Vaccination against COVID-19 and pregnancy

Autori:

Nenad Veček, Tatjana Nemeth Blažić, Diana Nonković, Branka Arch-Veček, Slobodan Mihaljević

Sažetak

Cjepivo je najučinkovitija medicinska preventivna mjera kojom se smanjuje rizik od razvoja teških oblika bolesti COVID-19. U trudnica je prepoznata sklonost za razvoj težeg oblika bolesti nakon 28. tjedna trudnoće s posljedičnim negativnim zdravstvenim ishodima ploda (uglavnom zbog prijevremenog porođaja), pa trudnice zahtijevaju povećanu preventivnu skrb tijekom pandemije bolesti COVID-19. Cijepljene trudnice imaju niži rizik za razvoj težeg oblika bolesti, smrtnog ishoda, prijevremenog poroda i mrtvorođenja u usporedbi s necijepljenima pa međunarodna stručna društva gotovo jednoglasno preporučuju cijepljenje trudnica i žena oko trudnoće
glasničkim cjepivima (gRNK). Sigurnosni profil cijepljenja gRNK cjepivom trudnica u bilo kojoj fazi trudnoće, žena oko trudnoće i opće populacije jest jednak. Trudnicama, bez obzira na trajanje trudnoće, dojiljama i ženama koje planiraju trudnoću ili liječe neplodnost preporučuje se cijepljenje protiv COVID-19 bez odgađanja. Ne preporučuje se odgađanje cijepljenja trudnicama koje se oklijevaju cijepiti tijekom organogeneze. Trudnicama i babinjačama treba preporučiti docjepljivanje šest mjeseci nakon cijepljenja. Odluku o cijepljenju treba donijeti žena osobno, a nakon što ju medicinski djelatnik informira o stručno i znanstveno argumentiranoj dobrobiti i potencijalnim rizicima cijepljenja.

Summary

Vaccine is the most effective preventive health measure that reduces the risk of developing a severe form of COVID-19 disease. Since it was determined that pregnant women were prone to develop more severe forms of the disease after being pregnant for 28 weeks with the consequent adverse pregnancy outcome (mainly due to the premature delivery), increased preventive care is required in pregnancy during the pandemic of COVID- 19. Vaccinated pregnant women are at a lower risk for severe forms of disease, lethal outcome, preterm labour and stillbirth compared with their unvaccinated counterparts, thus the vaccination during pregnancy with mRNA vaccine is recommended by the majority of International Societies for Obstetrics and Gynaecology. The mRNA vaccine safety is equal in pregnant women at any stage of pregnancy, both in women becoming pregnant and the general population as well. It is recommended that pregnant women, regardless of the duration of their pregnancy, along with breastfeeding women, women who are planning a pregnancy or treating infertility should be immediately vaccinated against COVID-19. Vaccination postponement due to organogenesis is not recommended. Both pregnant and puerperal women should be advised to get a booster six months after vaccination. Any pregnant woman should decide for herself whether to get vaccinated, after being informed by a medical professional of vaccine risks and benefits based on professional and scientific arguments.