidence-based information to help pregnant women make informed decisions.
Weighing the Benefits and Risks of the Vaccine, COVID-19 and Pregnancy
Vaccination is the best way to reduce the risk of adverse pregnancy outcomes associated with COVID-19 infection during pregnancy. While some temporary side effects may occur, the benefits of vaccination far outweigh the increased risk of contracting the virus.
Benefits of vaccination during pregnancy include:
- Reduced risk of severe COVID-19 illness for the mother
- Reduced risk of hospitalisation and intensive care admission
- Reduced risk of complications for the baby, such as preterm birth and stillbirth
- Potential passive immunity for the baby through antibodies in breast milk.
Risks of vaccination during pregnancy are minimal, with no significant safety concerns identified in large-scale surveillance data. Read more:
Pregnancy and COVID-19 Prevention
Protecting pregnant women from COVID-19 infection is crucial, as they are at higher risk of severe illness and complications compared to non-pregnant individuals. While vaccination is the most effective way to reduce these risks, combining it with other preventive measures for maximum protection against severe disease is important.
Importance of Preventive Measures
In addition to vaccination, pregnant women should continue to practise preventive measures such as social distancing, mask-wearing, and good hygiene to minimise the risk of infection.
Vaccination as an Additional Layer of Protection
While preventive measures are crucial, vaccination provides an additional and highly effective layer of protection against COVID-19, especially during pregnancy when the risks are higher. The combination of vaccination and preventive measures offers the best possible protection for pregnant women and their babies.
COVID-19 Vaccination and Breastfeeding
Breastfeeding mothers can safely receive COVID-19 vaccines, providing an additional layer of protection for both themselves and their infants. The mRNA vaccines Comirnaty and Spikevax are recommended for breastfeeding women, as they have been found to be safe and effective. The mRNA contained in Comirnaty and Spikevax vaccines undergoes rapid degradation within the body and is not believed to transfer into breastmilk.
Safety of Vaccination for Breastfeeding Mothers
Both Comirnaty and Spikevax are safe for breastfeeding mothers. Vaccination does not affect fertility, and getting vaccinated before conceiving means you will have some immunity against COVID-19 throughout your pregnancy.
- No significant safety concerns have been identified in breastfeeding mothers who receive COVID-19 vaccines
- Vaccination does not impact the quality or supply of breast milk
- There is no need to delay or discontinue breastfeeding before or after vaccination.
Potential Benefits for the Baby Through Antibodies in Breast Milk
Breast milk contains antibodies that may offer protection to infants through passive immunity, providing an additional layer of protection against COVID-19.
- Antibodies developed by the mother after vaccination can pass through breast milk to the baby
- These antibodies may help protect the baby from COVID-19 infection
- Breastfeeding after vaccination is a safe way to provide passive immunity to infants who are too young to receive the vaccine directly.
COVID-19 Vaccination and Future Pregnancy
Planning for Pregnancy After Vaccination
If you are planning a future pregnancy, it is essential to discuss your vaccination history with your healthcare provider. They can help you understand how your vaccination status may impact your pregnancy.
- COVID-19 vaccination does not affect fertility or the ability to conceive
- Vaccination before pregnancy can provide protection against COVID-19 during the early stages of pregnancy
- Healthcare providers can offer guidance on the optimal timing of vaccination in relation to pregnancy planning.
Addressing Concerns about Fertility and Vaccination
There is no evidence that any vaccine, including mRNA vaccines, affects fertility. Getting vaccinated before conceiving means you will have some immunity against COVID-19 throughout your pregnancy.
Healthcare Workers’ Experiences With COVID-19 Vaccination During Pregnancy
Healthcare workers have reported positive experiences among their clients with COVID-19 vaccination during pregnancy, with no significant safety concerns identified.
Ongoing Studies and Trials on COVID-19 Vaccination in Pregnant Women
Ongoing studies and trials are continuously monitoring the safety and efficacy of COVID-19 vaccines in pregnant women, ensuring that the best possible guidance is available.
Frequently Asked Questions
Addressing common concerns and misconceptions about COVID-19 vaccination during pregnancy is crucial. Here are some evidence-based answers to frequently asked questions:
Q: Are COVID-19 vaccines safe for pregnant women?
A: Yes, mRNA vaccines have been found to be safe for pregnant women, with no significant safety concerns identified.
Q: Will vaccination affect my fertility?
A: No, there is no evidence that any vaccine, including mRNA vaccines, affects fertility.
Q: Can the COVID-19 vaccine affect your pregnancy?
