“I don’t know if the finite nature of pregnancy is being appreciated: these women are going to deliver and some may deliver early. They need to receive the vaccine in a timely way,” she said.
A north shore GP clinic which recently informed local obstetricians it was prioritising Pfizer appointments for pregnant women quickly had its bookings exhausted after women travelled from as far as Westmead in Sydney’s west for doses.
Multiple obstetricians and GPs told the Herald a possible improvement to the vaccine rollout for pregnant women could be administering it in antenatal units at hospitals.
By August 7, a total of 39 pregnant women had tested positive to COVID-19 in Sydney’s outbreak, which continues to largely affect people in their 20s in the western suburbs.
RANZCOG president Dr Vijay Roach said, while the virus was initially thought to be mild during pregnancy, increasingly it was associated with severe disease.
“Over time, we have realised it results in severe respiratory distress, the need for admission to ICU, mechanical ventilation and an increased risk of stillbirth,” he said, noting recent cases in Sydney had needed early delivery.
This week, the college updated its advice to clarify women who are trying to conceive can safely receive any available vaccine.
Dr Roach said the recommendation that pregnant women receive an mRNA vaccine, such as Pfizer or Moderna, was only based on the availability of data about these vaccines in expectant mothers.
“It doesn’t really matter that you’re trying to get pregnant or breastfeeding because you’re not pregnant,” Dr Roach said, noting there was emerging evidence breastfeeding women can transfer protective antibodies through their babies in breast milk.
“There is no evidence at all that a viral vector vaccine, like AstraZeneca, or an mRNA vaccine affects the sperm or the egg or impacts early conception.”
Women who fall pregnant after receiving one dose of the AstraZeneca vaccine can receive an mRNA vaccine as their second dose.
It came after significant confusion among women who were trying for a baby or breastfeeding as to which vaccine they should receive, particularly after all adults in Greater Sydney were recommended to receive whichever vaccine they could book.
Anita Vitanova operates the Inner West Mums Facebook group, which has more than 26,000 members. The group recently hosted a video Q&A session with Dr Roach.
“There was so much confusion and so much inaccurate information going around before,” Ms Vitanova said. The session, which remains available online for the mums’ group’s public page, was watched more than 35,000 times.
Last week, people aged 16 to 39 living in the 12 local government areas of concern in Sydney became eligible to book Pfizer appointments at mass vaccination hubs.
A summary of the RANZCOG COVID-19 vaccination guidelines
- Pregnant women are a priority group for COVID-19 vaccination, and should be routinely offered the Pfizer vaccine (Comirnaty) or Spikevax (Moderna) at any stage of pregnancy.
- Research has shown that mRNA vaccines (e.g Pfizer or Moderna) are safe for pregnant women. There is less available data on the safety of viral vector vaccines (e.g AstraZeneca) in pregnancy, hence the current advice for Pfizer or Moderna. This advice is likely to change as more data on AstraZeneca becomes available.
- Women who are trying to become pregnant do not need to delay vaccination or avoid becoming pregnant after vaccination with any COVID-19 vaccine.
- Vaccination is recommended for breastfeeding women. You do not need to stop breastfeeding before or after vaccination. Either Pfizer, Moderna or AstraZeneca vaccine is considered safe.
- COVID-19 vaccination may provide indirect protection to babies by transferring antibodies through the placenta (for pregnant women) or through breastmilk (for breastfeeding women).
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