Vaccine worries for pregnant women remain

No clear data available on vaccines in India; gynaecs’ union wants Pfizer jab administered to mothers-to-be

As COVID-19 continues to take the lives of more pregnant women and put many more in a critically ill stage in ICUs in the State, obstetricians and gynaecologists are yet again pushing for the vaccination of pregnant women.

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

“Around 90,000 pregnant women in the U.S. have been vaccinated, mainly with the vaccines manufactured by Pfizer and Moderna, and there have been no safety concerns. Based on this data, the U.K.’s Joint Committee on Vaccination and Immunisation (JCVI) has recently suggested that pregnant women in the U.K. be offered Pfizer-BioNTech or Moderna vaccines. Now that Pfizer vaccine is being made available in India, we request the government to offer this vaccine to pregnant women as soon as it is available,” says senior consultant obstetrician V.P. Paily.

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

31 deaths in 3 months

Between March and May, Kerala lost 31 pregnant women to COVID-19, while several others are critically ill in ICUs. For every maternal death, there are several near-miss cases, which are mostly under-reported.

The clinical presentation of COVID and the prognosis for pregnant women has been so vastly different since April, when the second COVID wave hit and the virus mutant Delta (B.1.617.2) began sweeping across the State, doctors say.

“During the first wave, though we had the most number of deliveries by pregnant women with COVID, there was no mortality at all. But since April, we have had nearly 30 pregnant women with COVID requiring critical care and we lost five of them,” says K. J. Jacob, Head of Obstetrics and Gynaecology, Government Medical College Hospital, Manjeri.

Rise in premature births

Apart from a steep rise in maternal deaths, COVID has led to an increase in prematurity, stillbirths and Caesarean section deliveries also in the State, points out S. Ajith, Head of ObGyn department at Government Medical College Hospital, Kannur, who is also the president of KFOG. Nearly 50 % of the deliveries among pregnant women with COVID are C-sections.

COVID also seems to have induced high levels of anxiety, stress and depression among pregnant women, which by itself could be very risky. Apart from co-morbidities and risk factors like age above 35 years and obesity, one crucial aspect affecting the outcome of those contracting COVID is the delay or reluctance in recognising symptoms such as mild cough or fatigue to be that of COVID. No such symptoms should be dismissed during pregnancy and care should be sought early, Dr. Ajith says.

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

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