PREGNANCY, BREASTFEEDING AND THE COVID VACCINE

In our prenatal and postnatal classes over the last few weeks there has been much discussion on the COVID 19 vaccine. At Pippagina we represent women from all over the world, and the vaccine program varies from country to country. In this blog I have summarised the findings from the World Health Organisation(WHO), and Joint Committee on vaccination and Immunisation(JCVI); with reference to recommendations from The Royal College of Obstetrics and Gynaecology (UK), The Royal College of Midwives (UK); and The Centre for Disease and Control (USA). At the end of this article I have provided links for further reading. Coronavirus and pregnancy The risk to pregnant women and newborn babies following coronavirus infection is generally low. However, pregnant women are more likely to have severe coronavirus (COVID-19) infection if they have underlying health conditions such as:

  • Diabetes, high blood pressure or asthma

  • Are overweight

  • Come from a Black or Asian Minority Ethnic background

  • Over the age of 35 years. It has been shown that if you contract coronavirus with symptoms in pregnancy, then you have an increased chance that your baby will be born prematurely. The latest advice from the Joint Committee on Vaccination and Immunisation (JCVI) states that the COVID-19 vaccines should be offered to pregnant women at the same time as the rest of the population, based on the woman’s age and her clinical risk group, (Royal college of Obstetricans and Gynaecology. April 23rd 2021). The coronavirus vaccine can be given at any stage during pregnancy. Some women may choose to delay their vaccine until after the first 12 weeks (as the first trimester is the most important for the baby’s development); and plan to have the first dose at any time from 13 weeks onwards. As COVID-19 has more serious complications in later pregnancy, with a higher risk of the baby being born prematurely, women may wish to have the vaccine before their third trimester commences. Does it matter which vaccine I have? As with most medicines and vaccines, large clinical trials need to be carried out to ensure its safety. Although there is limited data on the coronavirus vaccines in pregnancy, available data does not indicate any harm to the pregnancy. The latest information from JCVI advice published on 16 April 2021 advises that it is preferable for pregnant women to be offered the Pfizer-BioNTech or Moderna mRNA vaccines, where available. In the USA, around 90,000 pregnant women have been vaccinated mainly with Pfizer and Moderna vaccines and no safety concerns have been identified. Evidence on COVID-19 vaccines is being continuously reviewed by the World Health Organization and the regulatory bodies in the UK, USA, Canada and Europe. Pfizer and Moderna vaccines are the preferred vaccines for pregnant women of any age who are coming for their first dose. Anyone who has already started the vaccination program and is offered a second dose whilst pregnant, should have a second dose with the same vaccine unless they had a serious side effect after the first dose.


Breastfeeding and COVID Vaccine The benefits of breastfeeding are well known. Clinical trials on the use of coronavirus vaccines while breastfeeding are not advanced. However, the available data do not indicate any harm to the breastfed infant and the Royal College of Obstetrics and Gynaecology state that new mothers do not need to stop breastfeeding in order to be vaccinated. In line with recommendations from the World Health Organization (WHO), the Joint Committee on Vaccination and Immunisation (JCVI) has recommended that any suitable coronavirus vaccine can be given to women who are breastfeeding. As with the Covid vaccine and pregnancy, the current recommendation from JCVI is for breastfeeding women to be offered the vaccination at the time when they become eligible. Below you will find further information discussing the risks and benefits of the coronavirus vaccine written by the experts. It is advisable to read and if you have further questions make sure you speak to a clinician before being vaccinated. References and further reading

  1. https://www.who.int/publications/m/item/safety-surveillance-of-covid-19-vaccines-in-pregnant- and-breastfeeding-women

  2. https://www.rcog.org.uk/globalassets/documents/guidelines/2021-02-24-combined-info-sheet- and-decision-aid.pdf

  3. https://www.gov.uk/government/publications/covid-19-vaccination-women-of-childbearing-age- currently-pregnant-planning-a-pregnancy-or-breastfeeding/covid-19-vaccination-a-guide-for- women-of-childbearing-age-pregnant-planning-a-pregnancy-or-breastfeeding

  4. https://www.rcm.org.uk/guidance-for-pregnant-women/

  5. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html

  6. https://www.rki.de/DE/Content/Kommissionen/STIKO/Empfehlungen/PM_10052021.html