COVID19 Vaccination Considerations for Pregnant Women: A Systematic Review

Zahra Ghafari, Amin Khameneh, Leila Vahedi

Abstract


Abstract

Background: Following the coronavirus disease 2019 (COVID‑19) pandemic, pregnant women are at a higher risk of developing severe COVID‑19 disease. This study investigated whether pregnant women should get vaccinated against COVID‑19 or not. Pregnant women in comparison with non‑pregnant women.

Materials and Methods: This study was a systematic review that searched the PubMed, Embase, and Scopus databases using the keywords “COVID‑19” OR “SARS‑CoV‑2” OR “Coronavirus Disease” OR “2019‑nCoV” AND “pregnancy “OR “pregnant” AND “vaccine” OR “vaccination” from January 2020 to April 2022.

Results: Of the 37 selected studies, 15 (40.50%) declared positive views, 9 (24.30%) had inconclusive views, and 13 (35.20%) opposed vaccination due to a lack of adequate information.

Conclusions: Despite the discrepancies among the studies, one‑third of the studies suggested that pregnant women be enrolled in clinical trials to investigate the outcomes of the COVID‑19 vaccination on maternal and fetal outcomes. However, the majority of the studies recommended maternal immunization against COVID‑19.



Keywords


COVID‑19, pregnancy, vaccines, women

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References


Helmy YA, Fawzy M, Elaswad A, Sobieh A, Kenney SP, Shehata AA. The COVID 19 pandemic: A comprehensive review of taxonomy, genetics, epidemiology, diagnosis, treatment, and control. J Clin Med 2020;9:1225. doi: 10.3390/jcm9041225.

Jackson LA, Anderson EJ, Rouphael NG, Roberts PC, Makhene M, Coler RN, et al. An mRNA vaccine against SARS CoV 2 preliminary report. N Engl J Med 2020;383:1920 31.

Van Spall HGC. Exclusion of pregnant and lactating women from COVID 19 vaccine trials: A missed opportunity. Eur Heart J 2021;42:2724 6.

Adhikari EH, Moreno W, Zofkie AC, MacDonald L, McIntire DD, Collins RRJ, et al. Pregnancy outcomes among women with and without severe acute respiratory syndrome coronavirus 2 infection. JAMA Network Open 2020;3:e2029256. [Last accessed on 2023 July 22].

Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: Characteristics of symptomatic women of reproductive age with laboratory confirmed SARS CoV 2 infection by pregnancy status United States, January 22 October 3, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1641 7.

Adhikari EH, Spong CY. COVID 19 vaccination in pregnant and lactating women. JAMA 2021;325:1039 40.

Tinetti ME, Esterson J, Ferris R, Posner P, Blaum CS. Patient priority directed decision making and care for older adults with multiple chronic conditions. Clin Geriatr Med 2016;32:261 75.

Whitelaw S, Sullivan K, Eliya Y, Alruwayeh M, Thabane L, Yancy CW, et al. Trial characteristics associated with under enrolment of females in randomized controlled trials of heart failure with reduced ejection fraction: A systematic review. Eur J Heart Fail 2021;23:15 24.

Rafeey M, Ghojazadeh M, Mehdizadeh A, Hazrati H, Vahedi L. Intercontinental comparison of caustic ingestion in children. Korean J Pediatr 2015;58:491 500.

Rafeey M, Ghojazadeh M, Sheikhi S, Vahedi L. Caustic ingestion in children: A systematic review and meta analysis. J Caring Sci 2016;5:251 65.

Khabbazi A, Vahedi L, Ghojazadeh M, Pashazadeh F, Khameneh A. Association of HLA B27 and Behcet’s disease: A systematic review and meta analysis. Auto Immun Highlights 2019;10:2.

Shahriyari E, Vahedi L, Roshanipour N, Jafarabadi MA, Khamaneh A, Laleh MG. Exploring the association of IL 10 polymorphisms in Behcet’s disease: A systematic review and meta analysis. J. Inflamm (London, England) 2019;16:26.

