Natasha is my friend and colleague, an obstetrician expecting her third baby here in Queensland. Natasha had the COVID-19 vaccine.
‘The risks of COVID-19 are higher for pregnant women, and I’m happy there’s enough evidence for vaccine safety to have it myself. Anyone pregnant should speak with their care provider about the pros and cons of vaccination and make the choice that’s right for them.’
So, should the currently active cases in Australia influence a woman’s decision? Influence anyone’s decision?
‘Absolutely, it should. We have a window of opportunity in Australia, a luxury that most of the world hasn’t had. We need to act now and get vaccinated to protect ourselves and our family.’
Benefits of COVID-19 vaccination
The Pfizer vaccine is routinely recommended for pregnant women, breastfeeding women and women planning pregnancy. Receiving a vaccine before conceiving means you are likely to have protection against COVID-19 throughout your pregnancy.
We know that the vaccine prevents severe COVID-19 infection. It reduces the chance you will need to go into the hospital and it prevents death due to COVID-19 complications for all people.
It is expected that the large majority of pregnant women infected with COVID-19 will experience mild or moderate cold/flu-like symptoms. COVID-19 infection in pregnancy, however, increases the risk of pre-eclampsia, preterm birth, intensive care admission for mother or baby, and death of mother or baby. Although these complications are not likely for most women, they are approximately 2-3 times more common if a woman experiences COVID-19 infection during pregnancy.
It is believed that pregnant women who are vaccinated will have similar benefits against both severe COVID-19 and complications of the disease seen in non-pregnant people. Vaccination also potentially reduces transmission to other members of the household.
You don’t need to avoid becoming pregnant before or after vaccination. You are not required to have a pregnancy test before getting vaccinated, and vaccination can be done at any time during pregnancy.
Is the vaccine safe?
The decision to recommend vaccination is not taken lightly and needs to balance all the risks and benefits to an individual. Pregnant women were not included in the original effectiveness and safety studies, but currently, over 130,000 women around the world have received the vaccination in pregnancy. There is no reported increase in pregnancy complication, miscarriage or stillbirth. It doesn’t cause infertility, affect breastfeeding or pass into breastmilk. The vaccine is effective and is the best way to prevent severe COVID-19 infection, whether you are planning pregnancy, currently pregnant or breastfeeding. Specific evidence regarding the safety of the COVID-19 vaccination in pregnancy is not yet available outside of the mandatory reporting databases, which have not identified any concerns. The risks of COVID-19 disease in pregnancy are more clear.
Are vaccines normally used in pregnancy?
Pregnant women and women who are breastfeeding are already routinely and safely offered vaccines in pregnancy, for example, to protect against influenza and whooping cough. Many of these vaccines also protect their babies from infection. These vaccines, like the COVID-19 vaccines, are non-‘live’ vaccines, which are generally considered safe in pregnancy.
What about the Delta variant?
We don’t have a lot of information about the Delta variant and pregnancy, but it is clearly more infectious. Despite vaccination, you can still catch and transmit COVID-19, although it’s less likely than if you weren’t vaccinated. Because of this, usual distancing measures and masks where recommended are still advised even after vaccination. There is less protection against the Delta variant after a single vaccine dose compared to the Alpha variant, so completing the course is important. The greatest risk of Delta is that it’s more likely you will catch it yourself and pass it on to others.
Currently, pregnant women are eligible for Pfizer vaccination in Australia. It appears that the current case numbers are unlikely to be controlled anytime soon and it takes 21 days to complete the course of two vaccines.
More information on the Queensland Health website.
DT