Title: COVID-19 Vaccine in Pregnant and Breastfeeding Women

Biography:

Dr. Gulten Guvenc received her Ph.D. from Gulhane Military Medical Academy in 2008. She studied as a visiting scholar at Texas Woman's University from August 2010 through August 2011 in Houston,the USA. She is currently Professor at Obstetrics and Gynecology Nursing Department in Gulhane Faculty of Nursing, University of Health Sciences Turkey. Her research interests include early detection and prevention of gynecological cancers, breast cancer, attitudes towards vaccination, women’s health and nursing education. Most of her research involves in developing and validating research instrument, assessing health beliefs that influence health behaviors, and evidence-based nursing interventions. She has peer-reviewed publications in reputed journals and has been serving as reviewer.

Abstract

Statement of the Problem: The new type of coronavirus infection (COVID 19), whose agent is SARS CoV 2 has been globally spreading since the end of December 2019 and it has now become a pandemic. Covid 19 pandemic has led to significant mortality and long-term morbidity globally. Risks associated with COVID 19 infection have been reported to affect pregnant women and women in the lactation period. Pregnant women are more likely to develop a more severe course of COVID 19 infection than their non-pregnant peers. Breastfeeding women are believed to have similar risks of serious disease as non-pregnant women.  Previous studies have revealed that immunization is effective and safe, especially for the prevention of severe forms of the COVID 19disease. Evidence continues to build showing that COVID 19 vaccination during pregnancy and lactation period is safe and effective. Severe disease and mortality rates have declined by the development of Covid-19 vaccines and utilization by the countries.
Methodology & Theoretical Orientation: In this review, the safety and effectiveness of Covid-19 vaccines in pregnant and breastfeeding women were summarized with a review of limited data and theoretical considerations of recommended guidelines for clinical use and published studies. A systematic search was conducted on PubMed, MEDLINE, and Embase to identify studies on pregnant and breastfeeding women and COVID 19 vaccine. This review also included the collaborative efforts of the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), American College of Obstetricians and Gynecologists (ACOG), National Institutes of Health (NIH), and Advisory Committee on Immunization Practices (ACIP).  The search was restricted to the English language. The search terms includes pregnancy, breastfeeding, lactation, COVID-19 vaccine and related terms. 
Findings: This review demonstrated that COVID-19 vaccination in pregnant and breastfeeding women is effective in preventing the transmission of COVID 19. Primary vaccine administration earlier rather than later in gestation provides the most maternal benefit as it reduces the maternal risk of hospitalization because of COVID-19, death from COVID-19,  and COVID 19 related pregnancy complications during more weeks of the pregnancy. Despite tremendous progress in vaccine 

development and administration, the current acceptance level of the COVID-19 vaccine remains inadequate. Health care providers provide evidence-based information and allowing the individual to weigh the risk and benefits of vaccination to make a well-informed decision.
Conclusion & Significance:  The results of this review support current recommendations of WHO and obstetrical and gynecologic societies that COVID-19 vaccines can be used safely during pregnancy and lactation.  A clear indication from healthcare providers would improve adherence to vaccination programs and reduce women’s anxiety with the decision.
Guidelines supports that COVID-19 vaccination be recommended to all pregnant and breastfeeding women, in the absence of a specific contraindication.