Explainer: What you should know about COVID-19 vaccine, pregnancy and fertility
The fear of COVID-19 vaccine affecting pregnancy and fertility of people hoping to procreate is one of the reasons some Nigerians are hesitant to take the jab.
This is even as the renewed surge of COVID-19 infections is driving calls for more people to get vaccinated against the new and aggressive Delta Variant of the virus.
However, there are concerns among some Nigerians that the jab might affect the fertility or even pregnancy of recipients.
This concern may have prompted Nigeria to exclude pregnant women from those eligible to receive the jab.
In February, Nigeria’s Minister of Health, Dr. Osagie Ehanire, said that Nigerians excluded from the first batch of vaccines donated to the country were those under 18 years and pregnant women, except they have been medically certified to take the jab.
“All eligible groups must get vaccinated as and when due, while the non-eligible groups should respectfully await their turn…Persons under 18 years and pregnant women are not eligible for now, except medically certified as vulnerable. The risk for them is not yet fully assessed,” he stated.
Echoing the minister’s stance, Chairman of Bauchi State Primary Healthcare Development Agency (BSPHCDA), Dr Rilwanu Mohammed, while advising members of the public to disregard misinformation and misconceptions about the vaccines, stated that “Pregnant women, those under 18 years of age and those with critical ailment will not be given the vaccine.”
Pregnant women at higher risk of Delta Variant
The advent of the Delta Variant of COVID-19 has thrown up novel concerns on the exclusion of pregnant women from receiving vaccines against the virus and the hesitancy of expecting people.
A paper-based on national data compiled by the UK Obstetric Surveillance System, published online on July 25, found that the proportion of pregnant women admitted to hospital with moderate to severe infection rose “significantly” after the Delta variant became dominant in May.
“It is very concerning that admissions of pregnant women to the hospital with COVID-19 are increasing and that pregnant women appear to be more severely affected by the Delta variant of the disease,” said the study’s chief investigator Marian Knight, professor of maternal and child population health at the University of Oxford.
While data on the impact of Delta Variant of COVID-19 on pregnant women in Nigeria are sketchy, the UK’s data “strongly highlight the urgent need for an international approach to tackle this misinformation and improve uptake of the vaccine during pregnancy.”
Studies conducted have shown that the variant spreads faster than others.
A medical epidemiologist, Perry Wilson, said when the Delta Variant is in an unrestrained environment, where potential hosts are not vaccinated or wearing masks, “delta would spread from one person to maybe 3.5 or 4 other people while the average person infected with the original coronavirus strain will infect 2.5 in the same environment.”
Citizens above the age of 65 and those with underlying health issues have been one of those prioritised to take the jab at the initial roll out of COVID-19 vaccines across the world.
Why should pregnant women take the vaccine?
Even though the World Health Organization (WHO) stated that pregnant women are not adjudged to be at higher risk of being infected with the virus, studies indicated that they are at high risk of having severe symptoms when infected, “compared with non-pregnant women of a similar age.” And having COVID-19 during pregnancy has also been associated with a greater chance of having a premature birth.
A report by Johns Hopkins Medicine, while noting that there is still limited information about whether COVID-19 in particular is associated with pregnancy loss, miscarriage or stillbirth, said there is certainty getting high fevers in pregnancy, especially in the first trimester, can raise the risk of birth defects.
A new study has also shown that unvaccinated women are being admitted to hospital with severe COVID-19 in the UK.
The report conducted by the Nuffield Department of Population Health (NPEU), University of Oxford, concluded that pregnant women are vulnerable to getting severe illness from COVID19 with one-tenth pregnant of them admitted to hospital “with symptoms of COVID-19 require intensive care. One in five pregnant women admitted to hospital with symptoms of COVID-19 gives birth prematurely.”
Dr. Kjersti Aagaard, a maternalfetal medicine specialist at Texas Children’s Hospital, told CNN that “One reason is a decreased lung capacity for the woman as the baby grows. You can develop respiratory compromise, to the extent that you can’t recover from it.”
Aagaard added that a pregnant woman’s heart pumps 1.5 times harder than it would normally to provide adequate blood for the baby and the placenta.
“That overaction of the heart, which we call a higher cardiac output, also renders pregnant women at risk from having heart failure problems, which can be a manifestation and potential cause of death from Covid-19 disease.”
A Registrar in Public Health at Nicola Vousden NPEU pointed out that “worldwide more than 200,000 pregnant women have now received a COVID vaccine, with more than 50,000 in the UK. This study shows that very few pregnant women are admitted to hospital with COVID19 after they have received a vaccine. Other studies have shown that women who have received a vaccine pass on antibodies to their babies, so the benefits of vaccination to both pregnant women and their babies are clear.”
Vaccine not dangerous to people expecting conception
The US Centre for Disease Control and Prevention (CDC) has refuted claims of infertility properties in COVID-19 vaccines.
“If you are trying to become pregnant now or want to get pregnant in the future, you may get a COVID-19 vaccine when one is available to you. There is currently no evidence that COVID-19 vaccination causes any problems with pregnancy, including the development of the placenta,” CDC stated.
The Centre further clarified that “there is no evidence that female or male fertility problems are a side effect of any vaccine, including COVID-19 vaccines.”
Similarly, the Executive Director of the NPHCDA, Dr Faisal Shuaib, has debunked the claim that COVID-19 vaccines were designed to depopulate Africa.
He said: “Those who came up with this theory said that anybody who takes the vaccine would die immediately.
“Today, as we all can see, nearly 4 million doses of the vaccine have been administered in Nigeria and we have not recorded any case of death linked to the vaccination.”
Data from the National Primary Health Care Development Agency revealed that as at the end of June 2021, about 2 million eligible Nigerians have been vaccinated with first dose while about 45,000 of Nigerians who have been vaccinated with first dose have collected their second doses.
Dr Shuaib said no one has died as a result of the COVID-19 vaccination.
Are the vaccines safe?
The American Centre for Disease Control recommended the use of available COVID-19 vaccines to pregnant women.
It noted that the vaccines work in the body as “experts believe they are unlikely to pose a risk for people who are pregnant.”
In the same vein, new data from the UK Obstetric Surveillance System (UKOSS) show that COVID-19 vaccinations offer effective protection from risks associated with the virus infection on pregnant women.
With Nigeria yet to roll out the second batch of its newly acquired COVID-19 doses, the Nigerian Centre for Disease Control and the National Primary Health Care Development Agency are yet to state if pregnant women are still barred from taking the jab or allow them as researchers are calling for the protection of expectant mothers.