An expert addresses key apprehensions and doubts about the safety and efficacy of the COVID-19 vaccines for pregnant and breastfeeding women.

With the unprecedented spread of the deadly virus in India and the parallel vaccine rollout in progress, my colleagues and I are often asked questions about getting vaccinated against COVID-19. Is this vaccine safe? What will be the effect on the pregnancy or infant after taking the vaccine? What are the risks to the mother and potential risks to the fetus or infant? What are the side-effects? Can lactating women take the prescribed medications?

There are apprehensions and doubts about the safety and efficacy of the vaccines, particularly in the case of expecting and lactating mothers. Today, majority of the patients need reassurance and calming advice – more so in the mental health aspect. Isolation, infodemic and mis- and disinformation all have contributed to growing anxiety and mental health problems.

In my view, vaccination is the key to come out of this pandemic. COVID-19 vaccines are safe and everyone should be encouraged to take the vaccine. Here are some important factors to consider for pregnant and lactating women:

* Pregnant women are at increased risk of severe COVID-19-associated illness compared with non-pregnant women because of their altered immunity. The first 12 weeks of pregnancy are most important for the baby’s development. So you may choose to wait until after this period to get vaccinated.

* Later in pregnancy, the risk of complications from COVID-19 increases and there is also a higher risk of the baby being born prematurely. Therefore, you may choose to have the vaccine before you enter the third trimester (28 weeks). However, this does not mean that other pregnancy-related vaccines should be missed out.

* It is advisable to ensure that no other vaccine was taken within 14 days of the COVID vaccine. There is, currently, no preference for the use of a particular COVID-19 vaccine. The recommendation is to complete the two-doses with the same vaccine product.

* There is no data to show that the vaccine will have an adverse impact on breastfeeding. The antibodies could pass to the babies as well and it may offer immunity to the baby also like other vaccines given in pregnancy. Breastfeeding has multifold benefits for both, the mother and child.

* One does not need to avoid becoming pregnant after having the vaccine. Depending on one’s individual situation, one may decide to delay trying for a baby until after the vaccination is completed.

* There is no evidence to suggest that COVID-19 vaccines affect fertility. However, post vaccination, it is recommended that any fertility treatment should be resumed within a span of 45 days.

* Recovery rate for expecting mothers is 99% and only 1% need hospital care. Although most pregnant women contracting COVID-19 tend to experience mild symptoms, the risk of severe complications increases in the third trimester. Women in their third trimester should pay extra attention to social distancing measures and seek support if they are concerned about any symptoms.

* Lactating mothers are discouraged to take any medicines, unless they are symptomatic. In consultation with their physician, they are advised to do the standard blood tests – like complete blood count (CBC), c-reactive protein (CRP), random blood sugar, D-dimer and interleukin 6 (IL-6) – to help understand if there are any inflammatory reactions in the body.

While vaccines protect you from serious disease, hospitalisation and death, it’s important to remember that you can still get a mild infection after vaccination. You can be an asymptomatic carrier. Therefore, it important that you continue to wear your masks, follow social distancing and good hand hygiene.

(The author is the Founder Chairman & Neonatologist, Cloudnine Group of Hospitals, Bengaluru)

Table of Contents