Updated Covid-19 Vaccine Advice for Pregnant Women and Other Questions Answered


Learn about updated vaccine advice for pregnant women and answers to other reader questions, including the safety of mix-and-match jabs.

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While it is possible to still contract the coronavirus after the shot, the vaccine lowers the risk of serious illness, hospitalization and death – and helps stop transmission.

While it is possible to still contract the coronavirus after the shot, the vaccine lowers the risk of serious illness, hospitalization and death – and helps stop transmission.

An updated medical advisory on Covid-19 vaccinations has been issued for pregnant and breastfeeding women. Image: iStocksource:istock

As the vaccine rollout in Australia accelerates and more people qualify for the injection, many people have questions about its safety for certain groups and whether they should wait.

Many news.com.au readers wanted to know whether women who wanted to conceive, were already pregnant, or were breastfeeding should get the shot.

Others were interested in whether they could mix and match vaccines and whether they were effective against variants such as the Delta strain that originated in Melbourne.

Infectious disease expert prof.dr. Peter Collignon of the Australian National University has answered the questions below.

I will soon be eligible for the Pfizer vaccine and have just had (and breastfed) a baby. Could you please clarify what the position is on women who are breastfeeding and why it is considered safe?

Prof Collignon said he would not hesitate to recommend that breastfeeding women who are at higher risk of becoming more seriously ill from Covid-19, such as those with diabetes or overweight, get vaccinated.

« The Pfizer vaccine in particular is not a live vaccine, so there is no reason to believe that a virus would pass into breast milk, » he said.

“I would just go ahead and get vaccinated. I don’t even see any theoretical reason to say there is a problem, » he said.

This is in contrast to the yellow fever vaccine, which is not recommended for pregnant women because it is a live vaccine.

However, for other women in their twenties and thirties with no risk factors, Prof Collignon wouldn’t force them to get the vaccine just because there are higher priority groups, such as the elderly or frontline workers, who should get vaccinated first.

« If you’re a 40-year-old who may become pregnant or breastfeeding, you’re more at risk of complications from Covid than a 20-year-old, » he said.

You can access a government decision guide for pregnant, breastfeeding or pregnant women here.

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Breastfeeding women who belong to a higher risk group for severe Covid-19 should be vaccinated.  Image: iStock

Breastfeeding women who belong to a higher risk group for severe Covid-19 should be vaccinated. Image: iStocksource:istock

My partner and I are planning a second child. Is it safe to get pregnant?

The Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG) and the Australian Technical Advisory Group on Immunization issued new advice this week that pregnant women should be routinely offered the Pfizer vaccine at any stage of pregnancy.

« This is because the risk of serious consequences from Covid-19 is significantly higher for pregnant women and their unborn babies, » a joint statement explains.

The authorities noted that global surveillance data from large numbers of pregnant women had not shown any significant safety concerns with mRNA vaccines such as Pfizer given at any stage of pregnancy.

« In addition, there is also evidence of antibodies in cord blood and breast milk, which may protect infants through passive immunity, » the statement said.

« Pregnant women are encouraged to discuss the decision regarding the timing of vaccination with their health care professional. »

Prof Collignon said that while there was not a large amount of data available on the safety of pregnant women who were vaccinated, this had to be weighed against the fact that they were more likely to have complications if they got Covid.

Pregnant women are three times more likely to be admitted to an intensive care unit if they get the coronavirus, compared with women of the same age who are not pregnant.

They are also three times more likely to require invasive ventilation, such as respiratory support.

Prof Collignon said it was not unreasonable for women to want to wait for more data to become available, especially as there wasn’t much Covid in Australia at the moment, but what data did indicate the vaccine was safe.

« What data we have available says it’s not a problem, it’s just not based on a lot of pregnant women, » he said.

However, he said he would advise people in higher risk categories, such as health care workers or quarantine workers, to get vaccinated because their risk of contracting the disease was higher.

People with risk factors such as diabetes or who are overweight should also consider getting vaccinated because of the higher risk of complications.

RELATED: Can I Go Abroad If I Get the Shot? And other questions answered

Pregnant women can get vaccinated with Pfizer.  Photo: Ishara S Kodikara/AFP

Pregnant women can get vaccinated with Pfizer. Photo: Ishara S Kodikara/AFPSource: AFP

I am a woman in her 30s, yet to have children, but consider it. Would the vaccine cause problems later in pregnancies or in fetal development? How much research has been done on this?

The updated advice from RANZCOG and ATAGI also said that women who are trying to conceive should not delay vaccination with the Pfizer vaccine or avoid becoming pregnant after vaccination.

Prof Collignon said he wouldn’t routinely recommend women to take the Pfizer before pregnancy, but he wouldn’t advise against it either.

« I think this is an individual decision. There is no data that it is harmful during pregnancy, but the data is not very comprehensive. »

I had the first injection of AstraZeneca, but I’m concerned if the vaccine is strong enough to fight the other strains of Covid?

Prof Collignon said the short answer is that authorities do not know definitively whether the AstraZeneca vaccine is effective in fighting other strains of the virus because there is not enough data.

However, real-world data from the UK suggests that AstraZeneca and Pfizer work against the Alpha (UK strain) and even the Delta strain now originated in Melbourne.

« At the moment the answer is yes, but we need to collect more data and wait and see, » said Prof. Collignon.

While the vaccine may not be as effective against the Delta strain, the data so far indicates it still offers some protection.

Prof Collignon pointed out that there were initially fears that the AstraZeneca vaccine would not work against the Alpha strain, but it appears to have been effective.

« When there are new strains, it takes a while to get enough data to answer the question, but it seems you’re getting at least partial protection, and when new data comes out, the protection is usually better than what people initially think it will be. »

Is it possible and safe to be vaccinated with more than one type of vaccine? If so, how soon after receiving the second dose of AstraZeneca vaccine can I receive a Pfizer injection?

Prof Collignon said there was vaccine mixing and matching data from Spain and England, where people have been given AstraZeneca for their first dose and then Pfizer for their second dose.

So far, it has been shown to be safe and appears to provide an equal level of protection compared to the person receiving the same vaccine for both doses. However, people may experience more side effects such as fever, aches and pains.

« They seem to have more side effects when they mix and match, but no increased serious complications, » Prof Collignon said.

« If you have to (mix-and-match), it’s fine to do, but you can feel even more unwell the day after. »

If someone does want to get a Pfizer vaccine after receiving AstraZeneca as their first dose, Prof. Collignon doesn’t understand why he should wait longer than three to four weeks.

But he thinks there’s no point in getting vaccinated with Pfizer if they’ve already had their second dose of AstraZeneca, because there’s no convincing evidence of benefits, including that it protects more against variants.

« I don’t think anyone should stand in line for a third dose. We don’t have any data to justify that, » he said.

Can my booster shot be from a different brand than my original AstraZeneca?

Prof Collignon said it seemed like people could get another booster shot after getting the AstraZeneca shot, but there was no evidence yet that it was necessary.

« Until now, there’s no evidence that if you get two doses (of AstraZeneca), you won’t have lasting protection within six to 12 months, » he said.

« If you’re fully vaccinated with AstraZeneca, it probably doesn’t make sense to re-vaccinate in a year. »

Prof Collignon said there wasn’t enough real-world data to answer questions about whether a booster shot was needed or when it would be needed.

« We’ll be wiser in a year. »

[email protected] | @charischang2


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