Viki Male: COVID-19 infection and vaccination during pregnancy and breastfeeding, understanding the risks and benefits

Dr Victoria (Viki) Male (Imperial College London, London, UK) delves into the impact of COVID-19 on pregnancy, and the current recommendations for COVID-19 vaccination for pregnant and breastfeeding women in this touchINFECTIOUS DISEASES interview. Dr Male also shares insight into the known efficacy and safety profile of COVID-19 vaccines in pregnant and breastfeeding women, as well as any potential risks of COVID-19 infection during breastfeeding. Finally, Dr Male discusses available resources for pregnant and breastfeeding women who have questions or concerns about COVID-19 vaccination or infection.

Interviews in this series:

Navigating concerns about menstrual cycle changes after COVID-19 vaccination

COVID-19 and family planning – Impacts of vaccination and infection

Questions:

1. What is currently understood about the potential impact of COVID-19 infection on pregnancy? (0:15)
2. What are the current recommendations regarding COVID-19 vaccination for pregnant women? (0:35)
3. Could you tell us about the known efficacy and safety profile of the COVID-19 vaccine in pregnant and women? (0:58)
4. What are the risks of COVID-19 infection in breastfeeding women? Is COVID vaccination recommended for breastfeeding women? (1:54)
5. Are they any resources you could recommend for pregnant and breastfeeding women who have questions or concerns about COVID-19 vaccination or infection? (2:32)

Available resources:

Coronavirus (COVID-19), infection and pregnancy FAQs  – Royal College of Obstetricians and Gynaecologists

Pregnancy, breastfeeding, fertility and coronavirus (COVID-19) vaccination – NHS

Coronavirus vaccine – summary of Yellow Card reporting

Disclosures: Victoria Male receives grant/research support from Borne, and has received support from Elsevier to attend the 16th Vaccine Congress as a speaker.

Support: Interview and filming supported by Touch Medical Media Ltd. Interview conducted by Katey Gabrysch.

Transcript

Hi I’m Dr. Viki Male, and I’m a reproductive immunologist at Imperial College London.

What is currently understood about the potential impact of COVID-19 infection on pregnancy?

Lots of people catch COVID when they’re pregnant will be just fine, and so will their babies. That’s particularly the case if you’ve been vaccinated, but being pregnant does put you at greater risk of needing intensive care and catching COVID. When you are pregnant it also increases the risk that your baby will be born pre-term or stillborn.

What are the current recommendations regarding COVID-19 vaccination for pregnant women?

Because of the increased risk of COVID in pregnancy, the Royal College of Obstetricians and Gynaecologists and the NHS both strongly recommend getting vaccinated against COVID, if you’re pregnant and you’ve not already been vaccinated. If you have already been vaccinated, then you’ll be offered an autumn booster to help your protection.

Could you tell us about the known efficacy and safety profile of the COVID-19 vaccine in pregnant and women?

Because it’s so important to be sure of the safety of COVID vaccines and pregnancy a lot of work has been done on researching this. 36 studies looking at more than 360,000 people vaccinated during pregnancy find no increased risk of any pregnancy problem following vaccination. Studies on effectiveness of the new bivalent boosters in pregnancy are still being carried out, but even the original vaccines and boosters, which we know are a bit less effective against omicron, which is the main strain circulating now, than they were against previous variants, even the original vaccines and boosters are still very good at preventing severe disease. And there have been no cases of COVID still reported among the vaccinated. Getting vaccinated or boosted in pregnancy also gives your baby some protection against COID after they’re born.

What are the risks of COVID-19 infection in breastfeeding women? Is COVID vaccination recommended for breastfeeding women?

There’s no evidence that COVID infection is more severe if you’re breastfeeding. And because of this, if you’re breastfeeding, you won’t be offered an autumn booster like you would be if you were pregnant. That said, if you’re being offered a vaccine, or a booster for another reason you maybe because you’re still unvaccinated or you’re being offered a booster because you’ve got a medical condition or because you work in healthcare. You don’t need to turn that down just because you’re breastfeeding. The evidence we have suggests that there’s no additional risk to COVID vaccines or boosters in those who are breastfeeding or and their babies.

Are they any resources you could recommend for pregnant and breastfeeding women who have questions or concerns about COVID-19 vaccination or infection?

The Royal College of Obstetricians and Gynaecologists has a thorough FAQ on vaccination in pregnancy and breastfeeding, and there’s also good information available on the NHS website. But if you’re still unsure, have a chat with your own doctor or midwife who will be able to give you information personalised your own situation.