Have the Covid-19 vaccines been tested in pregnant, or breastfeeding mothers?
No, the initial trials which were conducted excluded pregnant and breastfeeding women. Clinical trials that look at the safety and how well the Covid-19 vaccines work in pregnant and breastfeeding people are underway.
Is there any data available on the side effects, or benefits of the Covid-19 vaccine during pregnancy?
Initial Covid-19 trials excluded pregnant women, so there is limited data on any potential side effects of the vaccine during pregnancy. However, a very small number of women who were enrolled in the trials became pregnant after receiving the vaccines. As much as there were no reported adverse outcomes, these numbers were too small to draw any conclusions.
More information will be available in the future as our experience grows. The benefits of the vaccine in reducing the risk of getting Covid-19 infections are well established. It also reduces the severity of infection, hospitalisation and death from Covid-19.
More than 50 percent of women who test positive for Covid-19 in pregnancy are asymptomatic, but some pregnant women can get life-threatening illnesses especially if they have underlying health conditions. Later in pregnancy, women are at increased risk of becoming seriously unwell with Covid-19.
This increases the likelihood of premature birth threefold, with subsequent long-term effects associated with prematurity. The benefits of vaccination include; reduction in severe disease, a reduction in the risk of prematurity for the baby and potentially reducing transmission to vulnerable household members.
Should someone delay getting pregnant, or having fertility treatments when planning on getting the Covid-19 vaccine?
Women planning to get pregnant or having fertility treatment should not delay getting the vaccine.
Will the Covid-19 vaccine affect my fertility in the long run?
There is currently no evidence that any vaccines, including Covid-19 vaccines, cause fertility problems.
Does the choice of vaccine matter?
There is no particular vaccine that is preferred. Eligible women should get the vaccine that is available to them. It is important to note that none of the Covid-19 vaccines available contain ‘live’ virus particles and therefore there is no risk for transmission to the baby.
Vaccine-containing ‘live’ particles are usually avoided in pregnancy due to the risk of transmission and harm to the baby.
After receiving the first dose of the Covid-19 vaccination, should pregnancy be delayed until after the second dose?
There is no benefit in delaying pregnancy due to Covid-19 vaccination.
What should I consider about Covid-19 vaccines if pregnant?
Due to the phased rollout of the vaccination programme, I would advise all pregnant women who are at high risk of exposure e.g. frontline health workers, social service workers, and those with underlying medical conditions such as diabetes, including gestational diabetes, obesity, or overweight to consider vaccination.
The potential risk and benefits should be individually weighted, though the ultimate decision to take the vaccine should be made by the woman.
Since Covid-19 is more serious in later stages of pregnancy, it may be reasonable to delay until after the 12 weeks when the development of the baby is complete, since we do not know if there are any effects on this process. However, it is advisable to get the vaccine before 28 weeks since the risk of severe disease and prematurity increases after this gestation.
What is the safety of Covid-19 vaccines in lactating mothers?
Since the vaccines were not tested on breastfeeding mothers, we cannot say with 100 percent certainty that the vaccine is safe. What we know is that the ingredients used to make the vaccines are not harmful either to you and the baby.
If you have any questions regarding the safety of the vaccine, please talk to a trusted source including your healthcare provider for more information on the vaccine in pregnancy.
Dr Wanyonyi is an Obstetrician Gynaecologist and Foetal Medicine Specialist at Aga Khan University Hospital Nairobi
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