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If you are pregnant —or considering a future pregnancy — and have been offered a COVID-19 vaccine, the decision of whether or not to have the vaccination is a tough choice. A lack of concrete research on the subject makes it very worrying to receive the shots during pregnancy.

The World Health Organization (WHO), in its recent advisory, said that the use of the COVID-19 vaccine for pregnant women was currently not recommended unless they are at a higher risk of exposure. It added that “those pregnant women at high risk of exposure to SARS-CoV-2 (such as health workers) or who have comorbidities which add to their risk of severe disease, maybe vaccinated in consultation with their healthcare provider.” 

While pregnancy puts women at higher risk of severe COVID-19 and also increases the risk for premature birth, limited data is available to assess vaccine efficacy, risks, and safety during pregnancy. Hence, vaccine inoculation drive for pregnant women should be restricted until more data is available. 

Tara Smith, an epidemiologist at Kent State University, considers the WHO’s vaccine decision up to women and their doctors to be a blunder. On a similar note, Klein, a professor at Johns Hopkins, says it is unfair to burden women with the decision of vaccination without adequate information and amid too many negative stories.

The Indian health ministry has also recommended that pregnant and lactating women shouldn’t be administered the shots as they have not been part of any anti-coronavirus vaccine clinical trial so far. In its letter to all the states and Union territories, the ministry highlighted that “Pregnant and lactating women have not been a part of any COVID-19 vaccine clinical trial so far. Therefore, women who are pregnant or not sure of their pregnancy and lactating women should not receive COVID-19 vaccine at this time.” 

Appearing to conflict with this advice, some international experts believe that the vaccines are unlikely to pose a specific risk for people who are pregnant. However, there is currently limited data on the safety of COVID-19 vaccines during pregnancy. Further investigations are needed to confirm the appropriateness of many of the recommendations and guidelines for action in the specific case of pregnant women and COVID-19. 

Some companies are soon expected to conduct clinical trials to look at the safety and how well the COVID-19 vaccines work in pregnant women. Vaccine manufacturers are also keeping track of data from participants in clinical trials who became pregnant after receiving the vaccine.

Until then, pregnant women and their obstetricians will need to use available data to assess the risks and benefits of COVID-19 vaccines on an individualized basis. Factors that need to be considered by health care providers when counseling pregnant women include:

  • Ethnicity, 
  • Whether you are overweight or obese
  • Any underlying health conditions or comorbidities
  • Occupational exposure 
  • Ability to socially distance at work.

In closing, there remains a lot that we don’t yet know about the effects of COVID-19 on pregnant women and their babies.  So it is important that women seek adequate clarifications from their trusted doctor regarding the risk of complications, and whether they are more vulnerable to the virus. They should discuss the benefits and risks of having the vaccine and reach a joint decision based on individual circumstances.

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