Vaccine Confidence: Pregnant and lactating women

Tips for Health Workers to answer COVID-19 questions right

UNICEF
Mother breastfeeding child
UNICEF
29 December 2021

As a health worker, you play a critical role in educating and supporting pregnant women and lactating mothers and so they can make an informed decision about getting the COVID-19 vaccine.

WHAT DOES EVIDENCE SAY?

Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy, although limited, has been growing. Based on the current evidence, experts believe that approved COVID-19 vaccines are safe, effective and unlikely to pose a risk to pregnant women or their unborn babies.

Vaccination can be particularly recommended to pregnant women who are at increased risk of developing severe disease.

They include those aged 35 years old and over, those with health conditions that add to their risk of severe COVID-19, such as diabetes and heart conditions, those with a high chance of being exposed to COVID-19 and those with a high body mass index.

Pregnancy is not a contraindication for any of the approved COVID-19 vaccines and there is no increased risk of pregnancy complications, miscarriage or stillbirth.

All COVID-19 vaccines are safe and effective for pregnant women at all stages of pregnancy.

A history of anaphylaxis (allergic reaction) to any component of the vaccine is a contraindication to vaccination.

If anaphylaxis occurs after the first dose, a second dose of the vaccine should not be administered.

DEBUNKING 'COVID-19 VACCINES CAUSE INFERTILITY' MYTH

COVID-19 vaccines do not cause infertility. A myth that is circulating at the moment suggests that COVID-19 vaccines cause infertility. This myth has led to hesitancy in lots of women worldwide, who remain unvaccinated and unprotected.

With millions of people vaccinated across the world, including women, there is no evidence found to suggest that COVID-19 vaccines affect fertility in women or men. Women and men can be reassured that the COVID-19 vaccines will not impact their fertility. There is no vaccine on the market that decreases a woman's ability to become pregnant.

DEBUNKING 'PREGNANCY TEST BEFORE COVID-19 VACCINATION IS ESSENTIAL' MYTH

Taking a pregnancy test is not needed before getting the COVID-19 vaccine. The claim that women need to get a pregnancy test before the COVID-19 vaccination is a myth.

COVID-19 vaccines currently available do not contain live viruses and cannot harm either pregnant women or the developing fetus. So, taking a pregnancy test isn't necessary. All women who are planning to have a baby in the near future can get the COVID-19 vaccine.

 FREQUENTLY ASKED QUESTION

Can pregnant women get vaccinated against COVID-19?

Pregnant women can be vaccinated against COVID- 19, in consultation with their healthcare provider. Available data on COVID-19 vaccination in pregnant women show that there is no specific reason for concern.

Pregnant women are at high risk of severe COVID-19 disease, hospitalization and death when they are infected by the virus. The benefits of the vaccine highly outweigh any potential risks

Why should pregnant women get vaccinated?

Pregnant women, particularly those with co-morbidities and at higher risk of viral exposure (e.g. health workers), should get vaccinated to protect themselves against severe COVID-19 infection, hospitalizations, and death.

Available data shows that unvaccinated pregnant women are at increased risk of developing severe forms of COVID-19, getting hospitalized, and dying when infected with the COVID-19 virus compared to vaccinated pregnant women.

To avoid the risks and complications of severe COVID-19 disease, pregnant women should get vaccinated in consultation with their health providers.

Will COVID-19 vaccine give COVID-19?

No. COVID-19 vaccine cannot give COVID-19. There are no live virus in the vaccines.

Does pregnant women experience severe side effects after vaccination compared to others?

No. COVID-19 vaccines can cause mild fever, pain, or redness at the injection site for anyone.Serious adverse events are rare and pregnant women have not reported any different side effects than non-pregnant women after being vaccinated against COVID-19.

Are COVID-19 vaccines recommended for lactating women?

Yes. Vaccination for lactating women is high likely recommended. Though there is no available data for lactating women, the vaccine effectiveness and safety for lactating women is similar to others and also vaccines are unlikely to pose a risk to the breastfeeding child. You mustn't stop breastfeeding because of vaccination.

Will COVID-19 vaccines be harmful to the baby in the womb?

The current evidence shows that vaccinating pregnant women against COVID-19 has no negative impact on their unborn babies. There is no increased risk of miscarrying your baby if pregnant women get vaccinated against COVID-19.

Actually, there is growing evidence that getting vaccinated could help protect the baby against COVID-19 too.

What effects does the vaccine have on the child while the mother is breastfeeding?

Breast milk provides the ideal nutrition for infants.

Evidence on the safety of COVID-19 vaccines in lactating women or their breast infants is still growing.

However, from the knowledge on how vaccines work and information about COVID-19 vaccines, it is unlikely that COVID-19 vaccines will pose a risk to the breastfeeding child.

Therefore, it is highly recommended to continue breastfeeding after being vaccinated with a COVID-19 vaccine.

Can/Will the vaccine affect the milk supply?

Women currently breastfeeding should continue doing so after receiving the vaccine.

They can be confident that vaccination will not affect their milk supply.

Taking the vaccine should not be an impediment to begin breastfeeding or a cause for its interruption.

HAVE A MEANINGFUL CONVERSATION

Pregnancy is a special time full of excitement and anticipation. It is also a time of enormous physical and emotional changes in women.

In addition to it, the COVID-19 pandemic has clouded this time with fear, anxiety and uncertainty for pregnant women.

As a health worker, you play a central role in helping them to navigate this time. When talking to pregnant or lactating women about COVID-19 vaccines, allow time for them to ask questions and listen actively to their answers.

It helps you to frame the conversation with positive statements that will encourage women to feel more confident about protecting themselves and their little ones by getting the vaccination.

BUILD RAPPORT

Establish a connection with your patient to create trust. Foster a relationship by demonstrating care, concern and respect.

Use an opt- out approach, assuming the patient will choose to get vaccinated. Be attentive during the interaction.

How are you feeling today? Ready to get vaccinated to protect yourself and your loved ones?

ELICIT CONCERNS

Ask open-ended questions to encourage the patient to talk about their concerns. Respectfully explain why the vaccines are important and can protect them throughout their pregnancy.

Do you have questions? How can I help you feel safer?

ACTIVELY LISTEN

Listen attentively and actively. Tune into patients’ needs, cues, words and emotions that indicate vaccine hesitancy.

Don’t interrupt. Reflect on what you are listening to and seek confirmation.

If I am understanding you correctly, you think/feel....

EXPRESS EMPATHY

Acknowledge emotions and concerns as real and important and void judgement. Empathy is about understanding what others are feeling because you have experienced it yourself or can put yourself in their shoes.

 I understand your concerns because you want the best for your baby...

USE SIMPLE LANGUAGE

Use language that is clear and easy to understand. Medical jargons can easily lead to confusion and misinterpretation. Using simple language in a calm tone can lead to better understanding.

The virus is way more dangerous than the vaccine.

ENCOURAGE SHARED DECISION-MAKING

Help ease the worries and focus the discussion on how getting a vaccine can help protect them and their loved ones. Help your patient come to the decision to get vaccinated.

Let’s schedule your vaccination appointment?