Immunisation against COVID-19 in Pregnancy and of Women Planning Pregnancy

Abstract

Following reports of the first human SARS-CoV2 infection in December 2019 from Wuhan Province, China, there was such rapid spread that by March 2021, the World Health Organization (WHO) had declared a pandemic. Over 6.5 million people have died from this infection worldwide, although this is most likely an underestimate. Until vaccines became available, mortality and severe morbidity were costly in terms of life lost as well as the cost of supporting the severely and acutely ill. Vaccination changed the landscape, and following worldwide adoption, life has gradually been returning to normal. The speed of production of the vaccines was unprecedented and undoubtedly ushered in a new era in the science of fighting infections. The developed vaccines were on the already known platforms for vaccine delivery: inactivated virus, virus vector, virus-like particles (VLP) subunit, DNA and mRNA. The mRNA platform was used for the first time to deliver vaccines to humans. An understanding of these platforms and the pros and cons of each are important for clinicians who are often challenged by the recipients on the advantages and risks of these vaccines. These vaccines have so far and reassuringly been shown to be safe in reproduction (with no effect on gametes) and pregnancy (not associated with congenital malformations). However, safety remains paramount and continuing vigilance is critical, especially against rare fatal complications such as vaccine-induced thrombocytopenia and myocarditis. Finally, the waning immunity months after vaccination means repeated immunisation is likely to be ongoing, but just how often and how many such revaccinations should be recommended remains uncertain. Research into other vaccines and alternate delivery methods should continue as this infection is likely to be around for a long time.

Humoral and cellular immune responses analysis using FTIR spectroscopy on newborns of mothers vaccinated against COVID-19 with mRNA or viral vector vaccine

“…About this, Konje et al have stated that the transplacental transfer of antibodies starts in the second trimester. 30 Similarly, Kugelman et al…”

A Mother’s Dilemma: The 5-P Model for Vaccine Decision-Making in Pregnancy

“…Studies and research have shown that the COVID-19 vaccine provides numerous benefits to pregnant women, including a reduced risk of hospitalization and death for the mother, and transmission of neutralizing antibodies to the fetus that confers disease protection after birth [ 60 , 67 ]. Pregnant individuals with beliefs that the COVID-19 vaccine carried benefits were less vaccine-hesitant and more likely to be vaccinated against COVID-19 or report an intent to vaccinate [ 36 , 68 , 69 ].…”

A potential impact of the immunological profile of current covid-19 vaccines on pregnancy outcomes

“…Post-COVID-19 vaccination, elevated coagulation indexes (D-Dimer levels) may be associated with infrequent thromboembolic events during pregnancy [8][9][10]. Furthermore, beyond the pediatric population, pregnancy may be linked to infrequent covid-19 vaccine-induced potentially fatal complications, including myocarditis and/or thrombocytopenia, although these are infrequent and require further clarification [11].…”