Rinda AngomEven after the nightmare caused by the Covid-19 2nd wave in India, women who are pregnant, lactating or menstruating are still sceptical about taking the vaccine against the dreadful virus. This is mostly because there are rumours spreading against the vaccination on the internet or messenger apps or just being too careful. In order to clear your doubts once and for all, here is a compilation of information given by the doctors and health experts.
Pregnant Women
In a news on Indian Express Online (of 3rd April 2021), Dr Guleria started off by giving an example from the data of H1N1/swine that pregnant women were at the highest risk of getting the more severe disease. This was discussed in various groups including the WHO, the scientific advisory group of experts and suggested that pregnant women should be on top of the list to get vaccinated for two major reasons. One is the higher mortality and another because of the triple protection -1) it protected the mother, 2) it protected the foetus from stillborn and 3) it gives antibodies that crossed the placenta to the foetus which makes the newborn have some protection that lasts for 6 months. And thus even big bodies like the International Federation of Obstetrics and Gynaecology recommended the flu shot.
Coming to Covid-19 vaccination, he said initially, it occurred that pregnancy was not a risk factor as far as Covid-19 is concerned compared to H1N1. But then due to some data emerging, that pregnancy is also one factor that is associated with the risk to the foetus. This led people to start advocating to do a risk-benefit analysis and also consider giving the vaccine to pregnant women. However, Dr Guleria reminded us that we will never have a large database or a large number of trials on pregnant women to be able to actually confirm that it is safe and also will take some time for the confirmation. He further added that looking at the data we have, it seems safe and the risk-benefit analysis also suggests the benefit is more than the minor risks. He somehow assured that the guidelines will also change gradually wherein pregnant women will also come to the criteria as well as the lactating women. He added in the end that he also firmly agrees these women should be included in the criteria to be vaccinated.
Also on NDTV news (May 29, 2021) when he was asked that the studies done abroad are only with the vaccines like Pfizer or Moderna which are not available in India, he replied that Covaxin which is inactivated virus vaccine and is the same platform that is used for Flu vaccine that has already been given to pregnant women. Even for the Flu vaccine when it was approved for pregnant women, it was done by looking at the risk-benefit analysis. And for the Covid too, it’s more beneficial than being at risk. He also said both Covaxin and Covishield will come out with their data and have their approval for vaccinating women.
In an interview with WHO Chief Scientist Dr Saumya Swaminathan (Science in 5 publication of 4th June 2021), she said that pregnant women are at higher risk of getting severe COVID and also at higher risk of delivering a baby prematurely. So, in situations where there is a lot of COVID transmission in the country and a woman is exposed to it, or if she's in a profession like a health care worker or a frontline worker where she's at high risk of acquiring the infection, the benefits of getting the vaccine definitely outweigh the risks. And also particularly because of the fact that the platforms used currently for vaccines are the mRNA platform, inactivated viruses or the viral vectored platforms or subunit proteins. None of them has a live virus that can multiply within the body and that could potentially create a problem.
She asserted that pregnant women in every country should be explained about the benefits versus the risks and offer the vaccine if they would like to. She believes that vaccination is the right thing to do as pregnant women are at higher risk of getting infected and vaccination would benefit them.
On 25th June 2021, addressing a press meet, Indian Council of Medical Research (ICMR) Director-General Dr Balram Bhargava said, "The Ministry of Health has given guidelines that the vaccine can be given to the pregnant woman." He also said that the vaccine is useful for pregnant women and it should be given.
Lactating Mother
Dr Saumya has also confirmed that that breastfeeding mothers can also take the vaccination since there is no harm as none of the vaccines has live virus in it and there’s no risk of transmission through breastmilk. She added that the antibodies that the mother has can go through the breast milk to the baby and may only serve to protect the baby a little bit.
Dr Arvind Kumar, Chairman, Institute of Chest Surgery, Medanta on NDTV (May 21, 2021) talked about the latest changes in the guidelines on Covid-19 vaccination and confirmed that lactating mothers can now get themselves vaccinated against Covid-19.
Menstruating Women
With regards to menstruating women, Dr Saumya said that there’s no scientifically anything that would harm when vaccination is taken during this time apart from feeling a little tired. There’s no problem in taking the vaccination when you have periods.
Dr VK Paul (Member of NITI Ayog), in a press conference, had also confirmed that the vaccination can be and should be given to menstruating women and should not be a reason to postpone vaccination.
I hope the information is useful and helpful in clearing the doubts and myths regarding Covid-19 vaccination for pregnant, lactating and menstruating women. So, go and get your jab asap!