Webinar: Demystifying COVID-19 Vaccine Booster Vaccination in pregnancy : Safety and Boosters Speaker: Dr. Muniswaran Ganeshan More information, please visit: https://clinupcovid.mailerpage.com/resources/r1r5o3-demystifying-covid-19-vaccine-boo

1. Safety of
COVID-19
Vaccination
& Boosters in
Pregnancy
Dr. Muniswaran Ganeshan
Maternal Fetal Medicine Consultant,
Women and Children’s Kuala Lumpur Hospital

2. No conflict of interest
• This slide was prepared for the Webinar Demystifying the
COVID-19 Vaccine Booster on 8th Dec 2021, by Dr. Muniswaran
Ganeshan, Maternal Fetal Medicine Consultant, Women and
Children’s Kuala Lumpur Hospital, Malaysia.
•This is intended to share within healthcare professionals, not for
public.
•Kindly acknowledge “Clinical Updates in COVID-19
http://www.nih.gov.my/covid-19” should you plan to share the
information obtained from this slide with your colleagues.

3. COVID 19 & Pregnancy
Vaccination in pregnancy
Safety & Booster

4. COVID-19
&
pregnancy

5. What has history
thought us about
infections in pregnancy?

6. MALAYSIAN MMR (2000 – 2018)

7. COVID 19 statistics (31st
November 2021)
US
148,327
screened
positive
241 deaths 0.016%
UK 3371
symptomatic
14 deaths 0.4%
Malaysia
14,491
screened
positive
184 deaths 1.27%

11. Living systematic review
Covid-19 pregnant vs non pregnant women
Mortality
ICU admissions
Stillbirth
Neonatal death
NICU admissions
Fetal distress
C
O
V
I
D
Mothers

13. Systematic reviews
& pregnancy outcomes
Oxygen support
Mechanical ventilation
Caesarean section
Preterm delivery
Fetal distress
C
O
V
I
D
Mothers

15. First or
Second
wave?

16. First or
Second
wave?
1 in 10 alpha variant
1 in 7 delta variant

19. Other
publications

20. Other
publications

21. Malaysian COVID-19 CEMD

22. Timing of maternal deaths
66% of them required delivery

23. Maternal deaths – BMI & Co-morbidities

24. Maternal Deaths & Age

25. COVID 19 & Pregnancy
Pregnant mothers
are vulnerable
1 in 7 mothers
needed ICU
admissions
Risk of ventilation &
death is increased in
pregnancy
Fetal risk
Preterm, stillbirth,
neonatal death,
caesarean section
Risk of transmission
to fetus – 1-2%

26. Vaccination in
pregnancy

27. The Malaysian Experience
Medical & non medical frontlines
(Pregnant & Breastfeeding)
February – April 2021
High risk pregnancies
April- August 2021
All pregnant mothers
August 2021
Booster
All pregnant mothers

28. V safe pregnancy registry US
Total
vaccinated
177,736
Enrolled
6,685

29. V safe pregnancy registry US
Total
vaccinated
177,736
Enrolled
6,685
Malaysia
176,761 till 30th
November 2021

31. Effectivenes
s

37. Vaccination & Maternal deaths
66.7 % had
Sinovac
Total vaccinated pregnant
mothers : 176,761

38. Is it safe?

41. Safety of mRNA vaccinations in the first trimester

49. Other vaccines?

50. Other vaccines?

51. Fetal
benefits?

57. Booster or
no booster
in pregnancy?

58. •Prevent symptomatic infection (11-206)
•To prevent severe infections – 412-2058
•To prevent preterm delivery 200
•To prevent caesarean section - 182

59. •Prevent symptomatic infection (11-206)
•To prevent severe infections – 412-2058
•To prevent preterm delivery 200
•To prevent caesarean section - 182

63. Other guidelines

64. Summary
Fear COVID-19, not the vaccine
No evidence does not mean it is unsafe
Appreciate physiological adaptations in pregnancy
Science of probability
mRNA vaccines are safe
Be holistic, not fetal centric

65. Women don’t die
because of illness that
we cannot treat.
They die because
society still hasn’t
decided that their lives
are worth saving
Prof Mahmoud Fathalla

66. THANK
YOU
www.obstetricmedicine.my