A: No, there is no evidence that COVID-19 vaccines have any effect on pregnancy. The vaccines have been found to be safe for pregnant women and their babies.
Q: Does pregnancy protect against COVID?
A: No, pregnancy does not protect against COVID-19 infection. Pregnant women are just as likely to contract the virus as non-pregnant women.
Q: How can COVID-19 affect pregnancy?
A: COVID-19 infection during pregnancy can increase the risk of severe illness, ICU admission, preterm birth, stillbirth, and other complications for both the mother and baby.
Q: How do you protect pregnant women from COVID-19?
A: The best ways to protect pregnant women from COVID-19 are vaccination, mask-wearing, social distancing, good hygiene, and avoiding exposure to sick individuals.
Q: Is pregnancy a high risk for coronavirus disease?
A: Yes, pregnancy increases the risk of severe illness from COVID-19. Pregnant women are more likely to experience severe symptoms, require hospitalisation, and need intensive care compared to non-pregnant women.
Q: What happens if you're pregnant and get COVID-19?
A: If you contract COVID-19 while pregnant, you may experience mild to severe symptoms, depending on your individual health status and risk factors. Pregnant women with COVID-19 are at higher risk of severe illness, ICU admission, preterm birth, and other complications compared to non-pregnant women.
Q: What are the WHO guidelines for pregnancy during COVID-19?
A: The World Health Organisation (WHO) recommends that pregnant women receive the COVID-19 vaccine, as the benefits of vaccination outweigh the potential risks. They also advise pregnant women to continue practising preventive measures such as mask-wearing, social distancing, and good hygiene to minimise the risk of infection.
Q: How many doses of vaccine should I have during pregnancy or while breastfeeding?
The recommended regimen involves receiving two doses of the COVID-19 vaccine, referred to as the primary course. While the standard interval between these doses is 8 weeks, it may be shortened to 3 or 4 weeks, depending on the brand, for individuals who are immunocompromised, at high risk, or during an outbreak.
Individuals with severe immunocompromise are advised to get a third primary dose of the COVID-19 vaccine 8 weeks after their second dose. The guidelines for administering a third primary dose to individuals with severe immunocompromise are identical for both pregnant and non-pregnant women (refer to COVID-19 vaccine doses and administration for further details).
Conclusion
COVID-19 vaccination during pregnancy is crucial for reducing the risks associated with infection. By understanding the risks, vaccines, and considerations, pregnant women can make informed decisions about their health.
It is essential that women who are pregnant or planning a pregnancy discuss their vaccine concerns with healthcare providers and weigh the benefits and risks of vaccination. With the available evidence and expert recommendations, vaccination is the best way to protect both the mother and the developing foetus.
Consult a Healthcare Provider
For personalised guidance and to discuss your specific situation, consult a healthcare provider. They can help you make an informed decision about COVID-19 vaccination during pregnancy.
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References
[1] Travelvax. (2024). COVID-19 Vaccination During Pregnancy. Retrieved from https://www.travelvax.com.au/holiday-traveller/vaccinations/COVID-19
[2] Australian Government. (2024). COVID-19 Vaccination – Shared Decision Making Guide for Women Who Are Pregnant, Breastfeeding or Planning Pregnancy. Retrieved from https://www.health.gov.au/sites/default/files/2024-01/covid-19-vaccination-shared-decision-making-guide-for-women-who-are-pregnant-breastfeeding-or-planning-pregnancy.pdf
[3] Royal College of Obstetricians and Gynaecologists. (2023). COVID-19 Vaccines, Pregnancy and Breastfeeding FAQs. Retrieved from https://www.rcog.org.uk/guidance/coronavirus-covid-19-pregnancy-and-women-s-health/vaccination/covid-19-vaccines-pregnancy-and-breastfeeding-faqs/
[4] Centers for Disease Control and Prevention. (n.d.). Pregnancy Guidelines and Recommendations by Vaccine. Retrieved from https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/guidelines.html
[5] Australian Immunisation Handbook – retrieved from COVID-19 vaccine doses and administration
[6] Morgan JA, Biggio JR Jr, Martin JK, Mussarat N, Chawla HK, Puri P, Williams FB. Maternal Outcomes After Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Vaccinated Compared With Unvaccinated Pregnant Patients. Obstet Gynecol. 2022 Jan 1;139(1):107-109. doi: 10.1097/AOG.0000000000004621. PMID: 34644272.
Disclaimer: This content is for educational purposes only and should not be considered as personalised medical advice. For specific guidance on COVID-19 vaccination during pregnancy, please consult a healthcare professional. The content is based on current evidence and may change as new information becomes available.
