COVID Vaccine When Pregnant or Breastfeeding
Posted by Dr. Alda Ngo
As administration of vaccines begins to roll out, we’re getting a lot of questions about the vaccine and pregnancy.
The Society of Obstetricians and Gynecologists of Canada (SOGC) released an official statement on December 18th, which has also been endorsed by The Canadian Fertility and Andrology Society (CFAS).
Here’s a summary of the SOGC statement:
Because there haven’t been any clinical trials that can support any evidence-informed recommendations about the COVID-19 vaccine for pregnant and breastfeeding populations, the official recommendations are subject to change.
At the time of release of the statement, the Pfizer-BioNTech COVID 19 vaccine was the only authorized COVID-19 vaccine authorized for human use in Canada. This vaccine is administered in two intramuscular injections 21-28 days apart.
Pregnant and breastfeeding individuals were excluded from the Phase II and Phase III trials
Pregnant and breastfeeding individuals were excluded from the Phase II and Phase III trials involving the randomization of about 44,000 people, which showed an efficacy rate of 94.6% for symptom prevention at least 7 days after the second dose.
Unfortunately, pregnant and breastfeeding people were also excluded from all other vaccine trials for which Phase III results are available.
No potential harm has been flagged with the vaccine
Although no potential harm has been flagged, the potential risk of vaccination to a pregnant person and fetus remains unknown.
It is however known that pregnant people have an increased risk of severe morbidity if infected with COVID-19, and that severe infection carries risks to both maternal and fetal health.
There is increased risk of COVID infection to both maternal and fetal health
While pregnancy itself does not seem to carry increased risk of COVID infection, pregnant people may be vulnerable to increased risk of infection depending on their work situation (eg. health care workers, caregivers or outbreak settings). Other underlying comorbidities, like maternal age may also carry higher risk of COVID-related morbidity.
COVID-19 vaccine should not be offered to populations excluded from clinical trials until further evidence is available.
As such, the National Advisory Committee on Immunization (NACI) has advised that the “COVID-19 vaccine should not be offered to populations excluded from clinical trials until further evidence is available.
Risk assessment can deem that the benefits of vaccine outweigh the potential risks
However, if a risk assessment deems that the benefits of vaccine outweigh the potential risks for the individual or for the fetus/infant (in the case of pregnancy/breastfeeding) and if informed consent includes discussion about the insufficient evidence in this population, then a complete series of authorized COVID-19 vaccines may be offered to pregnant and breastfeeding individuals.”
People who are planning a pregnancy are advised to complete the series of 2 vaccination injections ahead of the pregnancy.
This is the official word on COVID vaccinations for pregnant and breastfeeding people, for more detailed information, you can read the full statement here.
For more information on supporting pregnancy and fertility health, feel free to contact us for a free 15-minute phone consultation.