Covaxin is safe for pregnant women with a history of blood clots, ideal to take jab after the first trimester
India reported 2.38 lakh fresh COVID cases over the past 24 hours, 7 per cent lower than yesterday. The positivity rate dropped from 19.65 per cent to 14.43 per cent. According to scientists, the way to retard the curve completely will be to ensure vaccination (primary doses) for all and a healthy seropositivity rate. Although India has amped up vaccination across all eligible age groups, there is still a significant proportion of the population that hasn’t received even a single dose and is most vulnerable to catching an infection.
As per government data, only 2.78 crore doses have been administered to pregnant women — 1.59 crore have got the first dose and 1.19 crore have taken both doses — as of January 15. “There are sporadic data available on vaccination among the pregnant population. The last state-wise data that is available in the public domain dates back to September-October 2021. We need to vaccinate this group urgently as they are also in the high-risk category to catch the infection and develop complications if not tended to. We don’t have data on the impact of this latest Omicron surge on pregnant women, but in my clinic, the calls have increased. My patients are hesitant of getting vaccinated as they fear the fever could cause havoc with their unborn,” Dr. Mithee Bhanot, told News9.
Out of 12 expecting mothers, she has three patients in their second trimester who are suffering from mild symptoms of COVID. “They are under home isolation and their condition is being monitored very carefully. One out of the three is fully vaccinated yet had a breakthrough infection. The rest of my patients are being advised to take their primary dose at the earliest,” she said.
In Delhi, around 2 lakh pregnant women and lactating mothers have received their vaccination and the state government has also decided to deploy ASHA and Anganwadi workers to create awareness and encourage those left to get the COVID vaccine at the earliest.
When is the best time to take a primary dose?
Due to the absence of data and studies around pregnancy and SARS CoV 2, doctors say it is difficult to pinpoint what is the best time but they agree that ideally the first trimester should be avoided for any dose of the vaccine. “It is very important to get your vaccination – both doses. We tell pregnant women who are in their first trimester to wait to get their vaccine since the foetus is still in the development stage. But as soon as the organogenesis is complete, it is advisable for all pregnant women to take the vaccine – be it Covishield or Covaxin. If there has been a history of blood clots in the past, we recommend that they go for Covaxin. COVID appropriate behaviour needs to be followed strictly like washing of hands, wearing a mask when someone comes to visit, self-isolating as much as possible (especially during waves like this) and it is important to get all family members tested for COVID, even if they are asymptomatic. We know this Omicron variant is highly infectious and maybe in community transmission but for pregnant women, we are looking at complete prevention of the disease rather than halting the severity,” Dr Gandhali Deorukhkar, a consultant of Obstetrics and Gynaecology at the Wockhardt Hospital in Mumbai, said.
Agrees Dr Sharmila Solanki, “If the first trimester is over, get jabbed with both doses as soon as possible. The vaccine may not give you 100 per cent protection against the variant but it will not let the disease develop into something serious. It’s best for the woman and her unborn,” she added.
On foetus getting antibodies too
Gynaecologists say it has to be impressed upon women that there are absolutely no harmful side effects of the vaccination. Even fever that is caused due to immunization is not a reason for worry. “The other thing to remind moms-to-be is that the vaccination will not only protect them from the severity of the Omicron/Delta variant but will also protect the foetus to a great extent. Getting both doses is a must and we haven’t seen any major reaction to the vaccine even when it has been taken in the third trimester,” Dr Birbala Rai. About 90 per cent of pregnant ladies on her list are vaccinated. “For the rest, we are in the process of counselling them to get the jab. Family pressure and rumours are keeping them away like complications during delivery or the baby being stillborn. But these are unfounded rumours,” she clarifies.
According to her, whatever antibodies the pregnant woman is developing the same goes for the foetus. “There is vertical transmission of antibodies. That is the basic purpose of giving those jabs in the first place when the woman gets pregnant. We are protecting the foetus from developing serious diseases. The same is true for lactating mothers. Through mother’s milk, antibodies are supposed to get transmitted to the baby,” Solanki tells you.
On reasons why women are hesitating to get vaccinated
There are several, says Deorukhkar. “Basic education on the impact of COVID during pregnancy is missing. There are many questions that are unanswered. Most people feel that if they are pregnant and get a vaccination, they will have a miscarriage. This is far from true. Studies have shown that vaccination has no bearing on miscarriages. In fact, getting vaccinated will prevent the mother from getting the virus or at least prevent hospital admission during the ongoing COVID surge,” she reiterated.
Should one avoid pregnancy if tested positive for COVID?
“To plan a pregnancy is a family decision. In the first wave and the second, we didn’t have much information about the virus. But today, we are better prepared. We have seen two waves and there is so much more that we know about COVID-19 – about the disease, the symptoms and the complications of not taking the jab,” Birbala says, adding that every virologist is stressing the fact that we have to learn to live with the virus. “If that is so, then any time is a good time to start a family,” she said.
If you have tested positive with COVID, you should wait for at least two to three months before planning a pregnancy. “If the mother gets the infection immediately after having conceived, our advice will be to continue with the pregnancy. There are no problems if a pregnant woman gets COVID. She just needs to take routine medication on the advice of her doctor. This will help to prevent any neural tube deficiency,” said Dr Deorukhkar.