All About Covid Vaccination In Women Especially During Periods, Before Fertility Treatment, Pregnancy & Breast Feeding

WHY SHOULD WOMEN GET COVID VACCINATION?

Itโ€™s because we get humoral (antibody production) and/or cellularย immunity is generated in our body to counter future infection.

* To reduce the risk of infection as it is a public health problem
* To reduce the risk of severe acute morbidity and mortality from the infection
*To prevent long term effects of infection
*To prevent transmission to other individuals

WHAT TYPE OF VACCINE IS AVAILABLE IN INDIA FOR WOMEN?

* COVISHIELD โ€“ being produced by Serum Institute of India (SII) in collaboration with Astra-Zeneca. This is an adenovirus based viral vector vaccine.
* COVAXIN โ€“ being produced by Bharat Biotech Ltd. This is an indigenous vaccine
and is an inactivated (killed) whole virus vaccine.

IN GENERAL WHAT KIND OF VACCINE IS NOT TAKEN JUST BEFORE PREGNANCY, DURING PREGNANCY AND AFTER DELIVERY WHILE BREAST FEEDING?

For pregnant women, live attenuated vaccines are contraindicated. It should be noted thatย none of the COVID vaccines available in the market globally are live attenuated.

WHAT IS THE DOSAGE OF COVID VACCINE IN GENERAL WOMEN POPULATION?

All vaccines at present recommend 2 doses. They are to be administered intramuscularย  preferably on deltoid muscle. Vaccinated person is to be observed for 30 minutes for anyย  immediate adverse effects. The interval between two doses is generally 4 to 8 weeks

HOW EFFICACIOUS IS THE COVID VACCINATION?

In India, the ICMR has released a press statement on vaccine efficacy a few days
ago. The risk of infection after one or two doses of Covaxin or Covishield is 0.02% toย  0.04%. This represents an approximately 80% protection rate from infection.
Sputnik Vย  91.6% efficacy- yet to come in India

WHAT IS THE CURRENT RECOMMENDATION OF COVID VACCINATION IN PREGNANCY AND BREAST FEEDING IN INDIA?

At present, the recommendations from the Ministry of Health and Family Welfare,ย Government of India state that pregnancy and lactation are contraindications toย vaccinations. This is based on the sound principle that there is no dataย available to ensure safety in pregnancy. Both Covisheild and Covaxin manufacturers in India also state the same in their product literature

CAN A DOCTOR PRESCRIBE COVID VACCINATION IN PREGNANCY OR BREAST FEEDING WOMEN IN INDIA?

At the present time, it is emphasized that individual practitioners cannotย advise vaccination to pregnant and lactating women in India until there is a change
in recommendations from the MOHFW, GOI.

CAN I TAKE COVID VACCINATION DURING PERIODS?

Women should receive the vaccine on any day of the menstrual cycle, even duringย menstruation.
Vaccine administration in the preconception period or for women undergoingย fertility treatment including assisted reproduction

SHOULD I DO PREGNANCY TEST BEFORE GETTING COVID VACCINATION?

It is notย recommended to test for pregnancy before vaccination routinely

WHAT IF WE GOT COVID VACCINATION WITHOUT KNOWING THAT YOU WERE PREGNANT?

Vaccine administered inadvertently to a pregnant woman in early pregnancy does not have any known teratogenic effects as per available evidences.

SHOULD I ABORT THE BABY IF I AM PREGNANT AND RECEIVED COVID VACCINATION?

Women who are vaccinated in this manner need not terminate theย pregnancy as the risk of congenital anomalies does not rise above the baseline risk when compared to non vaccinated. However, at the present time, it would be prudent to defer routine Vaccination in the first trimester as there is no substantial available data to establishย absence of teratogenicity.

CAN WE GET VACCINATED IF WE ARE ALREADY INFECTED IN THE PAST?

Vaccination is advisable even if there has been a past infection. As
for the general population, vaccination should be deferred for 12 weeks from theย infection or 4 to 8 weeks from recovery

CAN WE TAKE VACCINATION DURING BREASTFEEDING?

In India it is yet to get a yes. At present, there is no data on immunization of pregnant and lactating women with Covishield or Covaxin.
Research data pertains to 131 women who were vaccinated with theย  mRNA vaccine which is not available in India is is allowed.
Additionally, protective antibodies were also isolated in umbilical cord blood and breast milk, implying protection to the fetus andย  newborn

WHAT IS THE SIDE EFFECT OF TAKING IN COVID VACCINATION IN WOMEN?

Commonly seen minor side-effects may be immediate in the form of pain, sweating and nausea. In the first seven days, the vaccine may cause fever, fatigue, myalgia,ย  arthralgia, lymphadenopathy, local pain, swelling, redness, rash and diarrhea.

Anaphylactic and severe allergic reactions
Thromboembolic phenomena resulting in cardiopulmonary or cerebrovascular events
Severe gastrointestinal disturbances
Facial palsy
Local infections โ€“ cellulitis
Hospitalization

However out of 100 million doses had been administered and 617 seriousย  adverse events had been reported.

WHO SHOULD AVOID TAKING VACCINATION?

As for the general population, pregnant and lactating women should avoidย vaccination as Pregnancy itself is a thrombhoembolic state.
Anaphylactic or allergic reaction to a previous dose of COVID-19 vaccine Immediate or delayed-onset anaphylaxis or allergic reaction to vaccines or injectable therapies, pharmaceutical products, food-items etc.

Temporarily in the following conditions:
1) Diagnosed COVID-19 infection โ€“ defer for 12 weeks from infection or 4 to 8 weeks from recovery
2) Active symptoms of COVID-19 infection.
3) COVID-19 infection treated with anti-COVID-19 monoclonal antibodies or convalescent plasma
4) acutely unwell and hospitalized (with or without intensive care) patients due to any illness