COVID-19 vaccination during pregnancy — the number required for vaccination to avoid harm

Pregnant women are vulnerable to COVID-19 and are at increased risk of more serious illness and complications, especially if infected late in pregnancy.1Aroti J Stall E Bonnet M et al.Clinical Symptoms, Risk Factors, and Maternal and Perinatal Outcomes of Coronavirus Disease 2019 During Pregnancy: A Live Systematic Review and Meta-Analysis. Vaccination against SARS-CoV-2 during pregnancy has the same efficacy and side effects as the non-pregnant population, as no mechanism of fetal harm has been assumed based on previous experience with vaccines during pregnancy. Was expected. Although limited, current data supports this. No major safety signals were observed in animal reproductive toxicity studies or post-marketing surveillance. However, until recently, there was little consensus on routine immunization during pregnancy, and the hesitation of vaccination of pregnant women remains high.2Skjefte M Ngirbabul M Meiju O et al.Acceptance of COVID-19 vaccine between pregnant women and infant mothers: Survey results in 16 countries.Informed healthcare decisions require a balance between benefits and risks. This is difficult when considering COVID-19 vaccination and pregnancy due to geographically varying individual risks of SARS-CoV-2 infection.3Calafat E Maggie LA From Dadelszen P O'Brien P Karil A SARS-CoV-2 Vaccination During Pregnancy: A Unique Opportunity for Fairness. And temporally, and the relative lack of test data in this population. However, the average benefit of vaccination can be weighed against the average risk. As a general rule, vaccination of pregnant women is recommended only if the number required for vaccination (NNV) to prevent harm to the mother and fetus from COVID-19 is less than the harm-causing NNV. Should be.Absolute estimates of NNV based on point estimates of the benefits and risks of COVID-19 vaccination during pregnancy are: appendix, With methodological information. Considering the benefits, NNVs to prevent SARS-CoV-2 infection during pregnancy range from 11 to prevent infection to 206 to prevent one symptomatic infection. The NNV for preventing severe maternal COVID-19 was 412–2058 and the NNV for avoiding mechanical ventilation was 1371–6857. NNV for fetal benefits by avoiding pregnancy complications is 200 for preterm or caesarean delivery (176 and 182, respectively), 463 for neonatal problems, to avoid babies with a small gestational age Will be in the thousands. Or stillbirth.Considering the harm, COVID-19 vaccination generally causes local side effects, but serious adverse events are rare and less common than non-pregnancy vaccination ()appendix). NNV with mRNA vaccine, which causes one case of myocarditis (usually mild and self-restricting in itself), is over 37,000, and one case with thrombotic thrombocytopenia syndrome with viral vector vaccine is about 50,000 excess. Cause to. Importantly, there is no increase. Risk of pregnancy complications.Actual estimates of NNV in pregnant women are higher than those estimated here, especially based on the increased cumulative rate of SARS-CoV-2 infection in unvaccinated individuals and the prevalence of SARS-CoV-. It can be low (that is, better). Two variants of concern. Pregnant women are also less likely to receive COVID-19 vaccination, but have or live with other infants who are more likely to interact with others in activities and day care. There is a possibility.The risk balance favors COVID-19 vaccination during pregnancy, especially to avoid severe maternal infections and preterm birth or caesarean section. These data should be used to address and avoid vaccine hesitation caused by knowledge gaps.PO'B is the Co-Chair of the Royal College of Obstetrics and Gynecology and Vaccines. EM is funded by Gedeon Richter, Chugai Pharma, and Kebomed and was an advisor to Pfizer in 2018. AK is a member of the COVAX Working Group and is a Principal Investigator in the PregCov and PfizerCOVID vaccine trials. PH is the principal investigator of the PregCov trial. All authors lead and collaborate on COVID-19 vaccine research.Supplementary materialReferences1.1.Aroti J Stall E Bonnet M et al.Clinical Symptoms, Risk Factors, and Maternal and Perinatal Outcomes of Coronavirus Disease 2019 During Pregnancy: A Live Systematic Review and Meta-Analysis.BMJ. 2020; 370m33202.2.Skjefte M Ngirbabul M Meiju O et al.Acceptance of COVID-19 vaccine between pregnant women and infant mothers: Survey results in 16 countries.EurJ Epidemior. 2021; 36: 197-2113.3.Calafat E Maggie LA From Dadelszen P O'Brien P Karil A SARS-CoV-2 Vaccination During Pregnancy: A Unique Opportunity for Fairness.The lancet. 2021; 398: 951Article informationPublication historyRelease date: November 2, 2021IdentityDOI: https://doi.org/10.1016/S1473-3099 (21) 00691-5Copyright© 2021 Elsevier Ltd. All rights reserved.ScienceDirectAccess this article on ScienceDirect Sources 1/ https://Google.com/ 2/ https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00691-5/fulltext The mention sources can contact us to remove/changing this article

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COVID-19 vaccination during pregnancy — the number required for vaccination to avoid harm

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COVID-19 vaccination during pregnancy — the number required for vaccination to avoid harm

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