One year after the start of the coronavirus pandemic in Italy, enormous progress has been made on the topic of vaccinations. At present, thirteen vaccines are in a very advanced experimental phase and 6 have been authorized for use in humans.
The European Commission has in fact already signed several purchase commitments with the pharmaceutical manufacturers:
- Janssen-J & J,
But who will be vaccinated for Covid 19 and when? Above all: why are we not talking about children and pregnant women?
On December 27, with Vaccine day, it officially began in Italy the vaccination campaign. It will be divided into four phases.
It started by vaccinating health and social health workers, staff and guests of residential facilities for the elderly and the elderly over 80. In the subsequent stages, extremely vulnerable people are vaccinated, understood as suffering from diseases or disabilities that involve a particularly high risk of develop severe or lethal forms of COVID-19. Followed by people aged 70 to 79 and the population with at least one chronic comorbidity (source info.vaccinicovid.gov.it/). Then teachers and school staff, prisons, people with minor illnesses and the rest of the population. But what about children and pregnant women? How come we don’t talk about them?
Pregnancy, postpartum and breastfeeding are three delicate stages in a woman’s life. During a pandemic it is normal to be assailed by doubts, the main one of all is the fear of getting sick with Covid-19 or infecting the child.
What to do then? The first rule is to carefully respect the prevention measures against contagion from the new Coronavirus, especially during breastfeeding.
Rules for breastfeeding with a Covid-19 positive mother
In case of coronavirus positivity, the mother will have to:
- Wear a face mask when close to your baby
- Perform hand hygiene before and after having close contact with the baby
- Follow the other recommended general hygiene measures
- If there is a need to pump breast milk with a manual or electric breast pump, the mother should wash her hands before touching any instrument or part of the bottle and follow the recommendations for proper cleaning of the breast pump after each use.
- If possible, arrange for expressed milk to be given to the baby by someone who is in good health.
General rules for protecting the newborn from the coronavirus
To avoid the infection of the child, here are the indications:
- wash your hands before touching or breastfeeding the baby,
- wearing the mask during breastfeeding or with adapted milk,
- avoid kissing him,
- protect him from coughing,
- avoid visits from relatives or friends,
- wash your hands before and after feeding.
Fortunately, the data available to date suggest that children and infants appear to get less sick or otherwise appear to have a milder form of COVID-19 than adults. Most children positive for COVID-19 are in fact
asymptomatic or paucisymptomatic.
You can get vaccinated during pregnancy and breastfeeding against SARS-CoV-2
No data are currently available on the safety and efficacy of COVID-19 vaccines in pregnant and lactating women because pregnant and lactating women were not included in the Pfizer-BioNtech and Moderna mRNA vaccine evaluation studies. .
The WHO though not recommend the anti-Covid vaccine in pregnancy due to lack of data. This is not to say that the vaccine is unsafe. It just means that they don’t have enough elements to be sure of success. In particular theWorld Health Organization on January 26 recommended not to vaccinate pregnant women using the Moderna vaccine except under certain circumstances, but three days later she revised her statement in more permissive language, advocating offering the vaccine to pregnant women at high risk of exposure.
The Italian Obstetric Surveillance System (ItOSS) of the Istituto Superiore di Sanità (ISS) has drawn up a document, initially published on January 8, 2021 and then updated, which establishes what is written below.
These are the interim indications as of January 31, 2021:
- pregnant and lactating women were not included in the Pfizer-BioNtech mRNA (Comirnaty), Moderna and AstraZeneca vaccine evaluation trials so we do not have safety and efficacy data for these people
- studies conducted so far have not shown or suggested biological mechanisms that could associate mRNA vaccines with adverse effects in pregnancy and laboratory evidence on animals suggests the absence of vaccination risk
- currently pregnant and breastfeeding women are not a priority target of the COVID-19 vaccination offer which, to date, is not routinely recommended for these people
- from the data of the ItOSS study – relating to the first pandemic wave in Italy – it emerges that pregnant women have a low risk of serious maternal and perinatal outcomes and that previous comorbidities (hypertension, obesity) and non-Italian citizenship are significantly associated with a greater risk of serious complications from COVID-19.
- vaccination should be considered for pregnant women who are at high risk for serious complications from COVID19. Women in these conditions must evaluate the potential benefits and risks with the healthcare professionals who assist them and the choice must be made on a case-by-case basis.
- if a vaccinated woman discovers that she is pregnant soon after vaccination, there is no evidence in favor of termination of the pregnancy
- if a woman discovers that she is pregnant between the first and second dose of the vaccine, she can postpone the second dose after termination of pregnancy, except for those at high risk
- breastfeeding women can be included in the vaccination offer without having to stop breastfeeding.
As reported in the latest issue of the magazine “A Scuola di Salute”, written by the pediatricians of the Bambino Gesù hospital, even children can become infected with SARS-Cov-2 and can get sick with Covid-19, although it happens more rarely and , fortunately, less serious. Emergency vaccine studies have targeted adults and the elderly. In parallel, anti-covid vaccines have also been launched on children, because it is of fundamental importance that children can also be vaccinated.
As soon as the studies on the pediatric population are concluded, the coronavirus vaccination will likely be extended to children as well.