COVID-19 was declared as a global public health emergency by WHO on January 30, 2020, and later 11 March 2020 as a pandemic. The healthcare infrastructure is facing an enormous burden due to the pandemic. Vaccination against COVID-19 right now is the best solution to stop the infection. Vaccination against COVID-19 will reduce the risk of infection, severity, long-term effect of the infection and transmission to other individuals.
At present COVISHIELD and COVAXIN vaccines are being used in India as a guard against COVID-19. In a recent guideline, the government has approved the vaccination for pregnant women. This is a very progressive step as it will affect 50 million lives in India. Every individual needs protection from the surging COVID-19 infections, and vaccination seems to be the best and long-term solution. Now all mothers-to-be can be protected from COVID-19. The benefits of vaccinating pregnant women seem to far outweigh any theoretical and remote risk of vaccination.
TC46 connected with Dr Sonal Kumta, Senior Consultant Obstetrician & Gynaecologist and Dr Manjiri Mehta, Consultant Gynaecologist & Obstetrician, Fortis Hospital, Mumbai. Here they share 12 vital points about vaccination for pregnant women.
1. The importance of Covid-19 vaccination
Dr Sonal states, “First, it is important to note that pregnancy does not increase the risk of COVID-19 infection. Most pregnant women will be asymptomatic or have a mild disease, but their health may deteriorate rapidly, affecting the fetus. It is therefore advised that a pregnant woman should take the COVID-19 vaccine. It reduces the chance of infection, severity, and transmission to other individuals. The benefits of getting vaccinated far outweigh the risks associated with it. They need to take all precautions to protect themselves and the newborn from being infected, and that certainly includes vaccination against COVID-19.”
2. Impact of COVID-19 on pregnant women
Although most (>90%) infected pregnant women recover without any need for hospitalization, rapid deterioration in health may occur in a few. Symptomatic pregnant women appear to be at an increased risk of severe disease and death. In case of severe disease, like all other patients, pregnant women shall also need hospitalization. Moreover, pregnant women with underlying medical conditions like high blood pressure, obesity, and those over the age of 35 are at a higher risk.
3. Reasons to get the vaccination
If you are confused about whether to receive the COVID-19 vaccine while pregnant, consider:
- The risk of exposure to COVID-19
- The risk of severe illness
- The known benefits of vaccination
- The limited but growing evidence about the safety of vaccinations during pregnancy
4. Guidelines for pregnant women tested COVID-19 positive
“If a pregnant woman has tested COVID-19 positive, the first step is to isolate herself, consume plenty of fluids, and constantly check her temperature and oxygen levels, every 4-6 hrs. The doctor should be consulted even if there are no symptoms, because certain baseline investigations may be required. If fever, cough, cold, diarrhea, vomiting, loss of smell and taste develops, it should be informed to the doctor. In case of severe symptoms, like all other patients, pregnant women should consider hospitalization. Once infected with COVID-19, the vaccination is deferred for about 3 months.” explains Dr Manjiri.
5. Vaccination for recovered or infected pregnant women
Pregnant women who have recovered from COVID-19 are eligible for vaccination. Among such individuals, vaccination should be deferred for 12 weeks from the infection or 8 weeks after recovery. Please note, if a pregnant woman has already had COVID-19, she should be vaccinated soon after the delivery. Moreover, speak to your doctor and discuss all your doubts.
6. Process of registration for pregnant women
All pregnant women need to register themselves on the CoWIN portal or may get themselves registered on-site at the COVID-19 vaccination centre. The process of registration for pregnant women remains the same as of the general population and as per the latest guidance provided by the MoHFW. The need of the hour is to arrange for on-site consultation by Gynecologists, especially for those not registered for ante-natal (pre-delivery) care. We should also maintain a registry of vaccinated pregnant women for long-term follow-up and data collection.
7. Necessary measures to be taken before, during and after getting vaccinated
Dr Sonal says, “Before visiting the vaccination centre, pregnant women should have a valid appointment on the COWIN app to avoid crowds and standing in long queues. While getting vaccinated it is important to wear a double mask, have a healthy meal before visiting the vaccination centre, maintain physical distance and avoid going to crowded places. There are no additional precautions, requirements or measures recommended especially for pregnant women. After taking the jab, the person should wait for 30 minutes after getting the vaccine, to see if they have adverse reactions and ensure that they get the two doses on time. The side effects are usually very mild like fever and slight body ache for which paracetamol can be taken.”
8. Precautions to be taken to avoid any infection
It is also important that pregnant women take all precautions to protect themselves from being infected, and that certainly includes vaccination against COVID-19 but also these simple steps:
- Wear a double mask
- Practice frequent handwashing
- Maintain physical distance and avoid going to crowded places
9. Would-be parents can receive the COVID-19 vaccine
If you are trying to get pregnant now or plan to get pregnant in the future, would-be parents can receive the COVID-19 vaccine. There is currently no evidence that any vaccines, including the COVID-19 vaccines, could cause female or male fertility problems—problems getting pregnant. Most importantly, you cannot get COVID-19 infection from vaccination!
10. Take the vaccine during the second or third trimester
It is suggested that the vaccine should be taken during the second or third trimester. And women can take whichever is available – COVAXIN or COVISHILED.
11. Side effects of COVID-19 vaccine
The available COVID-19 vaccines are safe, and vaccination protects pregnant women against illness/disease like other individuals. Like any medicine, a vaccine may have side effects which are normally mild. After getting the vaccine injection, she can get a mild fever, pain at the injection site, or feel unwell for 1-3 days.
12. Consult a doctor if experiencing adverse effects
Dr Manjiri says, “A doctor should be consulted if the woman is experiencing adverse effects like shortness of breath, chest pain, swelling or pain in the limbs, severe or persistent headaches, vomiting, or any other explained symptom. Post-vaccination, mild fever, body ache and pain at the injection site is expected, anything other than that should immediately be informed to the doctor.”