The union Health Ministry, on 19 May, has released a new set of COVID vaccine guidelines to be implemented in all the states and UTs.
Of the list, one recommendation that stands out is this: "COVID-19 vaccination is recommended for all lactating women".
The recommendation, which was made by the health ministry's National Expert Group of Vaccine Administration for COVID-19 (NEGVAC), comes as a relief to all new mothers in the country, who were previously excluded from the vaccination drive.
Researchers and doctors have been urging the government to allow pregnant and lactating women access to COVID vaccines, considering they fall in the ‘high-risk’ category when it comes to COVID-related complications.
And though we rejoice that one part of this has been realised, we still have some way to go.
The NEGVAC's Recommendation
On 13 May, the government advisory panel, The National Technical Advisory Group on Immunisation in India (NTAGI) had recommended that pregnant women in India be given the choice of taking any COVID vaccine and that lactating women are eligible after delivery.
The panel had announced that the evidence from other countries would be considered in making the decision.
This recommendation was then reviewed by the NEGVAC before the decision to allow lactating women access to any COVID vaccine was finally made. The decision on pregnant women is still pending for 'further review.'
Why Is This Move Significant?
Pregnant and lactating women have been excluded from all COVID vaccinations in the country since the vaccines were first rolled out.
The reason cited for this exclusion was that the vaccines have not been tested on either groups in a clinical trial setting.
Covaxin in their fact sheet states that pregnant and lactating women should not be taking their vaccine.
Covishield on the other hand leaves it to the doctors to decide, giving no further information.
In spite of this, seeing as no clinical trials were actually being conducted to prove the safety and efficacy of these vaccines in pregnant and lactating women, researchers, scientists, and associations of doctors have been lobbying to make the vaccine available to them.
Groups of experts in the country, including the Federation of Obstetric and Gynaecological Societies of India (FOGSI) have been asserting the vaccines be made available to both lactating and pregnant women based on the existing evidence.
Speaking to FIT for a previous article, Dr Anant Bhan, Adjunct Professor & Researcher in Bioethics at Mangaluru’s Yenepoya University, said, based on the recent risk-benefit analysis, "the most sound thing to do is go with the recommendation of FOGSI, and to cover them for now."
“Especially considering the stage of the pandemic we are currently in, it is imperative that anyone who is able to, gets vaccinated.”Dr Anant Bhan
Considering the devastation that the second wave of COVID in India has caused, and considering how hard its been hitting young people (perhaps because they were unvaccinated), this move is another rung on the ladder to securing the protection of a vulnerable group.
Pregnant Women are Still Waiting
Along with lactating women, the question of covering pregnant women in India's COVID inoculation programme has been brought up time and time again.
Health experts across the world including the World Health Organisation (WHO), the US FDA and CDC, and the Federation of Obstetric and Gynaecological Societies of India (FOGSI), almost unanimously assert that it is safe for pregnant (and lactating women) to take the COVID vaccines.
Some other countries like the US, the UK and China have already allowed the vaccine to pregnant women, and found them to be safe. The US and UK have allowed pregnant women to take the mRNA vaccines based on real-world data that shows these vaccines are safe.
Some vaccine companies have even begun clinical trials on pregnant women to generate the necessary data on safety and efficacy, and have so far shown encouraging results.
Based on this available data, past knowledge and considering the theoretical risks, experts in India, too, have been pushing for their vaccination
Especially considering pregnant women have been found to be at a far higher risk of severe illness from COVID.
However, in India, pregnant women continue to be listed as “contraindication” to the COVID vaccines. The justification is the same—not enough clinical data.
The decision regarding COVID-19 vaccination of pregnant women, however, is currently under review.
This recommendation by the NEGVAC allowing the vaccination of lactating women, gives hope that they may also review NTAGI's recommendation to allow COVID vaccines to pregnant women soon.
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