Roshanipour N, Shahriyari E, Ghaffari Laleh M, Vahedi L, Mirjand Gerami S, Khamaneh A. Associations of TLR4 and IL 8 genes polymorphisms with age related macular degeneration (AMD): A systematic review and meta analysis. Ophthalmic Genet 2021;42:641 9.

Fell DB, Dimitris MC, Hutcheon JA, Ortiz JR, Platt RW, Regan AK, et al. Guidance for design and analysis of observational studies of fetal and newborn outcomes following COVID 19 vaccination during pregnancy. Vaccine 2021;39:1882 6.

Gill L, Jones CW. Severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) antibodies in neonatal cord blood after vaccination in pregnancy. Obstet Gynecol 2021;137:894 6.

Gray KJ, Bordt EA, Atyeo C, Deriso E, Akinwunmi B, Young N, et al. COVID 19 vaccine response in pregnant and lactating women: A cohort study. Am J Obstet Gynecol. 2021;225:303.e1-303.e17. doi: 10.1016/j.ajog.2021.03.023.

Hayakawa S, Komine Aizawa S, Takada K, Kimura T, Yamada H. Anti SARS CoV 2 vaccination strategy for pregnant women in Japan. J Obstet Gynaecol Res 2021;47:1958 64.

Kaur RJ, Dutta S, Bhardwaj P, Charan J, Dhingra S, Mitra P, et al. Adverse events reported from COVID 19 vaccine trials: A systematic review. Indian J Clin Biochem 2021;36:427 39.

Kounis NG, Koniari I, de Gregorio C, Velissaris D, Petalas K, Brinia A, et al. Allergic reactions to current available COVID 19 vaccinations: Pathophysiology, causality, and therapeutic considerations. Vaccines 2021;9:221. doi: 10.3390/vaccines9030221.

Saibene AM, Allevi F, Ayad T, Baudoin T, Bernal Sprekelsen M, Briganti G, et al. Appropriateness for SARS CoV 2 vaccination for otolaryngologist and head and neck surgeons in case of pregnancy, breastfeeding, or childbearing potential: Yo IFOS and CEORL HNS joint clinical consensus statement. Eur Arch Otorhinolaryngol 2021;278:4091 9.

Male V. Are COVID 19 vaccines safe in pregnancy? Nat Rev Immunol 2021;21:200 1.

Minkoff H, Ecker J. Balancing risks: Making decisions for maternal treatment without data on fetal safety. Am J Obstet Gynecol 2021;224:479 83.

Ortega Rodríguez NR, Audícana Berasategui MT, de la Hoz Caballer B, Valero Santiago A. The century of mrna vaccines: COVID 19 vaccines and allergy. J Investig Allergol Clin Immunol 2021;31:89 91.

Whitehead CL, Walker SP. Consider pregnancy in COVID 19 therapeutic drug and vaccine trials. Lancet (London, England) 2020;395:e92. [Last accessed on 2023 Jul 22].

Rasmussen SA, Kelley CF, Horton JP, Jamieson DJ. Coronavirus disease 2019 (COVID 19) vaccines and pregnancy: What obstetricians need to know. Obstet Gynecol 2021;137:408 14.

Stafford IA, Parchem JG, Sibai BM. The coronavirus disease 2019 vaccine in pregnancy: Risks, benefits, and recommendations. Am J Obstet Gynecol 2021;224:484 95.

Jaffe E, Lyerly AD, Goldfarb IT. Pregnant women’s perceptions of risks and benefits when considering participation in vaccine trials. Vaccine 2020;38:6922 9.

Atyeo C, DeRiso EA, Davis C, Bordt EA, DeGuzman RM, Shook LL, et al. COVID 19 mRNA vaccines drive differential Fc functional profiles in pregnant, lactating, and non pregnant women. bioRxiv 2021;13:1 13. doi: 10.1101/2021.04.04.438404.

