SHALINI SAKSENA speaks with DR NOZER SHERIAR about benefit versus risk assessment of COVID-19 vaccine for pregnant women
How safe are the COVID-19 vaccines for pregnant women?
There is no doubt that pregnant women need to be immunised against COVID 19 to enhance their protection. Unfortunately, much of the discourse has been driven by various messages on social media. Within the span of a month official directives have gone from not permitting the COVID vaccine for pregnant women and lactating mothers to the Government’s recent recommendation allowing COVID-19 vaccine for both pregnant and lactating women. While this was done with an intention of providing protection to these women, critical decisions like these should be based on scientific evidence with individual safety being priority.
Which vaccine is safe for pregnant women?
Based on documented evidence from the USA and the UK the only evidence of safety for use during pregnancy at the moment rests with the two mRNA vaccines — Pfizer-BioNTech and Moderna.
When one is dealing with pregnancy and lactation, the public health benefits at macroscopic level cannot outweigh the serious risks at microscopic level. A dreaded complication in a particular individual could be disastrous for a woman, her pregnancy and her family. The specific concerns with the rarer complications of some vaccines such as the risk of blood clots or thromboembolism cannot be brushed aside since being pregnant itself carries a manifold increase in the risk of thrombosis magnifying the vaccine related risk. We are in urgent need for more scientific evidence regarding safety before powering ahead.
Pregnant women are a vulnerable group and are at increased risk for severe illness from Covid-19. What illnesses?
In terms of getting the infection, pregnant women are just as vulnerable as any other person. But when a pregnant woman gets infected then she has a much higher risk of morbidity and mortality as compared to a non-pregnant woman. Pregnant women with severe disease are at greater risk of ICU admission, ventilation and death. Pregnant women with coexisting illnesses such as Diabetes, hypertension and obesity are at an even greater risk. There is also a higher risk of preterm birth, cesarean delivery and hypertension associated with Covid-19 infection during pregnancy.
The COVID-19 vaccine should be considered on the basis of benefit versus risk assessment. Who will assess the risk?
It is unfair for us to shift responsibility of whether or not to take the vaccine and which vaccine to accept and take to women shoulders since they do not have the necessary knowledge, understanding or skill sets to make such a decision. Besides this in reality a large population of women in India are not adequately empowered or free to make these choices. Only science can do this for women through good evidence backed by research. Once we have evidence of safety and clarity as to the type of vaccine to use the answer will be evident for all to see.