Status: 28.10.2021
Now a clear yes as a recommendation
I continue to receive questions about the coronavirus vaccination from expectant mothers. This shows me how much you care about your health and that of your baby. The Standing Committee on Vaccination (STIKO) had long hesitated to issue a clear vaccination recommendation for pregnant women. In its Epidemiological Bulletin No. 38 of 23 September 2021, it has now clearly positioned itself in favour of coronavirus vaccination for expectant mothers.
Nevertheless, some pregnant women are still unsure. Should I get vaccinated? Or would you rather not? When it comes to the STIKO's vaccination recommendations, you can be sure that there are no economic or political interests behind them. The committee of independent experts at the Robert Koch Institute (RKI) has been making recommendations on which vaccinations adults and children in Germany should receive since 1972. These recommendations are based solely on proven medical correlations and efficacy. The STIKO uses the latest scientific findings and carefully weighs up the benefits and risks of a vaccination both for the individual (or a group of people) and for society as a whole.
What does the STIKO now say about the coronavirus vaccination during pregnancy?
The Standing Committee on Vaccination currently recommends that all pregnant women be vaccinated with two doses of a mRNA vaccine from the 2nd trimester. Vaccination should only be carried out with two doses of the mRNA vaccine Comirnaty (BioNTech/Pfizer). The STIKO expressly points out that vaccination with the mRNA vaccine Spikevax (Moderna) or the protein vaccine Nuvaxovid (Novavax) should NOT be used, regardless of the age of the pregnant woman.
If a woman has already received a first vaccination and her pregnancy is only discovered afterwards, she should also only receive her second vaccination from the 2nd trimester onwards.
In addition, the STIKO strongly recommends that all women of childbearing age are vaccinated against Covid-19. This provides them with the best possible protection against a Covid-19 infection before they become pregnant. An mRNA vaccination is also recommended for breastfeeding mothers. You can read more about this here.
For a long time, the Standing Committee on Vaccination was very cautious with its coronavirus vaccination recommendation for pregnant women. Because there was still too little data available on how immunisation can affect expectant mothers or their (unborn) child, vaccination was not recommended or only recommended to a limited extent. The STIKO is now generally in favour of vaccination because it now considers the following findings to be reliable:
→ Severe courses of infection and complications as a result of corona are rare in unvaccinated pregnant women. Nevertheless, pregnancy in itself is already considered a risk for a severe course of the disease. This risk is further increased if the expectant mother has certain pre-existing conditions (e.g. diabetes mellitus or high blood pressure).
→ Overall, coronavirus vaccination during pregnancy is highly effective in preventing corresponding infections and severe courses of the disease.
→ The study results now available show that the mRNA vaccination is safe - both for the pregnant woman and her child. There is no evidence that adverse drug reactions occur more frequently during pregnancy after vaccination. This means that there are also no frequent miscarriages, premature births, stillbirths or congenital malformations in the children. Ultimately, the physical immune response of pregnant women to the vaccination is comparable to that of non-pregnant women.
→ Studies on protecting expectant mothers from the delta variant are still lacking. However, the STIKO emphasises that unvaccinated pregnant women are more at risk from this virus mutation than from other virus variants.
→ Vaccinated pregnant women develop antibodies against corona. These are also transferred to the unborn child via the placenta. Whether the baby is better protected against coronavirus as a result is likely, but has not yet been clearly proven.
Various gynaecological and reproductive medicine associations, such as the German Society of Gynaecology and Obstetrics (DGGG), the German Society for Prenatal and Obstetric Medicine (DGPGM) or the Professional Association of Gynaecologists (BVF) had already been calling for regular vaccination for all pregnant women since May 2021. They therefore welcome the STIKO's current recommendation.
How does the mRNA vaccination work?
With this vaccination, the human body cells receive a kind of "construction manual" for a single building block of the coronavirus. This is a protein from the envelope of the virus, the so-called spike protein. After the "inoculated" building instructions have been "read" by the human cells, they produce the protein according to plan. This is then interpreted by the immune system as a foreign, dangerous protein invader. The immune system reacts promptly to this: it produces defence cells and antibodies. If it later comes into contact with the real Corona virus, it already recognises its protein and can immediately provide the protective immune response.
Outdated status: 12/05/2021
Nothing is currently more topical than the issue of coronavirus vaccinations
When it comes to vaccinations, as a pregnant woman you probably immediately think of the coronavirus vaccination at the moment - like so many other people. This topic is currently everywhere. In my daily contact with expectant mothers, as a midwife I am also currently encountering a great deal of uncertainty and many questions: Can I get vaccinated against coronavirus as a pregnant woman? What if I belong to a risk group due to a previous illness? Or do I already belong to the risk group just because of my pregnancy?
Such uncertainties are understandable and easy to sympathise with. Even though more than a year of the pandemic is now behind us, the virus and how to deal with it continue to raise new questions. Even science and research are constantly learning and gaining new knowledge about the virus, its mutations and spread, as well as the risks of severe courses of infection.
