Covid’s Clarion Call - Co vaccinate

January 24, 2022

Coronavirus Infection, the disease and vaccination in pregnant and lactating mothers in India.

It is not the strongest of the species that survives, nor the most intelligent. It is the one that is the most adaptable to change.” – Charles Darwin.

It’s January 2022 and every passing day now brings us a rise in the number of cases of the Coronavirus disease – the pandemic is slowly moving onto its way to become endemic. The pregnant and lactating mothers in our country have for long now encountered enormous amounts of anxiety, confusion, myths and unanswered questions revolving around COVID 19. It’s important to rely on scientific data, rather than hear-say for something as life altering as the vaccine.

A motivational Mithila painting

Here’s a scientific take on the frequently asked questions related to the disease, infection in pregnancy and more importantly the vaccine.

• How does covid infection affect a pregnant mother and her pregnancy?

In the current wave of covid ( omicron variant ) - two-thirds of pregnant women with COVID-19 have no symptoms at all, and most pregnant women who do have symptoms only have mild cold or flu-like symptoms . Pregnant women with symptoms of cough, fever, myalgia and a stuffy nose – are NOT at an increased risk of SEVERE disease or complications.

Most pregnant women recover from the illness as with the common cold and require only this = temperature control with paracetamol, plenty of fluids, monitoring of temperature pulse and oxygen saturation, isolation from elderly and children and following Covid appropriate behavior (CAP).

Covid infection in any trimester of pregnancy in the current variant has NOT been associated with miscarriages, anomalies or complications in the baby or delivery process.

However pregnant mothers with diabetes, heart disease, morbid obesity, advanced age and vascular disease are at an increased risk of ICU admissions due to lower respiratory tract involvement and hence require critical care and monitoring. There have been isolated reports of preterm labor, sudden onset hypertension or eclampsia, sudden cardiac arrest, still birth and decreased amniotic fluid in a few pregnant patients with COVID 19 most of these towards term. However, most infected patients recover without preterm delivery.

In small proportion of pregnant mothers who contract severe Covid infection and are extremely unwell – there could be preterm labor pains or they may warrant a preterm delivery by the doctor - to reduce the strain on their respiratory system.

One in twenty pregnant women with COVID 19 infection require hospital admission. 95 percent of these mothers are unvaccinated.

• Is it recommended to take the COVID vaccine in pregnancy and post delivery?

The Covid vaccine in pregnancy (as per current data) is safe and is recommended as a preventable measure against severe Covid infection , ICU admission , ventilator requirement and death. Various routine immunizations in pregnancy like tetanus and influenza are given with the intent to protect the mother from severe disease. At the same time these vaccines protect the baby in the womb with antibodies too. (Passive immunization) – hence preferable to take the vaccine within the 36th week. Protective antibodies from the immunized breastfeeding mother to the baby are transferred through breast milk.

The same applies to the Covid vaccine and hence it is recommended by the MOHFW and FOGSI to be taken by all pregnant women and lactating women after their well informed consent, irrespective of their stage of pregnancy.

The WHO recommends that the COVID vaccine should be taken in pregnancy – as pregnant and lactating mothers are at a risk of exposure and are in a physiologically immunosuppressed stage.

• Is there a risk for couples trying for a pregnancy, undergoing infertility treatment or who have just conceived and are in the early pregnancy stages - with the vaccine?

No there is no risk. There is no mandatory pregnancy testing required before the vaccine nor does it affect the outcome of the infertility treatment. The vaccine is deemed safe.

• Is there a category of pregnant patients in whom the vaccine should NOT be taken?

The COVID vaccine is contraindicated in the following cases:

History of allergy or anaphylaxis to previous vaccines.
Active symptoms of COVID and infection.
History of confirmed COVID infection in the last 12 weeks
COVID-19 infection previously treated with anti-COVID-19 monoclonal antibodies or convalescent plasma
Acutely unwell and hospitalized (with or without intensive care) patients due to any medical illness

• Which vaccine brand is the safest – COVAXIN, COVISHIELD and PFIZER?

