• Health Minister Olivier Véran said on Tuesday that pregnant women could be vaccinated from the start of their pregnancy.

  • Since April 3, the anti-Covid vaccination has been open to pregnant women, but with some exceptions, they had to wait until the second trimester of their pregnancy to be eligible.

  • A precaution dictated by the lack of available data on the effects of the vaccine on this population, but which no longer needs to be maintained.

They had to wait until the second trimester of their pregnancy to claim it, but pregnant women will finally be able to be vaccinated against Covid-19 from the “first trimester”, Olivier Véran told the Assembly on Tuesday.

The extension of the health pass led the government to decide this question, a source of concern for women at an early stage of their pregnancy, who feared that they would not be protected against the coronavirus and that they would no longer be able to access certain places. before long weeks.

But what scientific data is this turnaround based on?

Is it safe for the health of women and their unborn children?

" That's very good news "

"This is very good news," says Dr. Marie-Claude Benattar, gynecologist. Women have continued to get pregnant since the start of the pandemic, and between the risks of severe forms of the virus and childbirth complicated by health restrictions, they have led their pregnancies with more anxiety. Their eligibility for the vaccine is obviously a good thing, to ensure the safety of their pregnancy, their good health and that of their unborn baby, especially with the explosion of contaminations caused by the Delta variant ”.

For the gynecologist, “if Olivier Véran gives the green light, it is because he is sure that messenger RNA (mRNA) vaccines are not harmful during the first trimester, neither for the mother nor for the unborn child. .

MRNA technology is safe and efficient.

We will be able to reassure our patients, and remind them that their partner also has an interest in being vaccinated, to allow the entire household to achieve immunity ”.

Only three medical contraindications have been established by the National Medicines Safety Agency (ANSM) and the vaccination strategy committee of Alain Fischer and the scientific council, explained Olivier Véran.

Precautionary principle

So, why not have authorized the vaccination earlier in the early stages of pregnancy? The French health authorities have adopted the precautionary principle, due to the lack of data available on the vaccination of pregnant women. First excluded, they have gradually been eligible. From March 2, the High Authority of Health (HAS) thus indicates that "despite the lack of sufficient data during pregnancy, the administration of vaccines against Covid-19 in pregnant women is not against indicated ”, and“ should be considered if the potential benefits outweigh the risks to the mother and fetus ”, especially in cases of overweight or co-morbidities. And as of April 3, "pregnant women from the 2nd trimester of pregnancy have priority in access to mRNA vaccines," indicates the ANSM.

"It was normal to rely on the precautionary principle: when this measure was taken, we did not have the perspective that we now have on vaccines, recalls Professor Olivier Picone, obstetrician gynecologist at the hospital Louis-Mourier, in Colombes, and member of the National College of French Gynecologists and Obstetricians (CNGOF). For the health authorities, this was to allow access to vaccination for pregnant women, who are known to be more at risk of severe forms of the coronavirus during the third trimester, while being extremely careful. The problem is that this created a form of misunderstanding from the start: this recommendation did not mean that vaccination was contraindicated at an earlier stage of pregnancy. Moreover, from the start, the Crat,the Reference Center on Teratogens, which studies substances that can cause fetal malformations, has indicated that there is no risk in starting the vaccination early in pregnancy, and that being pregnant should not prevent the continuation of the vaccination schedule. Moreover, when patients were vaccinated and discovered a few days after they were pregnant, I reassured them: there is no need to panic, they can continue their vaccination schedule without fear ”.when patients were vaccinated and discovered a few days after they were pregnant, I reassured them: there is no need to panic, they can continue their vaccination schedule without fear ”.when patients were vaccinated and discovered a few days after they were pregnant, I reassured them: there is no need to panic, they can continue their vaccination schedule without fear ”.

Reassuring returns from other countries and active pharmacovigilance

Other countries have also bet without delay on vaccination from the start of pregnancy.

Israel gets the ball rolling at the start of 2021 and at the beginning of March, the vaccination taskforce set up by the Belgian government gives the green light to the vaccination of pregnant women.

And the data collected on these populations is reassuring.

"The studies carried out to date have not shown any consequences of mRNA vaccines on the course of pregnancy", reassures the ANSM, which is then based on an observational study conducted in the United States, bringing together 35,000 pregnant women having already received a first injection of an mRNA vaccine during their pregnancy, and published in

The New England Journal of Medicine

.

“The frequency of local and systemic side effects in expectant mothers is similar to what is observed in the general population.

To date, the data do not show any risk for pregnant women and future children, ”indicates the ANSM.

“That is to say, no increased risk of miscarriage, prematurity, or death in utero linked to the anti-Covid vaccination during pregnancy, specifies Professor Picone.

There is no warning signal, and it is all the more reassuring that pharmacovigilance services around the world are very active and attentive in particular to the effects in these women.

If there had been the slightest concern, the alert would have already been given ”.

The pressure of extending the health pass

Reassuring data which is not new and dates from the spring of 2021. But it is more the extension of the health pass urged the government to review its copy. Without compromising on health safety rules. "In light of the recommendations on the health pass and the questions about vaccination in pregnant women, and given that nothing in the scientific literature indicates that there is an increased risk, the government has approached the rules in force on the seasonal flu vaccination, indicated for several years for pregnant women, whatever the stage of their pregnancy, analyzes Professor Picone. What to be afraid of is the Covid-19, not the anti-Covid vaccine ”.

A vaccine which, in addition to the absence of excess risk, "has demonstrated its protective effects on pregnant women," underlines Professor Picone.

The antibodies produced after vaccination by the mother not only protect her, but they cross the placenta and then protect the newborn during her first weeks of life.

Antibodies which also pass into breast milk, as is already the case with vaccination during pregnancy against influenza or whooping cough ”.

But the obstetrician gynecologist knows, "faced with the general risk of miscarriage during the first trimester, it is possible that some women prefer to wait before being vaccinated, in which case there is obviously no question of imposing the health pass for access to care for pregnant patients who have not yet been vaccinated!

"

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  • Covid 19

  • Coronavirus

  • Health

  • Anti-covid vaccine

  • Vaccination

  • Pregnancy