It is now known that serious cases of COVID-19 are more likely to be triggered by infection in pregnant women than in non-pregnant women. This means that the healthy development of unborn children is also significantly more at risk. The premature birth rate - and therefore the risk for the baby - is also increased in mild cases. In any case, it is important that you as a pregnant woman protect yourself particularly well against infection.
What does the STIKO say about the coronavirus vaccination during pregnancy?
In Germany, the Federal Joint Committee (G-BA) decides whether a vaccination is included in the immunisation guideline. If this is the case, the health insurance companies also bear the costs. The decision is based on the recommendations of the Standing Committee on Vaccination (STIKO). The Federal Joint Committee generally follows these recommendations, but can theoretically also deviate from them.
It is therefore important for you to know who the STIKO actually is - and what it says about the coronavirus vaccination for pregnant women.
The Standing Committee on Vaccination (STIKO) at the Robert Koch Institute consists of independent experts. The committee has been developing recommendations on which vaccinations adults and children in Germany should receive since 1972. The STIKO weighs up the benefits and risks of a vaccination both for the individual (or a group of people) and for society as a whole. The recommendations are then always based on proven medical correlations and efficacy. The latest findings are used for this purpose.
When asked about the coronavirus vaccination for women who are expecting a child, the STIKO says (as of April 2021) None general Vaccination for pregnant women and breastfeeding mothers who do not belong to a risk group. This is because the STIKO does not yet have sufficient research results or experience on how the corona vaccination affects the mother and the unborn child.
The STIKO takes a different view when it comes to pregnant women from a Risk group goes. If, for example, chronic high blood pressure or a respiratory disease is present, the risk of a severe course of Covid-19 disease is high. According to the STIKO, the vaccination could also be considered for a pregnant woman in these cases - but only after detailed medical information and counselling! This is because the benefits of coronavirus vaccination must be carefully weighed up against the risks.
In plain language
Even if you want to, no doctor's surgery will vaccinate you as a pregnant woman against Covid-19 unless the STIKO recommends it. Otherwise, the vaccinating doctor's surgery could be held liable if you or your child suffer any damage as a result of the vaccination. No doctor will take this risk.
However, as a pregnant woman who belongs to a defined risk group, you can be vaccinated against Covid-19 after receiving detailed medical advice. In this case, the informed decision is up to you.
What do the professional associations say?
The term "professional associations" refers to gynaecological and reproductive medicine associations. These include, for example, the German Society for Gynaecology and Obstetrics (DGGG), the German Society for Prenatal and Obstetric Medicine (DGPGM), the Professional Association of Gynaecologists (BVF) and others.
At the beginning of 2021, many professional associations still agreed with the STIKO recommendation: Corona vaccination for pregnant women not as regular Offer, but only if required due to an existing high risk. This is because the data situation was still too thin even for the professional associations.
Now (as of May 2021), eleven renowned professional societies are calling for this: Allen Pregnant and breastfeeding women in Germany should be vaccinated against COVID-19 - exclusively with an mRNA vaccine. Important prerequisites: The women want to be vaccinated, receive detailed counselling and there is nothing against it.
This demand is justified as follows:
- Pregnant women are more likely to develop severe cases of COVID-19 than non-pregnant women. This means that the healthy development of unborn children is also significantly more at risk.
- There is now extensive data on the safety of mRNA vaccines. This impression was created by a new study from the USA, among others. There, a good 4,700 pregnant women were observed after being vaccinated with an mRNA preparation. The result: compared to non-vaccinated pregnant women, there were no increased abnormalities such as more miscarriages, premature births and stillbirths or malformations in the child.
- Immunisation not only helps the pregnant woman, but also her child if necessary. The antibodies produced by immunisation in the mother are transferred to the baby via the placenta and protect it against infection with the coronavirus after birth.
It now remains to be seen whether the STIKO will follow this reasoning of the professional associations and extend its recommendations in the same way. Until then, you can only be vaccinated as a pregnant woman if you belong to a risk group.
Is your baby already born and you are breastfeeding? Then you no longer need to worry too much about immunisation. The STIKO considers it "very unlikely" that immunisation against the coronavirus poses a health risk to the child. You can find more information on the coronavirus vaccination during breastfeeding here.
How does the vaccination work?
Two types of vaccine are authorised in Germany: Vector preparations and mRNA preparations. Both transmit - only in different ways - a "construction manual" for a single building block of the coronavirus to the human body cells. This is a protein from the envelope of the virus, the so-called spike protein. Once the "inoculated" instructions have been "read" by the human cells, they produce the protein according to plan. This is now interpreted by the immune system as a foreign, dangerous protein invader. The reaction follows promptly: the immune system forms defence cells and antibodies against it. If it later comes into contact with the real Corona virus, it already recognises its protein and can immediately provide the protective immune response.
Updated on 12.05.2021.
