The Ministry of Public Health (MOPH) has released a leaflet for COVID-19 vaccination in pregnancy with the information for women trying for pregnancy, pregnant and lactating women. The patient information guide has been prepared by Dr. Salwa AbouYakoub, Chair of Obstetrics, Dr. Mariam Al Beloushi, Dr. Gamal Ahmed – Senior Consultants in Obstetrics and Gynecology; Women’s Wellness and Research Center, Hamad Medical Corporation and Dr. Soha Al Bayat, Head of Vaccination, Ministry of Public Health, Qatar. Find out all the details here.

Q1: What are the vaccines available in Qatar?

A: The vaccines that are currently available in Qatar, are the Pfizer BioNTech and Moderna vaccines which are given as an injection in your arm, in 2 doses, 21 and 28 days apart, respectively. Both are non-live vaccines.

Q2: Can women take vaccines while pregnant?

A: Yes, for some vaccines. Giving women vaccines during pregnancy is not new. We have been giving non-live vaccines as the Influenza vaccine and whooping cough vaccine to hundreds of thousands of pregnant women for many years without evidence of harm to mothers and their babies.

Q3: Is it safe to take Covid-19 Vaccines in pregnancy?

A: The two COVID-19 vaccines available in Qatar (Pfizer BioNTech and Moderna vaccines) do not seem to contain ingredients that are known to be harmful to pregnant women or to a developing baby.

The Joint Committee on Vaccination and Immunization (JCVI, UK), Medicines and Healthcare products Regulatory Agency – (MHRA, UK), and Food and Drug Administration (FDA, USA) has stated that there are no emerging concerns regarding the safety of Covid-19 vaccination in
pregnancy. This is all reassuring and studies are currently underway to confirm this.

JCVI (UK)'s current advice is that vaccination in pregnancy should be considered where the risk of exposure to Covid-19 infection is high or cannot be avoided and should be considered where the woman has an underlying condition that puts her at very high risk of serious complications of COVID-19. Similar advice was issued for breastfeeding women.

Q4: What are my options?

A: This guide is intended to help you make an informed choice regards whether or not you should take the Covid-19 vaccine while trying to get pregnant, in pregnancy and during breastfeeding. After consulting your doctor and reading this leaflet, you have 2 options:

• Decide to take the vaccine
• Decide not to take the vaccine and wait until more information is available or wait till after you finish the pregnancy and breastfeeding (understandably, this will take quite a few months)

Q5: Can I get Covid-19 disease from vaccination?

A: No. Covid-19 vaccines do not contain live coronavirus and cannot give you or the unborn baby the disease.

Q6: When can I take the vaccine in pregnancy?

1. The National COVID-19 Vaccination Program prioritizes vaccination for people most at risk of severe symptoms of COVID-19. If you meet the current priority groups, you will be contacted and offered an appointment for vaccination.
2. After consulting your doctor, currently, there are 2 criteria for vaccination eligibility;
   • You are pregnant and exposed to the virus more than others (e.g. you work in a health care facility)
   • You have certain medical conditions that lower your immunity

This means that if you are pregnant and is exposed to the virus more than others (for example you work in a health care facility) you should consider taking the vaccine - after consulting your doctor- rather than getting an infection.

It also means if you have certain medical conditions that lower your immunity (listed below) and after consulting your doctor, you should also consider taking the vaccine rather than contracting the disease and having a higher risk of acquiring a severe illness. Severe illness includes illness that results in intensive care admission, mechanical ventilation, or death.

It is important to understand that severe Covid-19 disease can also occur in pregnant women without the conditions below. Here are some of the conditions that can lower your immunity, make you more vulnerable for a severe disease and we would suggest you consider vaccination in pregnancy after consulting your doctor;

1. Cancer or currently undergoing cancer treatment
2. Organ transplant
3. Down’ syndrome
4. Bone marrow or stem cell transplant in the last 6 months
5. Significant lung condition, e.g. cystic fibrosis or severe asthma or chronic obstructive lung disease
6. Conditions that significantly increases the risk of infection, e.g. severe combined immunodeficiency (SCID) or homozygous sickle cell disease
7. Currently taking medication to suppress your immune system, sufficient to increase the risk of infection (for example prednisolone, azathioprine, Tacrolimus, Ciclosporin)
8. Conditions affecting your spleen, including having your spleen removed
9. Significant kidney conditions and/or on dialysis
10. Significant heart conditions as heart failure, coronary artery disease or cardiomyopathy
11. Morbid obesity and Body mass index > 40kg/m2
12. Diabetes including gestational diabetes
13. Other conditions that your doctor or healthcare professional feels that you are at risk of acquiring severe illness if you contract Covid-19 disease

Q7: What are the benefits of Covid-19 vaccination in pregnancy?

• Reducing the risk of acquiring Covid-19 disease
• Reducing the risk of having a severe illness while pregnant – requiring hospitalization or intensive care
• Reducing the risk of dying from the disease
• Reducing the risk of having a preterm baby
• Potentially reducing the risk of transmission of infection to other household members
• Potentially passing your newly gained immunity to your baby

Q8: What are the risks of taking Covid-19 vaccines in pregnancy?

A: Experts believe these vaccines are unlikely to pose a specific risk for people who are pregnant. Small side effects can occur. It is important that you weigh these relatively small, transient risks against the benefits of taking the vaccine. These side effects include a sore arm at the site of injection, tiredness and fatigue, headache and fever.

Q9: When in my pregnancy can I go and take the vaccine?

A: You can take the vaccine anytime in pregnancy. After discussion with your doctor, you may want to take the two doses of the vaccine any time before the third trimester (before 28 weeks). But you can also take the vaccine after that.

Q10: Will the Covid-19 vaccine affect my fertility?

A: There is currently no evidence or medical reason why it should affect fertility for men or women.

Q11: I had recurrent miscarriages and am now trying to get pregnant again. Should I postpone having a Covid-19 vaccine?

A: No. There is no reason to postpone having your Covid-19 vaccine as it will not affect your risk of having a miscarriage.

Q12: I am trying for pregnancy should I take the vaccine if I am offered it?

A: Yes, current advice by JCVI, CDC and MHRA is that you take the vaccine and not delay it because you are trying to get pregnant.

Q13: I have already taken the 1st dose of the vaccine, now I am pregnant; can I take the 2nd dose?

A: Yes. You can take the 2nd dose of the vaccine at the scheduled time after consulting your doctor.

Q14: Can I take the vaccine while breastfeeding?

A: The WHO (World Health Organization), US-based CDC and MHRA, JCVI (UK) current recommendations suggest that the vaccine can be taken during breastfeeding as it not thought to pose a risk to the breastfeeding infant.

Finally, MOPH also said that the guide has the information we know so far. Understandably as we know more about Covid-19 vaccination and pregnancy, some of the information will be updated accordingly.

RELATED ARTICLE: HMC recommends COVID-19 vaccine for at risk pregnant and lactating women

Source: MOPH (Twitter)

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