Covid-19: Doctors want early vaccination for pregnant women

Deaths among pregnant women or those who had recently given birth shot up by 35% in the first wave of Covid-19 and 40% in the second wave.

Women who have Covid-19 in late pregnancy and the early postpartum period can get extremely ill, and global data published in the Lancet shows maternal mortality and stillbirths have increased during the pandemic.

Vaccinations help but in SA pregnant women must wait for their age group to be eligible. “The vast majority of pregnant women [those aged 18 to 35] are still not eligible for a vaccine and will only be so by the beginning of September,” said University of Pretoria professor Priya Soma-Pillay, president of the College of Obstetricians and Gynaecologists (SA).

“But I think this is too late: we’ve already seen the devastating effect of the pandemic on our mothers with a 40% increase in maternal deaths.

“The third-wave data have not been analysed as yet but we saw a greater number of deaths in the second wave than the first and if we want to stop these deaths, our only armour is vaccination.”

In deciding not to prioritise vulnerable groups for jabs, she said, the health department may have overlooked the fact that with pregnant women “we are talking about two lives, not one”.

And “many pregnant mothers are often not just looking after themselves … there are often other children in the immediate family, the extended family, and even in the community for whom she is a caregiver and breadwinner”, said Soma-Pillay.

Professor Barry Schoub, who heads the ministerial advisory committee on vaccines, confirmed that pregnant women are not being prioritised. The current advice is to vaccinate only after 14 weeks of pregnancy, but this “does not mean all pregnant women after 14 weeks can access a vaccine”.

Dr Nicholas Crisp, the health department’s deputy director-general in charge of the vaccination rollout, said: “We are indeed advising pregnant women to get vaccinated. But there are no priority groups — so pregnant women … will have to register within their age cohort.

“We are on a flat-out programme to vaccinate everyone we can get to, and we are encouraging those with comorbidities, the elderly, the pregnant and so on, to come forward as soon as possible when it’s their age band.”

University of Cape Town associate professor Simone Honikman, who heads the Perinatal Mental Health Project, said the pandemic has had distressing social, psychological and physical consequences for women during pregnancy and in the postpartum period.

But “from 1 September, all women 18 years and older who are pregnant beyond 14 weeks or breastfeeding can be vaccinated and protect themselves and their babies”.

“The vaccine has been used for hundreds of thousands of pregnant and breastfeeding women all over the world and the safety profile is very good,” said Honikman.

Soma-Pillay said the virus has not been observed in the breast milk of infected mothers but “antibodies are detected in milk if the mother gets vaccinated” and “these antibodies are passed onto the child, so the infant thus also gets a level of protection”.

She said antibodies are transferred to the infant via the umbilical cord in pregnant women, then through breast milk.

“The risk of preterm birth and stillbirth can also be potentially decreased, and so overall, the benefits far outweigh any risks,” she said.

Far fewer pregnant women will end up in hospital on a ventilator, or dying, if more of them are vaccinated, she said.