The New York Times calls them the “hidden victims of the pandemic”: the coronavirus modifies the placenta’s ability to transport nourishment to the fetus and in women the enlarged belly alters respiratory exchanges, putting the lungs at risk
Il vaccine against Covid
pregnant it is safe and protects mother and fetus from any serious complications in a delicate moment such as that of gestation. On this neglected aspect and the adherence to the vaccination campaign by pregnant women, wrote the New York Times speaking of «hidden victims of the pandemic”: in the USA, it is emphasized, only 70% of women completed the primary course of Covid vaccination before or during pregnancy and, since the beginning of September, only 15% have opted for a booster injection.
Efficacy and studies
This low adherence by a category at risk of serious outcomes when ill with Covid has unnecessarily exposed future mothers and their children to considerable dangers.
A study cited by the NYT dating back to June 2020 showed that, among pregnant women infected with Covid, about 1 in 3 ended up in hospital (compared to 6% of non-pregnant women), 50% more risked being admitted to intensive care e 70% more that you need a fan.
According to a study coordinated by the American Centers for Disease Control and Prevention (CDC) and published in the New England Journal of Medicine, vaccination of mothers has been 52% effective in preventing the hospitalization of children under 6 months for Covid and del 70% in avoiding them intensive therapy.
The Children’s Hospital of Philadelphia has calculated (in a research published on Jama Network Open) that children born to mothers vaccinated during pregnancy have up to 10x more antibodies of those born to women who recovered from the Covid infection during the nine-month wait.
Safety of Covid vaccines
This in the face of demonstrated safety of vaccines anti Covid in each trimester of pregnancyfor both the woman and the fetus.
From the available studies and from the data collected by the pharmacovigilance systems, no signals emerge that indicate an association with an increased risk for the development of the embryo or fetus. In particular, the European Medicines Agency (EMA) has made public the results of a review of published studies (which evaluated a total of 65 thousand pregnancies), which confirms the safety of use of messenger RNA vaccines.
In Use contradictory messages
In the USA, the responsibility ofvaccine hesitancy is ascribed to the initial hesitation of official recommendations, given that the CDC approved vaccination for pregnant women only in September 2021, but also to the contradictory messages received by women in various fields: in October 2021, writes the NYT, the Maven Clinic interviewed 500 women and almost 70 percent of these said they have heard at least one person suggest they avoid the vaccine during pregnancy. In about a third of these cases, the source had been a healthcare worker.
The recommendations of the ISS
In Italy, the recommendations for pregnant women and the Covid vaccine arrived early, also because being pregnant is considered a risk factor (see Antonella Viola’s explanation further on, ed). The latest update from the Istituto Superiore di Sanità (ISS) is dated 7 September 2022 and reads: «The primary vaccination against COVID-19 and the booster doses (third and fourth dose) with mRNA vaccines are recommended to all pregnant women at any stage of pregnancy».
There are also data for Italy on risk reduction with the vaccine: the International Network of Obstetric Survey Systems (INOSS) has published data from six European countries, including ours (which participates in the network as ItOSS), which describe like over 90% of pregnant and puerperium women who developed severe Covid disease had not been vaccinated. ItOSS surveillance data also demonstrated a significant reduction in the risk of serious disease among vaccinated women (between January 1 and May 31, 2022).
Membership in Italy
With respect to Italian accession there are not many specific data, in the context of a country that has a high vaccine adherence, at least for the primary cycle (completed by 84.38% of the population).
A study on Lombardy by the State University of Milan that arrived at the end of 2021 had as data il 79,9%but an analysis relating to all of Northern Italy (finished in November 2021) lowers the value al 49,4%. Finally, a calculation made by the Vanvitelli University up to May 2022 in the geographical area of Naples, arrives only at 21.3%.
Why pregnant women are more at risk
Vaccination, in addition to being absolutely recommended for all pregnant women, is especially so to some of them: to those who are over 30 years old, are overweight or obese or have other concomitant pathologies. “It has been seen that pregnant women are more at risk of developing severe Covid disease for a number of reasons,” he explains. Antonella Violaimmunologist at the University of Padua —: both because during pregnancy there are metabolic alterations that can lead, for example, to diabetes, or to an increase in blood pressure, all factors that may predispose at a severe pathology; and because the enlarged belly presses on the ribcage and lungs so much to produce an alteration of the respiratory exchange»
.
Because fetuses and newborns are at greater risk
«Vaccination during pregnancy is also essential for the fetus and the child once born – adds Viola -. SARS-CoV-2 infection can cause profound damage to the placenta (especially in a gestational age under 30 weeks) and change its ability to transport oxygen and nutrition. Furthermore, infections in infants who are less than six months old can be dangerous because their immune system is not yet mature. The vaccine made by the mother, however, protects the very young: it has been clearly seen that the antibodies that mom develops after the anti Covid vaccination come transferred to fetuses con an effectiveness that reaches – on newborns – 80% (when mothers are vaccinated between 14 days and 21 weeks before giving birth) ».
Recommended to do the three vaccines together
In Italy we are also in a period in which theseasonal flu is at an all-time high, should pregnant women also get the flu shot? Can they do it together with the Covid vaccine? “There is no problem: both booster doses and primary vaccination can be done at the same time as the recommended vaccinations which – recalls Viola – are theflu and whooping cough. The immune system is absolutely capable of managing these three vaccines at the same time: let’s keep in mind that when we naturally encounter an infection, the antigens present on the viruses or bacteria are many more ».
It is strongly recommended for pregnant women to do all three vaccinations listed, especially now? «Of course, the reason why they are strongly recommended is that these pathologies have been seen to actually cause complications during pregnancy and can put both the mother and the fetus at risk. At the moment there is a great circulation of the flu, which is also quite aggressive, therefore absolutely, the recommendation for all pregnant women is to get all the vaccines at the same time “, concludes the immunologist.
December 14, 2022 (change December 14, 2022 | 14:47)
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