India charts fresh guidelines for vaccination of pregnant women

Medical experts have suggested a set of measures to ensure safe Covid-19 vaccination of pregnant women, just days after the Centre said they can be given the shots.

Experts, who for months have been saying pregnant women should be given Covid vaccines, said besides exclusive drives, officials should arrange for on-site consultations by gynecologists, especially for those not registered for ante-natal (pre-delivery) care. They added that a registry of vaccinated pregnant women should be maintained for long-term follow-ups.

“Pregnant women should be given priority at Covid vaccination sites. They should be assigned a day, or time of day, to ensure they don’t have to mix with the crowd,” said Sanjay Gupte, a Pune-based gynecologist who has been at the forefront of the demand for inclusion of mothers-to-be in the country’s Covid vaccine drive.

On June 25, the Centre revised an earlier policy to state that pregnant women should be vaccinated against Covid-19. “We should also have a separate registry — trimester-wise — for pregnant women who undergo vaccination, to facilitate follow-ups and data collection for future use,” said Gupte, who is also chairman (ethical committee) of the International Federation of Gynecology and Obstetrics — the organization that brings together global professional societies of obstetricians and gynecologists.

Patients suffering from severe pregnancy induced hypertension called pre-eclampsia or immune suppression treatment should be offered vaccines only after their obstetricians’ consultation and permission, the experts said.

“Besides this, women who are planning pregnancy — natural or through assisted methods — can take the vaccine and then attempt to get pregnant. Also, the vaccines do not affect fertility. Both husband and wife can take the same or different vaccines. It doesn’t matter,” said gynaecologist and infertility expert Sanjeev Khurd.

Specialists said the lead Covid vaccines in India — Covishield and Covaxin — do not contain any live virus. There is no biological mechanism in them to cause Covid in the mother or unborn foetus. Therefore, there is no transmission during pregnancy or through breast milk, they said.

“The decision will be useful for pregnant women with other comorbidities and those who are at high risk of exposure due to their work. Pregnant women account for about 5% of the population,” said gynaecologist Pankaj Sarode.

Before the June 25 revision, the health ministry had said “women who are pregnant or not sure of their pregnancy should not receive Covid-19 vaccine. But later the ministry said pregnant women should also be vaccinated.