Since news about the development of the COVID-19 vaccine has been the front-page splashed, it has prompted abundant questions on its safety during pregnancy and lactation.
Prior observational data has demonstrated that while the chances for these severe health effects are low, pregnant women with COVID-19 have an increased risk of severe illness including ICU admission, mechanical ventilation, and death compared to non-pregnant women of reproductive age.
At this point, only limited data are available on the safety of COVID-19 vaccines including mRNA vaccines administered during pregnancy. The World Health Organization (WHO) has recently updated its advice around pregnant women receiving the vaccine, stating only those who are at high risk of contracting COVID-19 through work or who have underlying health conditions which predispose them to develop complications from the virus, should take the vaccine. On the other hand, The Centres for Disease Control and Prevention (CDC) has said that the vaccines should be available to pregnant people but ultimately leaves the decision up to expectant parents and their doctors.
In general, mRNA vaccines do not contain the live virus that causes COVID-19. Thus, theoretically it won’t be able to give someone COVID-19. It does not interact with a person’s DNA because the mRNA does not enter the nucleus of the cell. Based on this, it is unlikely for the vaccine to pose a specific risk for people who are pregnant. However, the actual risks of mRNA vaccines to the pregnant person and her fetus are unknown because these vaccines have not been studied in pregnant women. One of the key considerations to note is that women who are pregnant and part of a group recommended to receive COVID-19 vaccine, such as healthcare personnel, may choose to be vaccinated after thorough discussion with their healthcare personnel.
Another crucial discussion includes
the risks of developing a severe allergic reaction balancing the benefits of vaccination itself. CDC recommends that all vaccine recipients, including pregnant people, should talk with their healthcare provider if they have a history of severe allergic reaction especially to another type of vaccine they have received prior. Side effects can occur after receiving COVID-19 vaccines and these side effects are not expected to be any different for pregnant women as compared to non-pregnant women. Pregnant women who experience fever following vaccination may be counselled to take paracetamol because fever has been associated with adverse pregnancy outcomes and paracetamol is considered to be relatively safe to be used in any trimester of the pregnancy.
There is neither data on the safety of COVID-19 vaccines in lactating women nor on the effects of mRNA vaccines on the breastfed infant or on milk production/excretion. Again, women who are breastfeeding and are part of a group recommended to receive a COVID-19 vaccine, such as healthcare personnel, may choose to be vaccinated.
In conclusion, there is no evidence to suggest that any of the COVID-19 vaccines are likely to have adverse effects to either mum or baby and the data as well as recommendations on it have been contradictory. However, in order to help protect them from these risks, it is important that pregnant women receive safe and reliable advice when it comes to getting the COVID-19 vaccines.
Dr Ida Lilywaty Md Latar,
Obstetrics and Gynaecology (O&G),
Pantai Hospital Cheras (PHC)
