Third dose also in pregnancy: the update of the positions of the Higher Institute of Health provides for the recommendation of a dose of mRNA vaccine, as a booster of a primary vaccination cycle in accordance with the provisions in force, to pregnant women who are in the second and third trimesters and wish to be vaccinated. The recommendation takes into account the numerous and growing evidence regarding the safety of vaccination in pregnancy, both for the fetus and for the mother; evidence relating to the increased morbidity associated with the Delta variant (and Omicron is not yet known); of its increasing circulation and the notable lowering of the median age of infection in Italy. To date, there is still little evidence of vaccinations performed in the first trimester, therefore women who wish to be vaccinated in this gestational period must evaluate the risks and benefits together with a healthcare professional.
Covid vaccines in pregnancy, gynecologists and obstetricians share the decision of the Ministry
Women at greater risk of contracting SARS-CoV-2 infection because they are more exposed (such as healthcare professionals or caregivers) and / or at greater risk of developing severe COVID-19 disease (women with risk factors such as age> 30 years, BMI> 30, comorbidities, citizenship of countries with high migratory pressure) remain the priority target for vaccination during pregnancy.
Administration must be performed in the dosages authorized for this purpose (30 mcg in 0.3 mL for Pfizer’s Comirnaty; 50 mcg in 0.25 mL for Moderna’s Spikevax), regardless of the vaccine used for the primary course, and provided that a minimum interval of at least five months (150 days) from the completion of the same.
The booster dose can be given at the same time as vaccinations against influenza and whooping cough recommended during pregnancy.
Vaccination in lactation
The ISS recommends offering a dose of mRNA vaccine, as a booster of a primary vaccination cycle in accordance with the provisions in force, even to breastfeeding women, without any need to stop breastfeeding.
Administration should be performed in the dosages authorized for the purpose (30 mcg in 0.3 mL for Comirnaty; 50 mcg in 0.25 mL for Spikevax), regardless of the vaccine used for the primary course and provided that a minimum interval of at least five months (150 days) from its completion.
Breast milk works like a Covid vaccine
by Tina Simoniello
For breastfeeding women, it should be noted that vaccination does not expose the infant to risks and allows it to take antibodies against SARS-CoV-2 through the milk.
The infant suckled by a vaccinated mother follows his vaccination schedule without any changes.
Other behavioral measures
All pregnant and breastfeeding women, regardless of the choice whether to vaccinate or not, are recommended to observe the following preventive measures: hand hygiene, use of the mask indoors and in the vicinity of other non-cohabiting / unvaccinated people, respect for the physical safety distance, ventilation of the rooms.
For further information, please refer to the interim indications on “Vaccination against COVID-19 in pregnancy and breastfeeding” of 22 September 2021 by the Italian Obstetric Surveillance System (ItOSS) Istituto Superiore di Sanità.
Column – The answers on Covid
Covid and pregnancy, vaccines do not cause infertility
by Jacopo Vergari