Klein SL, Creisher PS, Burd I. COVID 19 vaccine testing in pregnant females is necessary. J Clin Invest 2021;131:e147553. doi: 10.1172/JCI147553.

Dashraath P, Wong JLJ, Lim MXK, Lim LM, Li S, Biswas A, et al. Coronavirus disease 2019 (COVID 19) pandemic and pregnancy. Am J Obstet Gynecol 2020;222:521 31.

Rottenstreich A, Zarbiv G, Oiknine Djian E, Zigron R, Wolf DG, Porat S. Efficient maternofetal transplacental transfer of anti SARS CoV 2 spike antibodies after antenatal SARS CoV 2 BNT162b2 mRNA vaccination. Clin Infect Dis 2021;73:1909 12.

Rochelle P. Walensky, Experts discuss COVID 19 Vaccine doses, virus variants, and more. JAMA 2021;325:812 3.

Heath PT, Le Doare K, Khalil A. Inclusion of pregnant women in COVID 19 vaccine development. Lancet Infect Dis 2020;20:1007 8.

Bianchi DW, Kaeser L, Cernich AN. Involving pregnant individuals in clinical research on COVID 19 Vaccines. JAMA 2021;325:1041 2.

Cohen J. The line starts to form for a coronavirus vaccine. Science 2020;369:15 6.

Beigi RH, Krubiner C, Jamieson DJ, Lyerly AD, Hughes B, Riley L, et al. The need for inclusion of pregnant women in COVID 19 vaccine trials. Vaccine 2021;39:868 70.

Paul G, Chad R. Newborn antibodies to SARS CoV 2 detected in cord blood after maternal vaccination – A case report. BMC Pediatr 2021;21:138.

Lucas DN, Bamber JH. Pandemics and maternal health: The indirect effects of COVID 19. Anaesthesia 2021;76:69 75.

Rasmussen SA, Jamieson DJ. Pregnancy, postpartum care, and COVID 19 vaccination in 2021. JAMA 2021;325:1099 100.

Maykin MM, Heuser C, Feltovich H, with the Society for Maternal Fetal Medicine Health Policy Advocacy Committee. Pregnant people deserve the protection offered by SARS CoV 2 vaccines. Vaccine 2021;39:171 2.

Rubin R. Pregnant people’s paradox excluded from vaccine trials despite having a higher risk of COVID 19 complications. JAMA 2021;325:1127 8.

Chervenak FA, McCullough LB, Bornstein E, Johnson L, Katz A, McLeod Sordjan R, et al. Professionally responsible coronavirus disease 2019 vaccination counseling of obstetrical and gynecologic patients. Am J Obstet Gynecol 2021;224:470 8.

Costantine MM, Landon MB, Saade GR. Protection by exclusion: Another missed opportunity to include pregnant women in research during the coronavirus disease 2019 (COVID 19) pandemic. Obstet Gynecol 2020;136:26 8.

Costantine MM, Landon MB, Saade G. Response to letter. Obstet Gynecol 2020;136:431.

Mahase E. Vaccinating the UK: How the covid vaccine was approved, and other questions answered. BMJ 2020;371:m4759. doi: 10.1136/bmj.m4759.

Quintana SM. We have vaccine for COVID 19! What to recommend for pregnant women? Rev Bras Ginecol Obstet 2021;43:81 3.

Centor RM, Riley LE. Web exclusive. Annals on call pregnancy, lactation, and the COVID 19 vaccines. Ann Intern Med 2021;174:OC2.

Kampmann B. Women and children last? Shaking up exclusion criteria for vaccine trials. Nat Med 2021;27:8.

Ceulemans M, Foulon V, Panchaud A, Winterfeld U, Pomar L, Lambelet V, et al. Vaccine willingness and impact of the COVID 19 pandemic on women’s perinatal experiences and practices A multinational, cross sectional study covering the first wave of the pandemic. Int J Environ Res Public Health 2021;18:3367. doi: 10.3390/ijerph18073367.


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