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The question is : Should COVID-19 vaccines be given to pregnant women to prevent COVID-19 disease in the mother and the obstetrical complications that follow ?
Currently , maternal immunization is common to prevent maternal and infant morbidity and is specifically recommended to prevent influenza and pertussis . Unfortunately , pregnant women were not included in the development and clinical evaluations of COVID-19 vaccines or treatments , but the FDA and Advisory Committee on Immunization Practices ( ACIP ) have left open the option for pregnant and lactating women to receive the vaccines . Pfizer has just started a study using their vaccine in pregnant women . The World Health Organization ( WHO ) has not been helpful and on Jan . 26 , 2021 recommended against the vaccination of pregnant women . Because of immediate blowback , WHO then issued a revised statement on Jan . 29 , with more permissive language to include “ women at high risk .” 5 The American College of Obstetricians and Gynecologist ( ACOG ) and the Society for Maternal-Fetal Medicine ( SMFM ) have continued to advocate making COVID-19 vaccines available to pregnant and lactating women .
The reasons for vaccination of all pregnant women in all trimesters are : ( 1 ): COVID-19 disease adversely affects pregnant women in all trimesters and the vaccines will prevent COVID-19 infection . ( 2 ) COVID-19 has not been shown to cause fetal disease . ( 3 ) COVID-19 vaccines are not live virus vaccines . ( 4 ) Maternal antibodies cross the placenta and protect the fetus .
It is known that COVID-19 vaccines will prevent the clinical disease which significantly increases the pregnant woman ’ s medical risk and that of their fetus . It should be universally endorsed and made available for all pregnant women .
References :
1
Delahoy M J , et al : Morb Mortal Wkly Rep . 2020 : doi . 10.15585 / mmwr . mm 6933el .
2
Adhilari EH , Moreno W , Zofkie AC et al : Pregnancy outcomes among women with and without severe acute respiratory syndrome coronavirus 2 infection . JAMA Netw Open 2020:3 ( 11 ): e2029256 . doi . 10:1001 / jamanetworkopen . 2020.29256 .
3
Zambrano LD , Ellington S Strid P et al : CDC COVID-19 response : Pregnancy and infant linked outcome update : Characteristics of symptomatic women of reproductive age with pregnant women . MMWR Morb Mortal Wkly Rep . 2020:69 ( 44 ) 1641-1647 . Doi : 10.15585 / mmwr . mm6944e3 .
4
Kublak JM Murphy SA Yees J et al : Severe acute respiratory syndrome , coronavirus 2 serology levels in pregnant women and their neonates . Am J Obst Gynecol : epub January 22,2021 : doi : https : doi . prg / 10.10.1016 /: ajog . 01.016 .
5
The Moderna COVID-19 ( mRNA-1273 ) vaccine : What you need to know . World Health Organization . January 26,2021 . Accessed February 2 2021 . https :// www . who . int / news-room / feature-rtoties / detail / the-moderna-covid-19-mrna-1273- vaccines-what-you-need-to-know .
Dr . Gall is a retired obstetrician / gynecologist .
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