With the data from the mRNA vaccine PFIZER coming out early – its safety profile has been reassuring in pregnant women and has shown almost negligible adverse outcomes.

However the two vaccines widely available to the pregnant and lactating in India are COVISHIELD and COVAXIN. The major fear revolving around these vaccines is that of thrombosis of forming blood clots. Pregnancy and the days post-delivery are also a natural thrombogenic state.

With the data and studies that are available – it remains unknown whether the risk of thromboembolism increases due to vaccination in pregnancy or in the puerperium – the data is still evolving. However based on extrapolated risk analysis from the general population, it seems the risk of thrombosis in low risk pregnant women after vaccination is extremely rare.

Hence both vaccines are safe and are recommended in pregnant and lactating mothers. In special situations like women with history of hypertension, cardiac disease, anticoagulant medication or epilepsy – COVAXIN is preferred due to a slightly better thrombotic profile. This decision is to be taken after a proper consult and opinion of the health care provider or obstetrician.

• What are the immediate side effects of the Covid vaccine in pregnancy?

Like many vaccines, the COVID vaccine may have side effects which are normally mild. After getting the vaccine injection, one can have mild fever, pain at the injection site or feel unwell for 1-3 days. The fever is harmless to the pregnancy or the foetus.

Unusual symptoms like chest pain, breathlessness, leg cramps, swelling in the body and abdominal pain that appear within 20 days of the vaccine need to be reported promptly.

• Is it true that pregnant women who opt out of the vaccine out of personal choice will not be allowed to deliver in a hospital of their choice or not issued a baby birth certificate?

Pregnant Women are counselled by their health care providers, recommended and empowered to make their own decision, supported by caregivers. However there is no force or repercussions as above should a woman chose not to take the vaccine. The decision lies with the mother alone.

• Even after taking the vaccine can a pregnant mother still get infected with COVID 19?

Pregnant or lactating mothers who receive the vaccine - can be infected even after taking two doses of the vaccine. However there is almost negligible risk of severe disease or ICU admission in vaccinated pregnant mothers.

• Once vaccinated should pregnant and lactating mothers still follow CAP (Covid appropriate behavior)?

Yes, even after vaccination they should follow the standard preventive safety measures like wearing a mask, hand wash and social distancing in public places.

• Does the virus cross the amniotic fluid in the womb or breast milk post-delivery in a mother with an active COVID infection?

The coronavirus is not known to cross the placenta and into the amniotic fluid – if so in near nil amounts. This is why the fetal effects are negligible. It doesn’t transfer in breast milk either. A newborn can be infected only through airborne transmission from the mother and the infected newborns almost always have very mild disease.

The Coronavirus is not Novel anymore and is mutating by the day. Hopefully into strains and waves that will eventually become inconsequential and routine like the common cold.

The Benefits of the vaccine FAR OUTWEIGH the supposed risks.

Receiving two doses of the vaccine is the safest and most effective way of protecting a pregnant mother and her baby from COVID-19 infection. The second dose ensures long lasting protection.

Let’s COVACCINATE our pregnant and breast feeding mums – to ensure a healthy living for them and the little ones of our future.

‘Care is an absolute, prevention is ideal’



Dr Joylene DAlmeida
Dr Joylene DAlmeida is a consultant obstetrician and gynecologist, laparoscopic surgeon at Father Muller Medical College Hospital. Her areas of special interests are preventive gynecology and high risk obstetrics.
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Comment on this article

  • Melroy C.F.Fernandes, Mangalore

    Sat, Jan 29 2022

    The beauty of Freedom, Liberty and Democracy is : everybody is freely allowed to place their views on the table for anybody who is interested to assess and make their own decisions and choices. I applaud DWM for upholding the highest standards of freedom of expression.

