Vaccine concerns for pregnant women remain

No clear data available on vaccines in India; Gynecologists’ union wants Pfizer vaccine to be given to expectant mothers

As COVID-19 continues to kill more pregnant women and put many more in critical condition in state intensive care units, obstetricians and gynecologists are pushing again for immunizations for pregnant women.

There is no evidence to suggest that the vaccines available in the country are currently unsafe for pregnant women, but it is the lack of research and data that is preventing authorities from making a formal recommendation for pregnant women. But the news that Pfizer vaccines would soon be available in India has raised new hopes for expectant mothers.

“About 90,000 pregnant women in the United States have been vaccinated, primarily with vaccines manufactured by Pfizer and Moderna, and there have been no safety concerns. Based on this data, the UK Joint Committee on Vaccination and Immunization (JCVI) recently suggested that pregnant women in the UK be offered the Pfizer-BioNTech or Moderna vaccines. Now that the Pfizer vaccine is available in India, we call on the government to offer this vaccine to pregnant women as soon as it becomes available, ”said senior consultant obstetrician VP Paily.

The Federation of Obstetricians and Gynecologists of Kerala (KFOG) has already written to Union and state governments that if the Pfizer vaccine is made available in the country, it should first be offered to pregnant women.

31 deaths in 3 months

Between March and May, Kerala lost 31 pregnant women to COVID-19, while several others are critically ill in intensive care units. For every maternal death, there are several near-misses, most of which are underreported.

The clinical presentation of COVID and the prognosis for pregnant women have been very different since April, when the second wave of COVID hit and the mutant Delta virus (B.1.617.2) began to sweep the state, according to the doctors.

“During the first wave, although we had the highest number of deliveries to pregnant women with COVID, there were no deaths. But since April we have had almost 30 pregnant women with COVID requiring intensive care and we have lost five, ”said KJ Jacob, chief of obstetrics and gynecology, Government Medical College Hospital, Manjeri.

Increase in premature births

Besides a sharp increase in maternal deaths, COVID has led to an increase in prematurity, stillbirth and cesarean delivery also in the state, said S. Ajith, head of the ObGyn department at Government Medical College Hospital, Kannur, who is also the president of KFOG. Almost 50% of deliveries to pregnant women with COVID are cesarean sections.

COVID also appears to have induced high levels of anxiety, stress and depression in pregnant women, which in itself could be very risky. In addition to comorbidities and risk factors such as age over 35 and obesity, a crucial aspect affecting the outcome of those who contract COVID is the delay or reluctance to recognize symptoms such as a mild cough or fatigue as being those of COVID. None of these symptoms should be ruled out during pregnancy and care should be sought early, says Dr Ajith.

“It is the responsibility of the family and the community to take special precautions to ensure that pregnant women are protected from COVID-19. But this is an area where there is a lot of laxity, ”explains Dr Jacob.

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