Pregnant women with or without comorbidities can now be vaccinated against covid-19 from the first trimester of pregnancy. They can receive injections of the Pfizer-BioNTech and Moderna vaccines, in a vaccination center.
In France, pregnant women can receive vaccine injections at ARNm Comirnaty [Pfizer/BioNtech] and Moderna (except for those under 30) from the first trimester of pregnancy.
The question now arises of the realization a third dose in a patient whose vaccination schedule dates back more than 6 months, all the more so with the context of an epidemic resumption of Covid-19.In view of the scientific data in the literature, the National College of French Gynecologists and Obstetricians and the Group for Research on Infections during Pregnancy (GRIG), consider (in a press release of November 17) that due to the decline in immunity over time and the particular vulnerability of pregnant women to with regard to Covid, particularly if there is a co-ordination (chronic disease, immunosuppressive treatment, diabetes, hypertension, obesity, advanced age, etc.), a third dose of anti-SARS-CoV2 vaccine should be offered to women with the desire to become pregnant or pregnant, regardless of the term of pregnancy, when the initial regimen is more than 6 months old.
For now, the Ministry of Health has not commented on the issue.
Pregnancy is not a contraindication
“For pregnant women, the HAS recalls that despite the lack of sufficient data during pregnancy, the administration of vaccines against Covid-19 in pregnant women is not contraindicated. It should be considered. if the potential benefits outweigh the risks to the mother and fetus. In particular, pregnant women over 35 years of age or those with other co-morbidities such as obesity or diabetes or pregnant women who may be in contact with people infected as a result of their professional activity “underlined the High Authority for Health in its opinion on the March 2021 vaccination strategy. The Haute Autorité de Santé is based on the results of an American study which has shown that “pregnancy is an independent risk factor for developing serious forms, whether hospitalizations or deaths associated with Covid-19 “.
The HAS, in accordance with the recommendations of the ANSM, recommends giving preference in pregnant women to mRNA vaccines (Comirnaty® or Moderna® after 30 years), for which animal studies have not shown any consequences on the development of the fetus. .
Covid-19 vaccine and breastfeeding
On the issue of breastfeeding, the HAS and the Academy of Medicine take similar positions, indicating that vaccination in breastfeeding women is possible. HAS specifies that based on the rapid degradation of messenger RNAs, there is “has no effect expected in infants and children breastfed by a vaccinated woman“. The Academy of Medicine specifies for its part that it is important to preserve breastfeeding by women who have received the vaccine or who have been infected, because of the protective effect of”antibodies transmitted through breast milk“.
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