Covid vaccine in pregnancy, yes from the experts

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Catherine Le Nevez
@catherinelenevez
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Contents

  • 1 Coronavirus and pregnancy: 3 things to know
  • 2 Covid vaccine in pregnancy and lactation: the companies in favor 
  • 3 Covid vaccine in pregnancy: available studies 
  • 4 Covid vaccine during pregnancy and breastfeeding: why do it
  • 5 Covid vaccine and other vaccinations in pregnancy 
  • 6 Covid vaccine in pregnancy: information for women
  • 7 What if you don't want to get vaccinated?

The Coronavirus vaccine arrived in Del Paese at the end of a very heavy year in terms of infections and victims. The hopes placed in the vials that contain it are many: the desire to return to normal is strong in each of us. The debate on this vaccination fills the pages of newspapers and websites around the world. A very important issue concerns the administration of the Covid vaccine in pregnancy and lactation. Can it be done or is it better to avoid? On Monday, the position of the most important scientific societies in the gynecological and pediatric field arrived: there are no contraindications for either pregnant or breastfeeding women, but they must still be fully informed to make a reasoned choice. 



Coronavirus and pregnancy: 3 things to know

  1. Pregnant women have a similar risk to the general population of contracting SARS-CoV-2 infection, more commonly known as Coronavirus or Covid 19.
  1. Most pregnant women who get sick experience mild to moderate symptoms. The hospitalization in intensive care was necessary in about 3% of cases and, currently, no deaths of expectant mothers have been recorded. However, there were 4 stillbirths out of 538 fetuses and no neonatal deaths (data from the Istituto Superiore di Sanità updated to January 2, 2022).
  1. Maternal risks increase if there are other factors: maternal age equal to or greater than 35 years, the type of work activity (for example in health or social care), co-morbidities (presence of diseases) such as asthma, obesity, diabetes, hypertension , belonging to black ethnicity or other ethnic minorities. 

Covid vaccine in pregnancy and breastfeeding: the companies in favor 

Based on what is currently known about the Covid vaccine, the Scientific Societies of Gynecologists have created an "interim position paper", ie a document in which they say their position on this "hot" topic. The document, drawn up on the basis of the data offered by the international scientific literature and by the latest report of the Istituto Superiore di Sanità on obstetric surveillance (IToSS), takes stock of current knowledge and gives guidelines both to pregnant women and to operators sanitary. 



The scientific societies that have drawn up and shared the interim position paper on anti Covid 19 vaccination and pregnancy are: 

  • SIGO - Del Paesena Society of Gynecology and Obstetrics.
  • AOGOI - Hospital Obstetricians Gynecologists Association. 
  • AGUI - Association of University Gynecologists of the Paeseni. 
  • AGITE - Association of Territorial Gynecologists. 
  • SIN - Del Paesena Society of Neonatology. 
  • SIP - Del Paesena Society of Pediatrics. 
  • SIMP - Society of Perinatal Medicine. 
  • SIERR - Society of the Paesena of Embryology, Reproduction and Research. 
  • FNOPO - National Federation of the Orders of the Midwife Profession.

Covid vaccine in pregnancy: available studies 

The spread of the pandemic in a very short time has entailed an enormous effort (in terms of research and money) worldwide to arrive at a vaccine as soon as possible. Obviously, no steps were skipped and all the experimental phases were respected. However, the experts highlight that the available data derive from studies on animal models and there are still no data on safety and efficacy in pregnant and lactating women. The hope of the scientific societies is that these categories will also be included in the next experiments which certainly will take place.

Covid vaccine during pregnancy and breastfeeding: why do it

The fact that there is no certainty about administration during pregnancy and breastfeeding could be a little alarming for future and new mothers. Still, the experts reassure. The Covid vaccine is one with mRNA. In simple terms, this vaccine does not contain live viruses, unlike, for example, that against rubella or measles which are absolutely contraindicated during pregnancy. Furthermore, the mRNA particles are rapidly degraded. These two characteristics would therefore make the vaccine harmless when expecting a baby or when breastfeeding. 



According to the position paper, pregnant women "who do not have a recent history of Covid 19 infection and who have specific additional risk factors, may favorably consider receiving the vaccine." You can undergo the vaccine in the first trimester of pregnancy, in the second trimester and also to the third. The same indication also applies to mothers who are breastfeeding. 

Even those who have already fallen ill with Coronavirus can receive the vaccine. "Since the evidence indicates that reinfection is highly unlikely in the 90 days following the onset of infection, it is suggested that vaccination be deferred until the end of this period," the experts say. You must also consider that there is a precise vaccination schedule in our country: the priority is for health workers and the elderly. Then there will be all the others, including those who have had the virus. 

Covid vaccine and other vaccinations in pregnancy 

We have already had occasion to say that the vaccines strongly recommended in pregnancy are two: the anti-flu and the one against whooping cough. The first protects against the classic seasonal flu which, in a pregnant woman, can be more "tough" and cause complications. The second, on the other hand, allows antibodies against pertussis to be passed to the fetus through the placenta to protect the newborn until its first vaccine (at 2 months). 

If you plan to carry out these vaccinations (the flu shot at any gestational period, the other from the 28th week of pregnancy) and also against Covid, there are no particular contraindications. As a precaution, in the absence of scientific data, it is recommended to maintain an interval of at least 14 days between vaccines. 


Covid vaccine in pregnancy: information for women

The choice of the pregnant or nursing woman on the vaccine must be free and aware. It is therefore essential to seek advice from your trusted doctor who must be able to provide all the information necessary to get an idea and decide peacefully. Among the aspects to underline are: 


  • the level of circulation of the virus in one's community; 
  • the potential risks of the vaccine; 
  • the risks associated with Covid 19 infection in pregnancy, both for maternal and fetal health;
  • The fact that vaccines currently approved by the FDA have not been tested on pregnant women, and therefore there is no data regarding their safety in pregnancy. 
  • the fact that elements such as maternal age equal to or greater than 35 years, previous comorbidities such as asthma, obesity, diabetes, hypertension, and belonging to black or other ethnic minorities, represent an additional risk of developing severe maternal morbidity with possible repercussions also on fetus / neonatal outcomes;
  • professional employment as a health worker or caregiver in contexts where exposure to the virus is high represents a further element of additional risk to be considered in deciding whether or not to vaccinate during pregnancy and breastfeeding. 

What if you don't want to get vaccinated?

The Covid 19 vaccine is voluntary. That is, only those who wish to submit it because (at least for now) there is no obligation. Those who decide not to receive it must continue to take all necessary precautions such as the use of personal protective equipment (ie the mask), physical distancing and frequent hand washing. 

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