Covid-19 vaccine: should it be done in the first trimester of pregnancy?

in collaboration with

Olivier Picone (President of the Research Group on Infections During Pregnancy, member of the National College of French Gynecologists and Obstetricians)

Until last week, pregnant women were recommended to be vaccinated against Covid-19 only from the second trimester of pregnancy. A measure taken at the time as a precaution and for lack of scientific data. But on July 20, Olivier Véran, Minister of Health announced to the National Assembly that pregnancy was not a contraindication to messenger RNA vaccines, regardless of the stage of pregnancy. For good reason: no adverse effects have been detected in countries where vaccination has been offered to all pregnant women. This is particularly the case in the United States where a study published in June in The New England Journal of Medicine, which reveals that in more than 35,000 pregnant women vaccinated with a first dose of an mRNA vaccine, the frequency of side effects was similar to that of the rest of the general population. What do French scientific councils think? Pr Picone, president of the Research Group on Infections During Pregnancy (GRIG) and member of the National College of French Gynecologists and Obstetricians (CNGOF) responded to Doctissimo.

Would you advise pregnant women to get vaccinated in the first trimester of pregnancy?

Prof. Picone: There is no need to worry about the Covid-19 vaccination in the first trimester of pregnancy. The old recommendation to wait until the second trimester before getting vaccinated was a precautionary measure taken by the Government, due to the risk of spontaneous miscarriages relatively common during the first trimester. If pregnant women want or are obliged to be vaccinated by their profession, I see no objection. Afterwards, I understand that some people stress and wonder. It is a delicate period which always requires a lot of caution. If they want to wait until the first trimester ultrasound to monitor embryonic development before getting the vaccine, they can too.

Is the Covid-19 vaccine dangerous and likely to complicate pregnancy?

Prof. Picone: Patients should not be afraid or feel pressured into getting the vaccine. We must reassure them, explain to them, but also remind them that Covid-19 during pregnancy is much more serious than vaccination. You have to be afraid of the infection, not the vaccination. There is no risk that the vaccination that produces antibodies will interfere with the pregnancy. The antibodies produced during pregnancy, regardless of infection or vaccination, will pass the placenta especially from the 2nd trimester of pregnancy. They are not dangerous and will be transmitted to the child who will be protected from infection during the first months of his life.

But a pregnant woman infected with the coronavirus, especially between the second and third trimester of pregnancy, is more likely to suffer from complications such as respiratory distress, to be intubated, to be admitted to intensive care and to risk of death than a woman of the same age who is not pregnant. And the risk is much greater if she has co-morbidities. This is why they have been given priority for vaccination since April 2021.

What about women who are planning to have a baby or who are pregnant without knowing it?

Prof. Picone: As reported by the National Medicines and Health Products Safety Agency (ANSM), if a vaccination takes place inadvertently, that is, if a woman is vaccinated against the coronavirus and she is pregnant without knowing it, there is no need to worry. She can continue the vaccination schedule.

For women who are in a pregnancy plan, I advise them to be vaccinated now, so that the question no longer arises during pregnancy. There is no need to wait a certain time between vaccination and project start-up. On the contrary, the vaccination should not delay a pregnancy project or an IVF project.