New Delhi: The Ministry of Health and Family Welfare (MoHFW) announced on July 2 that women who are pregnant can now take the vaccine against COVID-19. The Union Health Ministry said that it has made the decision based on the recommendations of the expert panel National Technical Advisory Group on Immunisation (NTAGI). As it expands the eligibility criteria to help protect expecting mothers and their unborn babies from the disease, MoHFW said that the available Covid vaccines are useful for pregnant women, and they should get vaccinated. So, if you are pregnant and thinking of getting vaccinated, here is what the government says about the safety and side-effects in its operational guidance for COVID-19 vaccination of pregnant women.
When Should Pregnant Women Get Vaccinated And Why
According to the Union Health Ministry’s guidelines, expectant mothers can get vaccinated at any point of time during their pregnancy. It says that pregnant women are at an increased risk for severe illness from COVID-19 compared to non-pregnant women if they get infected.
The Ministry added in the guidelines that pregnant women with COVID-19 are at increased risk for preterm birth and might have an increased risk of other adverse pregnancy outcomes including higher chances of neonatal morbidity. Pregnant women who have advanced maternal age or obesity or high body mass index and those with pre-existing co-morbidities like Diabetes or organ transplant or respiratory diseases or heart diseases among others are at a high risk of developing complications after COVID-19 infection.
Weighing the risk versus benefit ratio, the Union Health Ministry recommends pregnant women to come forward and inoculate themselves soon.
The guidelines also specify that in case a woman has been infected with COVID-19 during the current pregnancy, then she should be vaccinated soon after the delivery.
Adverse Events Following Immunization Of Pregnant Women
The guidelines direct vaccinators to inform women in reproductive age about adverse events following immunization (AEFI).
The full impact of Covid vaccine on pregnancy outcomes for mother and fetus as well as for newborn is still unclear. Therefore, pregnant women require special considerations and systematic reporting of AEFI, the guidance document said.
Obstetrician and gynaecologist, paediatrician or neonatologist to be included in AEFI committees.
According to the guidance document, like any medicine, a vaccine may have side effects which are normally mild like fever, pain at the injection site, feeling unwell for about 1-3 days. Very rarely, pregnant women may experience some of the following symptoms within 20 days after getting the injection which may need immediate attention:
– Shortness of breath
– Chest pain
– Pain in limbs or swelling in the limbs (arm or calf)
– Small haemorrhages or bruising of the skin beyond the vaccination site
– Persistent abdominal pain
– Severe and persistent headaches
– Weakness/paralysis of limbs or any particular side of the body
– Persistent vomiting without any obvious reason
– Blurred vision/pain in eyes
Contraindications For Vaccination During Pregnancy
On any specific contraindications for vaccination in pregnancy, the guidelines state that as for the general population, pregnant women also should avoid vaccination in conditions such as anaphylactic or allergic reaction to the previous dose of COVID-19 vaccine, anaphylaxis or allergic reaction to vaccines or injectable therapies, pharmaceutical products, among others.
How Will Pregnant Women Get Their Jab
The guidelines say that modality for registration of beneficiaries, reporting of vaccination, generation of certificate and others remains the same as the general population. This implies that pregnant women who are above 18 years of age can choose to register on CoWIN (Covid Vaccine Intelligence Work) portal or walk into the nearest Covid vaccination centre to get themselves inoculated.
Pregnancy and COVID-19 Vaccination: What Do Experts Have To Say
Commenting on the concerns related to the safety of vaccines for pregnant women and the timeframe in which the jab needs to be taken during the pregnancy, Dr Gaayatri Juneja, Gynecologist, Apollo Cradle Hospital said,
Earlier the guideline was that if pregnant women are to be vaccinated, we should vaccinate them after three months of the pregnancy, but now, the latest guideline has come. In animals, at least the studies have shown that the vaccine is not affecting the embryo or the fetus. So, it is safe to take the vaccine anytime in pregnancy. The earlier the pregnant woman takes the vaccine, the better.
However, Dr Juneja added that according to WHO’s guidelines on vaccination if a woman has an active infection, she should not take the vaccine for 12 weeks after the infection or 4-8 weeks after recovering from it.
While talking about the evidence showcasing benefits of the Covid vaccine for pregnant women, Dr Suneela Garg, Member, Lancet Commission of the Covid India Taskforce and Director and Professor of the Community Medicine of the Maulana Azad Medical College and advisor to ICMR (Indian Council of Medical Research) said,
Now we have enough data as a lot of pregnant women have been immunised against the Covid in the country and globally. We have seen in the second wave particularly that pregnant women who got infected got a severe infection. So, the woman needs to make a choice between the disease and the vaccination which is preventing the disease. If a woman has Covid infection, then she can give birth to low-birth-weight babies (born with less than 2.5 kgs weight) and also have preterm birth, which are already very prominent in the country. Vaccines are safe and that is why the decision has been taken to inoculate pregnant women. World Health Organisations’ Strategic Advisory Group of Experts on Immunisation also recommend that pregnant women must take the vaccine because the positive effects of vaccines outweigh the adverse effects.
Explaining why pregnant women are at greater risk of severe illness and mortality due to COVID-19 as compared to other women, Dr Ritu Petkar Palve, Gynecologist, SL Raheja Hospital said,
What happens in the pregnancy is that it is a condition where the woman has more chances of getting the infection as compared to the non-pregnant woman because her immunity during this time is low. So, getting vaccinated is extremely important. It is the best armour against Covid. There can be some normal side-effects like pain at the site area or some drowsiness but nothing that will last over 3-4 days or that which cannot be managed. Keep your doctors in the loop and take the jab because the benefits outweigh the risks hugely.
While the Central government’s guidelines remain silent on the long-term risk assessment of the vaccine on pregnant women and their children, Dr Palve said,
Currently, there are no long-term studies because the disease itself is about two years old. We are still looking into the picture, but vaccines are lifesaving and will help pregnant women save themselves during this pandemic.
In the United States of America, the Centres of Disease Control and Prevention (CDC) also encourages pregnant women to get the vaccine shot and says that the group is at a higher risk of severe illness from Covid-19 and initial studies have not identified any concerns about the safety of the shots so far. Apart from the USA, other countries like Australia, the United Kingdom (UK), Canada and Israel have also included pregnant women in their vaccination drives.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.
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