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Covid-19: should pregnant women be vaccinated as a priority?

2021-02-04T14:34:10.816Z


DECRYPTION - While pregnant women are more likely to develop severe forms of the coronavirus, there is as yet no scientific consensus on their vaccination.


“Is it necessary to protect future mothers?

Dangerous for the baby's development?

The coronavirus vaccine raises more questions in pregnant women than science answers today.

By the summer, all adults who wish will be able to receive a dose, Emmanuel Macron promised Wednesday, February 3.

But expectant mothers have not been on the list of vulnerable people eligible for vaccination since January 18.

For good reason, to date there is no scientific consensus concerning pregnancy.

Read also: Coronavirus, what to know this week: all vaccinated at the end of the summer?

In its opinion of January 8, the Haute Autorité de santé advises against vaccination during pregnancy and the duration of breastfeeding:

“In the absence of robust data on the tolerance and efficacy of the vaccine during pregnancy, the HAS recalls that its use in pregnant women should be considered only if the potential benefits outweigh the potential risks to the mother and fetus, ”

she wrote.

In other words, women with significant comorbidities such as obesity or diabetes may be eligible, if their attending physician judges that the vulnerability requires taking the risk.

Read also: Covid-19: Does a Stanford study really show that containment is ineffective?

Particularly vulnerable pregnant women

Pregnant women have long been excluded from clinical trials of different vaccines.

For Pfizer and Moderna, the only data available relates to tests performed on animals, says the Centers for Disease Control and Prevention (CDC), the main US federal health agency.

“No safety concerns have been demonstrated in rats given the Moderna COVID-19 vaccine before or during pregnancy;

studies on the Pfizer-BioNTech vaccine are ongoing, ”

the CDC said, adding that

“ studies in pregnant women are planned ”

.

"In bioethics, pregnant women are considered a complex population

,

"

Ruth Faden, bioethicist at Johns-Hopkins University, who specializes in the rights and health of pregnant women, told the BBC.

“Nowhere else do you have two entities at the same time, both of which are objects of moral concern.

You can't involve them in clinical studies from the start. ”

There is no a priori reason to think that pregnant women should be excluded from vaccination campaigns ”.

Cyril Huissoud, Secretary General of the National College of Gynecologists

But does this prudence in principle withstand the urgency of the epidemic?

The International Federation of Gynecology and Obstetrics has called on laboratories to include pregnant women in phase 3 of their clinical trials, considering that they constitute a "high priority" group.

Decrease in immunity, decrease in respiratory capacity in connection with the increase in the size of the uterus which compresses the diaphragm and the lungs, increase in cardiac work ... Pregnancy induces physical changes which make future mothers particularly vulnerable to the coronavirus:

"It is difficult to say whether pregnant women are more at risk of contracting the virus, because they protect themselves better and apply barrier techniques better.

On the other hand, they more often develop serious forms of the disease, ”

observes Cyril Huissoud, deputy head of gynecology and obstetrics at the Hospices Civils de Lyon and secretary general of the national college of French gynecologists and obstetricians.

“For an average age of 35, 10 to 30% of symptomatic pregnant women must be hospitalized.

Many require oxygen therapy or mechanical ventilation. ”

Read also: Covid-19: why are pregnant women more at risk?

No risk of infecting the baby with the vaccine

The National Council of Gynecologists and Obstetricians is therefore advocating for vaccination of all pregnant women, whether or not they present co-morbidities.

"There is no a priori reason to think that pregnant women should be excluded from vaccination campaigns

,

"

continues Cyril Huissoud.

"

As for any population at risk, pregnant women should be able to have the choice to benefit (as a precaution) from the protection offered by vaccines."

Especially since the vaccines currently offered

"do not contain living attenuated organisms that could potentially be transmitted to the baby,"

adds the CNGOF.

Caution is also required in Belgium and the United Kingdom, which, although admitting that the first studies

"did not raise any concerns about safety during pregnancy

", for the moment advise against routine vaccination of pregnant women. .

But in Israel, the Ministry of Health has been advising them since January 28 to be vaccinated.

In the United States, these are even considered by the Food and drug administration (FDA) as a priority.

More than 10,000 pregnant women have already received an injection in the country.

"For the moment, there has been no red flag

,

"

said Anthony Fauci to the American newspaper

USA Today

.

Source: lefigaro

All tech articles on 2021-02-04

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