Covid-19 vaccine may be offered to breastfeeding moms, ‘high-risk’ pregnant women — expert

By: Cathrine Gonzales - 3 years ago

Vaccination drive in Malabon kicks off with Sinovac’s vaccine inoculated on health care workers. Image from the Facebook of Malabon Mayor Lenlen Oreta

MANILA, Philippines — Covid-19 vaccines may be offered to pregnant women who are classified as high risk for infection, as well as for breastfeeding mothers, a health expert said Tuesday.

Dr. Sybil Lizanne Bravo, chief of the Division of OB-GYN Infectious Diseases at the Philippine General Hospital and president of the Philippine Infectious Diseases Society for Obstetrics and Gynecology, noted that there are no studies yet on the safety of administering Covid-19 vaccines to pregnant and breastfeeding women.

“There are no studies to prove the safety and efficacy among pregnant and breastfeeding women, but we adopted what the WHO [World Health Organization] and CDC [Centers for Disease Control] guidelines have formulated. Ang sabi po nila, merong exemptions [They said there are exemptions]. We can offer the Covid vaccines—any of those two that are available here in the country, the Sinovac or AstraZeneca—to pregnant women who are at very high risk,” Bravo said in an online media forum hosted by the Department of Health (DOH).

Bravo said the vaccines may be offered to pregnant women belonging to the “high risk” group, including healthcare frontliners and uniformed personnel.

She also said that “pregnant and breastfeeding women with comorbidities… may be vaccinated with proper informed consent,” noting that comorbidities may put them at higher risk of severe infection.

According to Bravo, vaccine components do not go into breastmilk as observed in vaccination for other diseases.

She added that a pregnancy test is also not a requirement prior to Covid-19 inoculation, but noted that opting to undergo this test before inoculation is still the choice of the woman.

However, Bravo said pregnant women who would want to get vaccinated against Covid-19 should do so after the first trimester of their pregnancy.

“If ever lang po, kunwari may [there is a] pregnant woman who is a doctor, she wants the vaccine after consultation with her obstetrician-gynecologist, she can have the vaccine basta [as long as it is] past sa first trimester if ever she is willing to be vaccinated. We can only give the vaccine during the second and third trimester of pregnancy,” she explained.

According to a practice bulletin from the Philippine Obstetrical and Gynecological Society presented by Bravo, there is still limited data on the safety of administering a Covid-19 vaccine during the first trimester of pregnancy.

“Immunization should be avoided in most patients during the first trimester to avoid a coincidental association with spontaneous abortion, which is common in the first trimester,” the document read.

Bravo noted that the risk of getting infected with coronavirus is the same for the pregnant and non-pregnant population, but pregnant women are at a higher risk of severe infection.

“Kapag ang isang buntis ay nagkaroon ng Covid infection, they are more at risk of having the severe form of COVID infection. So sila po ‘yung maaaring mahirapan huminga, ma-intubate, mag-undergo ng preterm labor and delivery, so maaari po silang manganak prematurely,” she explained.

(When pregnant women get infected with Covid-19, they are more at risk of having a severe infection. They may experience difficulty in breathing, they may be intubated, or undergo a preterm labor and delivery and give birth prematurely.)

The information posted on WHO’s website dated January 8 showed that it does not yet recommend the vaccination of pregnant women.

“In case a pregnant woman has an unavoidable risk high of exposure (e.g. a health worker), vaccination may be considered in discussion with their healthcare provider,” said WHO.

“If a breastfeeding woman is a part of a group (e.g. health workers) recommended for vaccination, vaccination can be offered. WHO does not recommend discontinuing breastfeeding after vaccination,” it added.

The DOH explained that experts in the country recommend that pregnant women with high risk of exposure may still get vaccinated as long as they have clearance from their doctors.

JPV