Covid-19 Vaccination & Pregnancy

Dr. Thalia Isaacs, Obstetrician & Gynaecologist at Melomed Bellville
MBChb Cape Town, FCOG (SA), MMEB (O&G) (CapeTown), Dip Obs (SA)

As a global nation we have experienced our greatest challenge in the last 27 months. COVID-19 has affected the lives of each one of us whether it has been through lockdown regulations, physical or mental illness, death or loss. While there is some hope that the pandemic may be becoming less deadly and more endemic it is still of utmost importance that we utilize every tool made available to us in our fight in the war against the COVID-19 virus.

Pregnancy is a unique physiological state. It is both a beautiful and petrifying time in a woman’s life. While she hopes to knit together a new being within herself, she potentially offers her life in the process. While it is considered that pregnancy itself is not a risk factor for contracting the COVID-19 virus, it has been shown both internationally and locally that women who are pregnant and have COVID-19 infection are at a higher risk of increased disease severity, a need for oxygen supplementation, hospitalization, ventilation and death. Their fetuses are at an increased risk of preterm delivery and all the risks and complications associated thereof and a minor increase of being stillborn.

COVID-19 vaccines are safe and effective for pregnant women. The Pfizer-BioNTech vaccine has an efficacy of 95% (95% CI 90.0–97.9%) and the Janssen vaccine has an efficacy of 66.1% (95% CI 55.0–74.8%) against symptomatic COVID-19. All women in the reproductive age group should be offered a vaccine against the COVID-19 virus as well as a booster shot whether they are pregnant or are planning a pregnancy. Global studies have shown a reduction in the severity of disease, reduction in the risk of iatrogenic preterm deliveries, a reduction in stillbirths associated with COVID-19 and passive passage of antibodies against COVID-19 to the newborn after vaccination against the COVID-19 virus.

Women who are pregnant may opt to have a COVID-19 vaccine during pregnancy after 14 weeks, in line with South African Society of Obstetricians and Gynaecologists (SASOG) recommendations. Peak levels of immunity are achieved 14 days after a booster shot. Therefore, it is best if you can have both jabs two weeks before you reach your third trimester.

It is also safe to have a vaccine in the postpartum period after a normal vertex delivery also known as a vaginal delivery or after an uncomplicated caesarean section. It is also safe to have a vaccine while breast feeding.

Side effects experienced when being vaccinated are usually mild and short lived and include pain, swelling and redness at the injection site, headache, fever and body aches. More severe side effects such as thrombosis are extremely rare and there has been no evidence to date showing that having the vaccine has any negative effects on the unborn fetus.

There is also no evidence that COVID-19 vaccines affect fertility. Please do consider having a vaccine. While it remains your choice it may be what saves you or a loved one’s life. Please ask your health care provider, your obstetrician or gynaecologist for more information if you are uncertain on whether having a vaccine is safe for you. You can also find more information regarding the COVID-19 virus from reputable organisations such as the National Institute for Communicable Diseases, South African Society of Obstetricians and Gynaecologists, Royal College of Obstetrics and Gynaecology and the American College of Obstetricians and Gynaecologists. Most importantly stay well and stay safe.