Is COVID-19 Vaccination During Pregnancy Safe?

There is no evidence of a direct effect of COVID-19 vaccination on pregnancy and miscarriages, revealed an international study.

Highlights:

Pregnant women with COVID-19 are at an increased risk for adverse outcomes, and so vaccination is recommended during pregnancy
However, safety data on COVID-19 vaccination during pregnancy remain limited
To address this issue, a new study tracked nearly 18,500 pregnant women in Norway
Found no link between COVID-19 vaccines and pregnancy loss

There is no evidence for the association between COVID-19 vaccination and early pregnancy loss, according to a new study conducted by the Norwegian Institute of Public Health.

As the COVID-19 vaccination programme starts to be rolled out, many young women are hesitant to accept the vaccine, citing concerns about fertility.

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Meanwhile, those offered the vaccine during pregnancy must decide whether they will accept depending only on data on accidental pregnancies that occurred during the trials.

Increasing study data about pregnant people who receive the vaccine can help these groups to make informed decisions.

A new study published in the New England Journal of Medicine used 20,000 Norwegian registries on first trimester pregnancies to perform the case-controlled research on safety issues of COVID-19 vaccination during pregnancy.

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Each pregnant woman's COVID-19 vaccination status, background characteristics and underlying health conditions were considered as factors.

Researchers identified women having a pregnancy loss before 14 weeks of gestation as case patients and those with primary care-based confirmation of ongoing pregnancy in the first trimester as controls.

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Among 13,956 women with ongoing pregnancies, 5.5% were vaccinated and 4521 women with pregnancy loss, 5.1% were vaccinated. The average number of days between vaccination and pregnancy loss or confirmation of ongoing pregnancy was 19.

Later they analyzed all available vaccine types in an analysis stratified according to the number of doses received (one or two), and insensitivity analyses limited to healthcare personnel (for whom vaccination was routinely recommended other than in the first trimester) or women with at least 8 weeks of follow-up after confirmed pregnancy (to exclude subsequent pregnancy loss).

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Vaccination for pregnant women in all the stages is emphasized strongly by the healthcare experts, for otherwise, the COVID-19 pregnant mothers, face severe clinical implications.

The results found no correlation between COVID-19 vaccinations, which included Pfizer, Moderna and AstraZeneca, and the risk of first-trimester pregnancy loss.

This study found no evidence of an increased risk for early pregnancy loss after COVID-19 vaccination and adds to the findings from other reports supporting COVID-19 vaccination during pregnancy.

The findings are reassuring for women who were vaccinated early in pregnancy and support the growing evidence that COVID-19 vaccination during pregnancy is safe.

A limitation of this study is that the registry lacks information on gestational age at the time of early pregnancy registration, and so they could not match case-patients and controls according to gestational age.

Pregnant women must be vaccinated since they have a higher risk of hospitalizations and COVID-19-complications, and their infants are at higher risk of being born too early.

Also, vaccination during pregnancy is likely to protect the infant against COVID-19 infection in the first months after birth.

Even Australia's Department of Health sites pregnant people as a priority group for COVID-19 vaccination with Pfizer as the recommended vaccine.

In the absence of evidence that pregnancy is a contraindication, providers should make clear that the known benefits of receiving the vaccine far outweigh the unlikely potential harms.

Health professionals must continue to spread awareness about COVID-19 vaccine safety and should encourage pregnant patients to take the COVID-19 vaccine.

References:

COVID-19 Vaccination in Pregnancy: The Benefits Outweigh the Risks - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8267012/)
Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons - (https://www.nejm.org/doi/full/10.1056/NEJMoa2104983)
COVID-19 Vaccination in Pregnant and Lactating Women - (https://jamanetwork.com/journals/jama/fullarticle/2776449)

Source-Medindia