covid 19:Vaccine for pregnant women the recommended 3rd dose


 According to the High Council of Public Health (HCSP) and the High Authority of Health (HAS), women who are pregnant or have a desire for a child should receive a third dose of the SARS-CoV2 vaccine when they were vaccinated more than 6 months ago. We take stock of the latest recommendations of the health authorities.

covid 19Vaccine for pregnant women the recommended 3rd dose

Pregnant, should I do the 3rd dose of vaccine?

 Since 1 September 2021, a booster of the Covid-19 vaccine is recommended for people at very high risk of severe form and for people with comorbidities that increase the risk of severe forms of Covid-19. In an opinion issued on November 17, the French National College of Gynecologists and Obstetricians (CNGOF) and the Research Group on Infections during Pregnancy (GRIG) explain that due to the decline in immunity over time and the particular vulnerability of pregnant women to COVID, especially if there is comorbidity,  'a third dose of SARS-CoV2 vaccine should be offered to women with a desire to become pregnant or pregnant, regardless of the term of pregnancy, when the initial scheme is more than 6 months old. The CNGOF and the GRIG also recall that pregnant women are recognized as a risk group for severe forms by the High Council of Public Health (HCSP) and the High Authority of Health (HAS), especially if there is comorbidity. "Compared to an uninfected pregnant woman, there is an 18-fold increased risk of admission to intensive care, 2.8-fold fetal loss, 5-fold risk of newborn admission to intensive care and more if comorbidity," they insist. These two reference bodies also specify that studies have shown that vaccinated pregnant women are less often infected and that vaccines against Covid-19 are safe and effective and recommended by many independent learned societies.

Pregnant, should I get vaccinated against Covid-19?

In a statement published on July 12, 2021, the National College of French Gynecologists and Obstetricians (GNGOF) and the Research Group on Infections during Pregnancy (GRIG) already insisted on the importance of getting vaccinated as soon as possible when you are pregnant. Ditto for couples in desire of the child. And for good reason, 'Covid is a potentially very serious disease during pregnancy. 

Vaccination of pregnant women: at what month of pregnancy?

On July 20, 2021, health minister Olivier Véran said that pregnant women could be vaccinated against Covid-19 from the first trimester of pregnancy.

Vaccination of pregnant women: what recommendations?

In its press release of July 12, 2021, the National College of French Gynecologists and Obstetricians (GNGOF) and the Research Group on Infections during Pregnancy (GRIG) recalled that "vaccination is possible and even recommended during pregnancy". 

Does the health pass apply to pregnant women?

To allow the proper continuity of the care of pregnancies, the health pass does not apply to patients. They can therefore continue to come to consult at any time without having to have a health pass. The need for vaccination should not be an obstacle to pregnancy follow-up.

Vaccination of pregnant women: what contraindications?

According to the Minister of Health, only three situations on the advice of the National Agency for the Safety of Medicines (ANSM), Alain Fischer's committee on vaccine strategy and the scientific council "which potentially concern a few hundred French people", can give rise to a contraindication to the vaccine. Thus, only the 'PIMS syndrome', or pediatric multi-systemic inflammatory syndrome or "reactions such as myocarditis, pericarditis and severe hepatitis that required hospitalization and following the first injection of mRNA vaccine", are concerned, he said on July 20. As well as people allergic to one of the components of the vaccine, this "which must concern about ten cases in our country", reassures Olivier Véran. In these three cases, only 'proper medical certificates can be recognized as contraindications'. The Minister of Health adds that there are "no contraindications to the messenger RNA vaccine, including pregnancy in the first trimester".

What vaccines for pregnant women?

The Directorate-General for Health already recommended the Pfizer-BioNTech vaccines or the Moderna vaccine for future mothers. In a previous opinion, the High Authority for Health also recommended RNA vaccines such as the Pfizer and Moderna vaccines rather than the AstraZeneca vaccine, which is likely to cause more high fevers after vaccination. 

On March 8, the French National College of Gynecologists and Obstetricians (CNGOF) and the Research Group on Infections during Pregnancy (GRIG), which requested vaccination of all pregnant women, also made recommendations regarding the type of vaccine to be used. "mRNA vaccines (Comirnaty® or Moderna®) should be preferred. The DNA vaccine (VaccineAstraZeneca®) is not contraindicated but it is more frequently the cause of a reaction, fever without the specific risk that can be treated with paracetamol. There is? To date, no argument to think that the vaccines mentioned can induce a deleterious fetal effect? But an injection during the first trimester of pregnancy is to be avoided in principle, "said the experts.

Covid vaccine and pregnancy: what are the risks for pregnant women?

The various studies conducted on pregnant women have shown that messenger RNA vaccines against Covid-19 are not dangerous for pregnant women and their fetuses and that it is also safe to be vaccinated during breastfeeding. The Reference Centre on Teratogenic Agents (Crat) therefore advises to 'start the protocol between 10 and 20 weeks of amenorrhea [no rule], i.e. After the end of organogenesis and early enough for the pregnant woman to be protected in the third trimester'. However, there is currently little data on vaccination before 12 weeks of pregnancy, even though it is practiced in other countries. And among women who were vaccinated in early pregnancy, especially those who did not yet know they were expecting a baby, no risk was observed.

Covid and risks of premature births?

At a press briefing by the Belgian vaccination task force, Dr. Frédéric Debiève, head of the obstetrics department at the Cliniques Universitaires Saint-Luc, said that 'pregnancy increases the possibility of being treated in intensive care for Sars-CoV-2. Due to the physiology of a pregnant woman, mechanical and invasive ventilation is often necessary." Studies conducted in the United Kingdom and the United States with 4,000 pregnant women who have been affected by the Covid-19 show that they have a "60% additional risk of giving birth prematurely," said the doctor. Vaccination prevents severe forms of Covid-19, premature deliveries as well as maternal and perinatal mortality. In addition, antibodies are transmitted during pregnancy and lactation, which protects the baby."

Can I get vaccinated while breastfeeding?

Regarding breastfeeding young mothers, the CNGOF and GRIG assure it: "vaccination does not disrupt breastfeeding and breastfeeding does not prevent vaccination in any way". A breastfeeding mother can therefore be vaccinated during breastfeeding without risk to herself or her baby.