In a low-income country, P(H1N1)2009v infection in pregnancy is associated with considerable mortality. Delayed presentation to a tertiary care center, lack of awareness, and restricted access to treatment might have contributed to the high mortality.

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BackgroundGalacto-oligosaccharides (GOS) are prebiotics added to commercial milk formula of infants and mothers. In recent years, cases of allergy related to GOS in atopic children have been reported in the South East Asian region.Case presentationsWe describe a series of pregnant (n = 4) and lactating mothers (n = 2) who developed anaphylactic reactions after consumption of maternal milk formula containing GOS. All six subjects had pre-existing atopy and a positive skin prick test to GOS and 5/5 of the subjects who were tested had positive basophil activation tests to GOS. All of the mothers and their babies had normal neonatal outcomes after the reactions.ConclusionsThe supplementation of GOS into milk and beverages in the Asian region should take into account the rare chance of allergenicity of GOS in the atopic population.

What is already known about this topic? COVID-19 infection in pregnancy leads to an increase in adverse maternal outcomes. Owing to paucity of data regarding SARS-CoV-2 vaccine use in pregnancy there is uncertainty regarding safety of use and subsequent pregnancy outcomes. What does this study add? Provides an overview of the available SARS-CoV-2 vaccines, their mechanisms of action and feasibility of use in pregnancy. Summarises recommendations regarding vaccination of pregnant or lactating women. Data Availability-Data sharing is not applicable to this article as no new data were created or analyzed in this study. Acknowledgements:We would like to acknowledge Mr Mohesh K Mohan for his assistance in the illustration, Ms Cecille Laureano Asibal for her administrative support.