  • Daniel, Mangalore

    Sat, Jan 29 2022

    Looks like Doctor might have forgotten about or overlooked on Autism... Why hurry ? Test it for atleast two to three years then release? Usually vaccines require 3 to 4 years study right? now why like instant noodles? then why life long suffer? ///// Also, Research on aborted fetal cells (DNA fragments) used in vaccines causes autism or double, confusing personality..... Both of these, World Renowned Genetics Doctor Dr. Theresa Deishe and Vaccine researcher Pamela Acker Correlate Autism with fetal cell / DNA fragments in vaccines in following referenced articles at Ref: Ref2:

  • Rudolf Rodrigues, Mumbai

    Sat, Jan 29 2022

    An investigation by the Canadian COVID Care Alliance (CCCA) has found that Pfizer’s Wuhan coronavirus (COVID-19) vaccine only has an efficacy rate of 0.84 percent. They added that Pfizer’s vaccine has done “more harm than good.” The CCCA recently published a video and an accompanying 50-page PDF presentation that provides a thorough explanation of their investigation of the recent data released by Pfizer regarding the development and testing of the Big Pharma company’s COVID-19 vaccine. The video and presentation explain that the CCCA is merely quantifying and contextualizing Pfizer’s claim that taking its COVID-19 vaccine is an act of risk reduction. When the Big Pharma company first unveiled its vaccine to the public, it claimed that it showed 95 percent efficacy seven days after the second dose. But the CCCA said that the 95 percent efficacy is the reduction of “relative risk,” and not “absolute risk,” which the organization said is the more accurate scientific measurement to judge efficacy. According to the absolute risk reduction value, Pfizer’s COVID-19 vaccine only has an efficacy rate of 0.84 percent. In Pfizer’s trials for its COVID-19 vaccine, only eight out of 18,198 vaccinated participants were reported to have developed COVID-19. In the unvaccinated placebo group, 162 out of 18,325 developed COVID-19. For the untrained eye, this data shows that getting Pfizer’s COVID-19 vaccine makes a person less likely to contract the virus. But the trial data shows that, even without the vaccine, the risk of contracting coronavirus was “extremely low,” at 0.88 percent for the unvaccinated and 0.04 percent for the vaccinated.

  • Rudolf Rodrigues, Mumbai

    Sat, Jan 29 2022

    What is the new Omicron subvariant? The new version of the variant is known as BA.2, while the original Omicron is BA.1. According to the World Health OrganizationTrusted Source, the BA.2 subvariant differs from BA.1 in some of the mutations, including the spike protein. Some experts are calling the new subvariant the “stealth Omicron” because while it registers as positive on a PCR test, it isn’t immediately discernible as the Omicron variant. “Omicron and other COVID viruses can mutate when they infect new persons and multiply abundantly,” said Dr. William Schaffner, professor of preventive medicine, department of health policy, and professor of medicine, division of infectious diseases, Vanderbilt University Medical Center. “The majority of such mutations, or genetic changes, are harmless and have no impact. By statistical chance, a mutation, or a series of mutations, can occur that can alter one or more of the basic characteristics of the virus,” he said.

  • Dev, Mangalore

    Sat, Jan 29 2022

    Article is mostly based on data and lies spread by Vaccine companies which wanted to hide trial data from public until 2076. Pregnant mRNA vaccine recipients had 90% abortions while after second trimester recipients had still births which were abnormally high. As per data given here 2 thirds of pregnant women had no symptoms and others not in any danger which means experimental vaccines needn't be injected into human guinea pigs as no trials were conducted by Vaccine marketing companies on pregnant or comorbid people. Pregnant comorbid women are at risk even without corona. Finally seasonal cold virus infection turned into business of gain never needs any Emergency Use Authorised experimental jabs as no long term study has been done as with survival rate of 99.997% it doesn't qualifies to be a pandemic but Scamdemic only. DNA altering mRNA vaccines can cause future epidemic of Thalidomide like defects in generations to come. Better Beware and Safer than Suffer for Lifetime.

  • Rudolf Rodrigues, Mumbai

    Thu, Jan 27 2022

    49% of Karnataka's Covid samples in December-January had DeltaThe highly transmissible Omicron variant was found only in 27 per cent of the samples (766), other variants accounted for 24 per cent (670) Of the 2,791 samples sent from Karnataka and sequenced at INSACOG labs, 1,355 were found to have the Delta variant and its sub-lineages. The highly transmissible Omicron variant was found only in 27 per cent of the samples! This figure after DNA sequencing makes the issue more complex and shocking! Hence it's too early to predict the future course of this virus and the after effects of these experimental vaccines!

