Are there any pregnant women

What pregnant women should know about the COVID-19 vaccination

The study situation makes it clear: In the corona pandemic, pregnant women are among the high-risk group for COVID-19 disease. In countries such as the USA, Great Britain, Israel and Belgium, expectant mothers have therefore moved up on the list of those who should be vaccinated as a priority.

In Germany, too, gynecological associations and gynecologists are now putting pressure on the still hesitant Standing Vaccination Commission (STIKO) with a statement. She believes vaccination against COVID-19 also makes sense during pregnancy, but would not generally recommend it - with reference to too few valid data.

In the federal state of Saxony they didn't want to wait for the STIKO. The Saxon Vaccination Commission (SIKO), the only other vaccination commission in Germany besides the STIKO, has just decided to recommend the COVID-19 vaccination for pregnant women.

In the rest of the country, the risk-benefit assessment of a vaccination is left to the gynecologists and, above all, the pregnant women themselves. It is all the more important that parents-to-be know a few facts.

How dangerous is COVID-19 infection during pregnancy?

"In principle, pregnant women are more susceptible to all infectious diseases," says Cornelia Hösemann, specialist in gynecology and obstetrics and chairwoman of the Saxon regional association of the professional association of gynecologists (BVF). "During pregnancy, the mother's immune system is shut down so that the baby is not rejected, half of which comes from the father's genetic makeup and is foreign to the mother's body."

Eleven professional associations are calling for the vaccination of pregnant women to be preferred because there is sufficient data to show that COVID-19 infection can also be dangerous for mother and child.

"Many pregnant women are justifiably concerned that they could become infected and become seriously ill," Christian Albring, practicing gynecologist and president of the BVF, who was involved in the statement, told DW. "Gynecologists in the university clinics report that in the current wave of infections there are more seriously ill pregnant women in intensive care units than in the previous year."

The position paper of the professional associations states that pregnant women need intensive care six times more often than non-pregnant women.

A study published in the journal "Jama Pediatrics" reads particularly alarmingly: The researchers found not only more severe disease courses in pregnant women than in non-pregnant women, but also a higher mortality rate in mother and child.

In the NDR podcast "Coronavirus Update", the virologist Christian Drosten points out that the scientists included expectant mothers in the study in 18 countries, including in nations where generally poor health care generally makes pregnancies more risky - even without a COVID-19 infection.

Why are pregnant women vaccinated in some countries but not in Germany?

"Since the vaccination in Germany, the pregnant women come to my practice and understandably ask: Why not us too?" Says gynecologist Hösemann.

The STIKO justifies its reluctance to say that pregnant women have so far been excluded from clinical studies with the COVID vaccines. A precaution to protect mother and child.

However, the vaccine manufacturers Pfizer and BioNTech started a clinical study in February to test the effectiveness of their vaccines on pregnant women and justified the step with the high risk of severe COVID-19 disease.

Can a vaccination be harmful to mother and child?

So far there is no data that would support this thesis - on the contrary. In the USA, more than 106,000 people have registered with the so-called V-safe COVID-19 Vaccine Pregnancy Registry of the health authority Centers of Disease Control and Prevention (CDC) who stated that they were pregnant during the vaccination (as of May 3, 2021) .

"The analyzes did not reveal any safety concerns for pregnant people who were vaccinated or for their babies," reports the agency. Still, more research is needed, especially in women who are vaccinated during the first and second trimester of pregnancy.

The risk of miscarriage is particularly high in the first three months of pregnancy. From the US data it can at least be deduced that the rate of miscarriages in vaccinated people is not increasing.

In France, however, they do not want to take any risks and only vaccinate pregnant women after the first trimester of pregnancy has been completed. Virologist Drosten describes France's approach as a "good, careful compromise".

The gynecologist Hösemann, who is also a member of SIKO, proudly announces in an interview that the Saxon Vaccination Commission has now also decided to recommend vaccination for pregnant women from the 13th week of pregnancy. "We are relying on data from the US and other countries that have already recommended vaccination and found it safe."

Which vaccine is suitable?

Pregnant women are only given an mRNA vaccine such as that offered by BioNTech / Pfizer or Moderna. This is mainly due to the fact that most pregnant women in the USA or Israel were given an mRNA vaccine and the available data suggest that the vaccine is effective and safe.

"It has also been proven that the IgG antibodies (which are formed in the body after vaccination against the virus) get to the child via the placenta, ”says Hösemann.

A study published in the American Journal of Obstetrics and Gynecology found the vaccine-induced antibodies in breast milk.

Hösemann tells of a woman who was vaccinated with the AstraZeneca vaccine before she knew about her pregnancy. The doctor reassures that there is no need to panic. "Anyone who has no symptoms for several weeks after the vaccination and feels good has tolerated the vaccination well." The second dose will then be an mRNA vaccine.

If the STIKO does not recommend the vaccine, can gynecologists still vaccinate?

For all gynecologists and pregnant women in Saxony, this question has just been settled. In the rest of the country, vaccination remains an individual risk-benefit assessment. "This can already happen in individual cases after a very detailed consultation, when the risk of infection AND a severe course are very high," says BVF President Christian Albring.

Pregnant women, whose risk increases due to obesity or previous illnesses, for example, have a better chance of getting the injection because their doctors are more likely to prioritize them.

All others, who the doctors advise against vaccination for the time being, can at least hope for one thing: two contact persons could receive a vaccination offer and in this way indirectly protect the mother-to-be.

Cornelia Hösemann, however, is cautiously optimistic that the STIKO will not wait long, but will soon follow the vaccination recommendation from Saxony. Then there is really only one thing missing: enough vaccine.

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