On 2nd July, the Government of India approved the COVID-19 vaccination of pregnant women. This decision was taken as per the recommendations issued by the National Technical Advisory Group on Immunization (NTAGI). Expert body FOGSI (Federation of Obstetric and Gynaecological Societies of India) had been constantly encouraging the government to take this step, especially after India witnessed the devastating second wave of COVID-19.
This decision holds utmost importance as pregnant women are at high risk of developing severe disease of COVID-19. But, by getting vaccinated, women may be able to protect themselves and their unborn children from complications of the virus.
Since vaccination is a voluntary decision, laying forward the benefits and risks of taking the COVID vaccine during pregnancy will help the ladies make informed decisions. Hence, here, we take up some questions you may have about COVID-19 in pregnancy and taking the COVID vaccine during pregnancy.
Q.1. Why should pregnant women take the COVID-19 vaccine?
COVID-19 is an unpredictable disease. While most pregnant women (>90%) who got infected with COVID-19 developed mild or asymptomatic disease, some women’s condition deteriorated rapidly. If the latter occurs, they may require hospitalization and critical care. Moreover, pregnant women with COVID-19 are at increased risk for preterm birth and might have an increased risk of other adverse pregnancy outcomes, including higher risk of death during neonatal period.
As per FOGSI, WHO, and NTAGI, pregnant women should get vaccinated as the benefits of vaccination outweigh its risks, especially if they comorbidities or are at a higher risk of contracting the virus.
Since pregnancy is such a delicate period, it is extremely crucial to take all the precautions against COVID-19, including the vaccination.
Q.2. Are pregnant women at a higher risk of contracting the virus?
No, pregnancy doesn’t increase the risk of contracting the virus, but it may put women at risk of developing severe disease. However, some factors may increase the risk of getting exposed to the virus, such as:
– Working as a health care professional or a frontline worker.
– Living in a community with high or increasing rate of COVID-19 infections
– Coming in frequent contact with people outside the household
– Difficulty in complying with social distancing if living in a crowded household
Q.3. How does COVID 19 affect the health of the pregnant woman?
More than 90% of infected pregnant women recover at home, but few may experience rapid deterioration in health. The risk of severe disease is higher in symptomatic pregnant women. Unlike uninfected pregnant women, they are also at an increased risk of needing ICU treatment, preterm birth (without labor), pre-eclampsia-like symptoms, Caesarean section, and even death.
Q.4. Can COVID-19 impact the unborn child?
Most unborn children remain unaffected once their mothers recover from COVID-19. However, getting COVID-19 while being pregnant increases the chances of premature delivery. The baby born may weigh less than 2.5 kg.  Also, in extremely rare situations, miscarriages may happen.
Q.5. Are there any side effects of the COVID-19 vaccines that can harm the pregnant woman or fetus?
Just like any other medicine or vaccine, there may be side effects of the COVID-19 vaccine. These side effects are usually mild. Post-vaccination you may experience mild fever, pain at the injection site, or feel unwell for 1-3 days. On getting a fever, you can take paracetamol and rest.  For pain and swelling at the injection site, you can apply ice towels for 20 mins at a time. Do not rub and avoid pressing hard while sleeping. Although long-term effects and safety have not been studied, it was seen that the benefits of the available vaccines outweigh the risks. Expert bodies like FOGSI and WHO believe that taking the COVID vaccine during pregnancy shouldn’t pose any threat for the mother or the baby because of the way these vaccines evoke immunity in the body.
Q.6. Are there any post-vaccination symptoms that a pregnant woman must be aware of?
Very rarely (1 in one lakh people), some symptoms may occur within 20 days of getting vaccinated. If any of these occur, you must seek immediate medical attention. The symptoms include:
– Shortness of breath (difficulty in breathing)
– Chest Pain
– Pain in limbs/pain on pressing the limbs or swelling in the limbs (arm or calf)
– Small pinpoint hemorrhages (petechial) or bruising of the skin beyond the vaccination site
– Persistent abdominal pain with or without vomiting
– Seizures in the absence of previous history of seizures with or without vomiting
– Severe and persistent headaches with or without vomiting (in the absence of previous history of migraine or chronic headache)
– Weakness/paralysis of limbs or any particular side of the body
– Persistent vomiting without any obvious reason
– Blurred vision/pain in eyes
Any other symptom or health condition which is of concern to the recipient or the family.
Q.7. When should the COVID vaccine be given to the pregnant woman?
You can start the COVID-19 vaccination schedule anytime during pregnancy.
Q.8. How should a pregnant woman register herself for Covid-19 vaccination?
The registration process remains the same for everyone, including pregnant women. They should register themselves on Co-WIN portal or at the COVID-19 vaccination center near them.
Q.9. If a pregnant woman has already had COVID, should she take the vaccine?
If a woman gets infected with COVID-19 during her current pregnancy, then she should get the vaccine soon after the delivery.
Q.10. Which pregnant women are at higher risk of developing complications after COVID- 19 infection?
Pregnant women may be at higher risk of developing COVID-19 complications if they:
– Have diabetes, chronic respiratory conditions like COPD, asthma, cystic fibrosis, or have had an organ transplant
– Are above 35 years of age
– Are obese
– Have a history of clotting in limbs
Getting vaccinated is a personal choice. It slashes your risk of getting severe COVID-19 disease. As per experts, the way the available COVID-19 vaccines work shouldn’t pose any risks for pregnant women and their unborn child. However, it’s understandable to have doubts about taking the COVID vaccine during pregnancy. If you still have queries, please discuss your thoughts with your doctor and follow their instructions religiously.
Keep adhering to the best tools against COVID-19 even after you get vaccinated. These include:
– double masking
– avoiding crowds
– maintaining social distancing
– washing or sanitizing hands frequently
Links to all e-books: https://www.1mg.com/coronavirus-covid19
(The article is reviewed by Dr. Swati Mishra, Medical Editor)
1. Operational Guidance for COVID-19 Vaccination of Pregnant Women. Ministry of Health and Family Welfare (MoHFW). https://www.mohfw.gov.in/pdf/OperationalGuidanceforCOVID19vaccinationofPregnantWoman.pdf
2. COVID-19 Vaccines While Pregnant or Breastfeeding. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html