  • Daniel, Mangalore

    Thu, Jan 27 2022

    No long term study on Pregnant mothers? Are we making them research study materials ? or guinea pigs? Because of 1st wave deaths, either forced or fear of virus people got vaccinated. Results, As per available stats Locally deaths during 2nd wave increased by 130% again with booster we will have to wait and see what is the increase? Looks like Western countries communist mRNA vaccine boosters will have high death rate, luckily we are using same boosters so may be less here but again these western designed SPIKE generating vaccine instead of spike suppressing how they act we will have wait and see because these are emergency approved experimental vaccine with no long term study or on animal study or recently just got full authorisation. (only 1 year) What will happen if repeated vaccination or boosters, again wait for another year?

  • Rudolf Rodrigues, Mumbai

    Wed, Jan 26 2022

    Now there's compelling evidence that while Covid-19 has primarily been a respiratory disease, about 90 per cent of people with "moderate to severe" infections have lasting effects on the heart, said experts here. Covid affects lungs the most, but studies have shown there is increasing evidence of cardiovascular complications due to Covid-19. The virus can cause acute myocardial injury and chronic damage to the cardiovascular system.

  • Rudolf Rodrigues, Mumbai

    Tue, Jan 25 2022

    Very good information based on data published, but there's no mention of long-term effects some of which are coming to light now like it causing brain fog by damaging the brain, permanent anosmia, body pains etc. Time only will tell what conditions it will leave behind over a period of time! This vaccine companies had pushed the vaccines hastily and were supposed to be for emergency use only; also thr concerned company is infamous for fudging data! Also by now most ethical people know that fda and who are mere puppets at the hands of the powerful pharma lobby! Even the RTPCR TEST is suspect, my very personal experience when it came positive when done at your hospital and when immune repeated in two other hospitals came out as negative which was shocking! Please don't take offense to my post as I have posted facts after doing my own research with an unbiased mind! Incidentally one of my close healthy relative expired day before from a break through infection even after taking both jabs! Again please take my comment in the right scientific spirit. Thanks and wish you all the best!

  • Dr. Radhia. T, Mangalore

    Tue, Jan 25 2022

    Excellent article. Great information. Thank you 💐


    Tue, Jan 25 2022

    Very good article about vaccination and the impacts on pregnancy. Thank you very much for the timely information. How are you doing Jolene? Hope you remember me.. Henry Misquth, Bahrain/ India

  • Lovereena, Mangaluru

    Tue, Jan 25 2022

    Thanks a lot Dr Joylene. Best article and lot of information for the young women.

  • Saurabh Kumar, Mangalore

    Tue, Jan 25 2022

    Informative. Health education at its best

  • Lolita, Mangalore/ Melbourne

    Tue, Jan 25 2022

    Really good detailed information Doctor Joylene. Thanks for clearing all the doubts.

  • Mithilesh, Mangalore

    Mon, Jan 24 2022

    Very informative.. thank you doctor.

  • Sr Lily Fernandes, Maria Kripa, Mysuru

    Mon, Jan 24 2022

    Thank you Dr Joylene, for a timely article. It has cleared many doubts and fears. God bless you!

  • Sujai, Mangalore

    Mon, Jan 24 2022

    Very nice explantion Dr Joylene good informatiom ...

  • Boniface D'Souza, Moodubelle/Bangalore

    Mon, Jan 24 2022

    congratulations for your article which is highly informative and useful especially to pregnant and lactating mothers. Shall we expect many more articles in the near future also.

  • Ashok Shah, Mangalore

    Mon, Jan 24 2022

    Lots of information..... Thankyou doctor..

  • Dr. Edward Nazareth, Mangalore

    Mon, Jan 24 2022

    Well written and aptly explained article.... it answers many questions and solves several doubts about current COVID-19 situation, vaccination and their impact on pregnancy. Timely information.

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Title: Covid’s Clarion Call - Co vaccinate

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