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- 1. Hypertension Infection ICU admission Longer hospital stay Cesarean delivery Premature birth Update on WHO interim Recommendations on COVID-19 Vaccination of Pregnant Women and Lactating Women, June 2, 2021 Villar J, Ariff S, Gunier RB, et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women with and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatr. Published online April 22, 2021. RISKS of COVID-19 in Pregnancy
- 2. Pregnant women NOT included in clinical trials Increasing COVID cases among pregnant women More reported data regarding safety of COVID vaccination
- 3. Is it safe to administer the COVID-19 vaccine during pregnancy? No evidence of ADVERSE maternal or fetal effects No HARMFUL effects in pregnancy COVID-19 vaccination is RECOMMENDED for pregnant women Update on WHO interim Recommendations on COVID-19 Vaccination of Pregnant Women and Lactating Women, June 2, 2021 ACOG Practice Advisory: COVID-19 Vaccination Considerations for Obstetric-Gynecologic Care, July 30, 2021
- 4. What should we know about COVID-19 vaccination? BENEFITS RISKS COVID-19 infection is more severe in pregnancy COVID-19 vaccines are not yet tested among pregnant and lactating women Studies have shown very high efficacy rates for COVID-19 vaccination Side effects: pain/redness on injection site, fatigue, headache, fever, muscle pain COVID-19 infection is not acquired by vaccination These side effects do not affect pregnancy Study in US among 35,000 pregnant women from Dec 2020 to Feb 2021 <14% risk of miscarriage, no congenital anomalies seen, mild reactions RCOG: Updated advice on COVID-19 vaccination in pregnancy and women who are breastfeeding 30 December 2020
- 5. Is COVID-19 vaccination recommended among breastfeeding women? Vaccination- induced antibody levels were significantly higher compared with antibody levels induced by natural COVID-19 infection in pregnancy. Update on WHO interim Recommendations on COVID-19 Vaccination of Pregnant Women and Lactating Women, June 2, 2021 ACOG Practice Advisory: COVID-19 Vaccination Considerations for Obstetric-Gynecologic Care, July 30, 2021 Gray KJ, et al. COVID-19 vaccine response in pregnant and lactating women: a cohort study, American Journal of Obstetrics and Gynecology (2021)
- 6. AVAILABLE COVID-19 VACCINES* • BNT162b2 or Pfizer-BionTech ® COVID-19 Vaccine • SARSCoV-2 Vaccine Coronavac (Sinovac-CoronaVac ®) • ChAdOx1-S (AstraZeneca Vaxzevria ®) • Sputnik V Gam-COVID Vac ® • Janssen Ad26.COV-S Vaccine (Johnson & Johnson) • Whole Virion, Inactivated Corona Virus Vaccine (Covaxin ®) • COVID-19 mRNA Vaccine (Moderna ®) *approved for Emergency Use Authorization by the Philippine Food and Drug Administration (FDA)
- 7. COVID-19 vaccination booster Primary Vaccination Interval for Booster Homologous Booster Dose Heterologous Booster Dose Sinovac At least 3 months Sinovac Astrazeneca Pfizer Moderna Astrazeneca At least 3 months Astrazeneca Pfizer Moderna Pfizer At least 3 months Pfizer Astrazeneca Moderna Moderna At least 3 months Moderna Astrazeneca Pfizer Janssen (J&J) At least 2 months --- Astrazeneca Pfizer Moderna ACOG Practice Advisory: COVID-19 Vaccination Considerations for Obstetric-Gynecologic Care, December 3, 2021 Centers for Disease Control and Prevention CDC. Vaccination considerations for people who are pregnant or breastfeeding. December 6, 2021 DOH Department Memorandum 2021-0484. November 16, 2021 | DOH Department Memorandum 2021-0492B. December 21, 2021
Editor's Notes
- Risks of COVID-19 in pregnancy which includes higher rates of pregnancy-induced hypertension, preeclampsia-eclampsia, infections requiring antibiotics, greater risk of ICU admission, longer hospital stay, increased cesarean delivery rates, and premature birth.
- Pregnant women were not included in the Phase 3 clinical trials of the COVID-19 vaccines, therefore safety and efficacy data in pregnancy are limited. Guidance, however, regarding COVID-19 vaccination of pregnant and breastfeeding women is necessary as more data are reported regarding the safety of COVID vaccination in pregnancy over the last several months and the increase in cases among pregnant women.
- COVID-19 vaccination is recommended for pregnant women. There is no evidence of adverse maternal or fetal effects from vaccinating pregnant individuals with the COVID-19 vaccine. Post-introduction surveillance data have not shown harmful effects in pregnancy.
- COVID-19 vaccination is recommended among breastfeeding women. There is no need to avoid initiation or discontinue breastfeeding in patients who receive the COVID-19 vaccine. Vaccine-induced antibodies were found in breast milk samples among women given the Pfizer/BioNTech or Moderna mRNA COVID-19 vaccine, indicating the transfer of antibodies from mothers to infants. Vaccination-induced antibody levels were significantly higher compared with antibody levels induced by natural COVID-19 infection in pregnancy.