Coronavirus: Pregnant women eligible for COVID-19 vaccine in Ontario

Coronavirus: Pregnant women eligible for COVID-19 vaccine in Ontario
Coronavirus: Pregnant women eligible for COVID-19 vaccine in Ontario

Pregnant people in Ontario are now able to book a COVID-19 vaccine after the Ministry of Health on Friday announced pregnancy had been moved up to the “highest risk” category in the provincial rollout.

Obstetricians had for days been calling on the government to prioritize expectant mothers for vaccination after seeing a startling increase in the number of pregnant women with COVID-19 needing hospital and ICU care.

So far in April, doctors who spoke to the Star said they have seen more pregnant women with COVID-19 receiving critical care than at any point in the pandemic.

Ontario’s Ministry of Health pointed to this alarming trend in their Friday announcement of further prioritizing pregnant people for vaccines.

“In response to emerging data on the increased risk of severe illness for pregnant women, all pregnant individuals will be eligible to register for vaccination appointments under the highest risk health conditions in the Phase 2 prioritization guidance starting today,” a spokesperson said in a statement to the Star.

Pregnant people who want a vaccine can make an appointment with their local public health unit or through the provincial booking centre, the statement said.

Dr. Tali Bogler, chair of family medicine obstetrics at St. Michael’s Hospital in Toronto, welcomed the move by the province.

“This is an important accomplishment to move pregnant individuals to the highest risk category in the vaccine rollout, given what we are seeing right now in terms of pregnant individuals getting more sick from COVID-19, requiring hospitalization and ICU admission in Ontario,” she said.

“The next step is to ensure the process of actually signing up and receiving the COVID-19 vaccine is straightforward and accessible for all pregnant women in Ontario, as well as other provinces.”

On April 15, the Society of Obstetricians and Gynecologists of Canada (SOGC) called on all provinces to “immediately prioritize vaccination for pregnant women,” and said all pregnant individuals should be eligible. The statement noted some of its members were seeing “a daily wave of pregnant women coming into Ontario ICUs, many requiring ventilators.”

Pregnant women with COVID-19 are at higher risk of complications, including needing intensive care and preterm birth, and obstetricians say they may be more vulnerable to the variants of concern.

Until Friday’s Ministry of Health announcement, pregnant people were included in Phase 2 of Ontario’s vaccine rollout as “individuals with at-risk health conditions,” and were estimated to be eligible for their first shot by the middle of May.

Dr. Jon Barrett, chair of the department of obstetrics and gynecology at Hamilton’s McMaster University, said he and other members of the provincial COVID-19 pregnancy task force are pleased the ministry is allowing pregnant people access to the vaccine.

“We are delighted they heard us and are taking actions to make sure this vulnerable group are prioritized, as are all vulnerable groups, while we are dealing with the unfortunate reality of vaccine rationing,” Barrett said.

Though the initial vaccine trials excluded pregnant people, Barrett said “there is no reason to suspect the vaccine is dangerous,” and encouraged people to not be afraid of getting vaccinated.

“There is no evidence of harm and in the situation where COVID is rapidly spreading in the community and you are at risk as a pregnant woman, please go and get vaccinated.”

Bogler as well pointed to the reassuring emerging real-world safety data on the mRNA COVID-19 vaccines in pregnant people.

“Early data does not indicate any safety concerns with respect to pregnancy or neonatal outcomes related to getting the COVID-19 vaccine in pregnancy,” she said. “And there is no major difference in side effect profiles between pregnant and nonpregnant individuals receiving the vaccine. There is also good evidence that pregnant people mount as good of an immune response as nonpregnant people.”

On Wednesday, researchers from the U.S. Centers for Disease Control and Prevention published preliminary results from more than 35,000 people who received mRNA COVID-19 vaccines while pregnant.

The study, published in the New England Journal of Medicine, found “no obvious safety signals,” for either the Moderna or Pfizer vaccines, which use mRNA, though authors noted more long-term research is needed.

Chief Public Health Officer Theresa Tam on Friday said there is no reason the COVID-19 vaccine wouldn’t be effective during pregnancy, and pointed to the recent SOGC recommendation that it should be available to pregnant women in all provinces.

“We are seeing higher risks of severe outcomes for women during pregnancy from COVID-19,” Tam said. “We are also seeing ICU admissions more recently associated with this current resurgence.

“If you look at that risk and benefit balance, in my mind, in general, the benefits outweigh the risks.”

Tam also suggested pregnant people talk to their health-care provider as they make their decisions.

In its statement to the Star, the ministry said pregnant people do not require a letter from their health-care provider to book a COVID-19 vaccine, and that the “extended dose interval of 16 weeks remains appropriate for this population.”

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Jose S Vanhorne
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