Pregnant women should weigh the risks and benefits of COVID-19 vaccines
Little research is available on the effects of vaccines on expecting mothers and their unborn babies
But it ’ s not new for pregnant women to be excluded from vaccine trials , or many other drug trials for that matter .
Pregnant women have been excluded from almost all of the clinical trials for the COVID-19 vaccines currently in use , leaving medical professionals uncertain whether these vaccines are fully safe and effective for them .
But it ’ s not new for pregnant women to be excluded from vaccine trials , or many other drug trials for that matter . One of the main reasons is that certain medications can cross through the placenta , making the foetus more vulnerable to drugs that have been designed for adults .
In addition , including pregnant women in trials can drive up the costs of complex and large-scale study programmes , while offspring also need to be monitored , potentially pushing up the costs of insurance . In addition , pharma companies worry about possible litigation .
Despite these concerns , medical authorities have long endorsed the inclusion of pregnant women in vaccine studies , with support coming from such august bodies as the US National Institutes of Health and the overarching Council for International Organisations of Medical Sciences . Still they are rarely accepted into trials .
This current lack of data on the effects of vaccines on pregnancy will doubtless be of concern to expecting mothers thinking of getting their COVID-19 shots at a time when it ’ s natural to double check anything related to their health or the health of their developing baby .
Though pregnant women are no more likely to get COVID-19 than other healthy adults , and roughly two-thirds of pregnant women with COVID-19 have no symptoms at all , they do face an increased risk of becoming severely ill if they get the virus compared to non-pregnant women , particularly in the third trimester .
According to the Royal College of Obstetricians and Gynaecologists ( RCOG ) in the United Kingdom , “ Studies have shown that there are higher rates of admission to intensive care units for pregnant women with COVID-19 compared to non-pregnant women with COVID-19 .
“ It is important to note that this may be because clinicians are more likely to take a more cautious approach when deciding whether to admit someone to the intensive care unit when a woman is pregnant . At present , it is unclear whether pregnancy will impact on the proportion of women who experience ‘ long Covid ’ or a post-COVID-19 condition .”
Current evidence also suggests that the virus is unlikely to cause problems with an unborn baby ’ s development , and there have been no reports of this so far . There is also no evidence to suggest that COVID-19 infection in early pregnancy increases the chances of a miscarriage .
“ Transmission of COVID-19 from a woman to her baby during pregnancy or childbirth , known as vertical transmission , seems to be uncommon . Whether or not a newborn baby gets COVID-19 is not affected by mode of birth , feeding choice or whether the woman and baby stay together . It is important to emphasise that in most of the reported cases of newborn babies developing COVID-19 very soon after birth , the babies remained well ,” the RCOG guidelines note .
Nevertheless , studies have shown that there is a two- to three-fold increased risk of premature birth in pregnant women who become very unwell with COVID-19 .
In most cases , however , this was due to medical recommendations that their babies be born early for the benefit of the women ’ s health and to enable them to recover earlier .
In Southeast Asia , Malaysia is one of the countries that have issued guidelines on whether pregnant women should be vaccinated for COVID-19 .
“ Pregnant frontline workers should receive priority in vaccination due to the risk of repeated exposure to COVID-19 ,” the guidelines say , adding that expecting mothers who are not frontline workers and want the vaccination “ should receive the first dose between the 14th and the 33rd week of gestation .”
They add that , in the case of women who conceive after receiving the first dose of vaccine , they “ should make sure to delay the second dose 14 weeks .”
“ A lot of women who are pregnant , they are worried about taking the vaccine during pregnancy because they don ’ t know if it ’ s going to harm the foetus ,” Dr Leong Wai Yew , a consultant obstetrician , gynaecologist , and fertility specialist at Alpha IVF and Women ’ s Specialists in Kuala Lumpur , told Global
42 APRIL 2021 GlobalHealthAsiaPacific . com