Covid-19 vaccines and pregnancy: what to expect

Research has identified pregnancy as a factor that contributes to severe illness during Covid-19 infection. Non-pregnant women have a lower risk of hospitalisation and death after being infected with the virus. 

It has, therefore, become necessary to include pregnant and breastfeeding mothers in the current vaccine roll-out plan. Health regulatory bodies advocated for the vaccination of women who are at high risk of infection and serious illness due to comorbidities and working in the medical sector.

When the Sisonke Trial was kickstarted in April 2021 in SA, pregnant and breastfeeding mothers were not included. 

According to Dr Carmen Burns, “the reason they weren’t included initially in the Sisonke rollout which was a clinical trial and not technically part of the national rollout was that these group of people was excluded from the initial clinical trials which tested the vaccines.” 

Internationally, pregnant women were not included in Covid-19 clinical trials. According to the National Center for Biotechnology Information (NCBI), “this is due to several factors including ethical concerns about fetal exposure, liability risk, lack of interest from pharmaceutical companies, and complex regulations.

By June 2021 621,370 were listed on the World Health Organisation’s vaccine registry. Over 50% of these excluded pregnant women, and only 16 were pregnancy-specific. 

According to the Centers for Disease Control and Prevention (CDC) “studies in animals receiving a Moderna, Pfizer-BioNTech, or J&J/Janssen Covid-19 vaccine before or during pregnancy found no safety concerns in pregnant animals or their babies”.

Women in the UK and US have been receiving the vaccines and Dr Carmen says, “no issues with safety have been found to date in those women who chose to be vaccinated.” 

SA pregnant women can choose to vaccinate 

Pregnant women are allowed to vaccinate based on a personal choice, because “the risk of Covid-19 outweighs the risk of vaccination in pregnancy”, Dr Carmen says. 

After consulting with their medical professional, pregnant and breastfeeding women can register for their Covid-19 jab. 

Currently, over 35s are receiving their vaccinations, and those aged 18-34 can register from 1 September. This will contribute to a significant increase in vaccination numbers, currently sitting at 6.3 million which is 10% of SA’s population. 

The target to achieve herd immunity in the country is 67% of the population. 

The effects of Covid-19 vaccines in women and newborns 

The biggest concern for vaccinating pregnant and breastfeeding women is the potential risks to the fetus. According to new research from the Massachusetts General Hospital (MGH), Brigham and Women’s Hospital and the Ragon Institute of MGH, MIT, and Harvard, Covid-19 vaccines not only protect the mother but the baby as well. 

Babies born to vaccinated mothers have been found to have Covid-19 antibodies. 

The study looked at 181 women of reproductive age: 

• 84 pregnant women 
• 31 breastfeeding moms 
• 16 non-pregnant women 

The women received either the Pfizer-BioNTech or Moderna vaccines and no adverse results were identified amongst them. 

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According to the American Journal of Obstetrics and Gynecology (AJOG) “the study also demonstrated the vaccines confer protective immunity to newborns through breast milk and the placenta.” This means women transfer vaccine-generated antibodies to their babies during pregnancy and breastfeeding. 

Can pregnant women take the Johnson & Johnson’s vaccine? 

The Sisonke trial was temporarily halted in April after some people developed thrombosis with thrombocytopenia syndrome (TTS) which causes clotting. 

When the trial resumed two weeks after, pregnant women who are at high risk of infection were encouraged to vaccinate. These included women who with cormobidities and frontline workers.

Women younger than 50 years should be advised of the risk of clotting and the benefits of vaccinating outweigh the potential risks.