How safe is the COVID-19 vaccine for pregnant women?

Being pregnant in a time of a global pandemic can be very stressful. Moms-to-be are understandably worried about both contracting the virus, as well as the possible adverse effects of vaccines on their babies.

What does the evidence say? Should you be vaccinated if you are currently pregnant?

It’s about weighing the risks of a COVID-19 infection versus that of possible vaccine adverse events.

Pregnant women are at a greater risk than non pregnant women for severe disease after getting COVID-19 infection. The development of serious complications might increase the pregnant woman’s risk of requiring intensive unit care (ICU), invasive ventilation, as well as developing lethal complications like deep vein thrombosis and pulmonary embolism. They also have a doubled risk of preterm birth if they are symptomatic as the babies may require intensive care.

On the other hand, pregnant women should consider the risks of the vaccine for themselves and their child.

In that regard, the COVID-19 vaccine has been shown to be safe and effective.

Real world evidence of 35,000 pregnant women in the US who received the mRNA based vaccines (i.e. Pfizer and Moderna) showed no difference between pregnancy complications between unvaccinated and vaccinated women. Effectiveness was also shown in an Israel study that showed lower risk for vaccinated pregnant women compared to unvaccinated ones.

The mRNA vaccines have been shown to generate antibody production in both pregnant and breastfeeding women. These antibodies, designed to protect against the virus, are transferred passively across the placenta to the baby during pregnancy and should provide some degree of immunity when the baby is born.

How and when to get vaccinated?

You are advised to get vaccinated after 13 weeks of pregnancy after having an informed discussion with your obstetrician. Side effects can be managed with standard treatment like paracetamol, which is safe for use in pregnancy. Our site is also equipped to handle any immediate vaccination related emergencies such as a severe allergic reaction.

Conclusion:

The data for safety and efficacy for COVID-19 vaccination for pregnant women has shown to be positive. Though we are unable to have longer term results, patients should discuss with their obstetrician to weigh the risks of COVID-19 complications with risks of potential vaccine events.

Getting your Pfizer BioNTech Vaccine at Intemedical Clinic

Before your visit - Book your appointment through https://www.vaccine.gov.sg/ and select Intemedical Clinic (Kovan) - Both doses must be taken at the same centre - Appointment times are between 1pm - 9.30pm

At your visit - Bring proof of your identification (Eg. NIRC/Passport) - Patients <18 years of age will require parental consent - Patients between 12-13 years of age will need parent/legal guardian to come along - Set aside about 1 hour for the visit including 30 minutes of observation time

After your vaccination - Remember to book your appointment for your 2nd vaccination - Rest and hydrate. Take medications for symptomatic relief for common side effects such as pain over the injection site or fever. If your fever lasts more than 2 days, consult a doctor. - Avoid alcohol for 2 days. Avoid vigorous exercise for 1 week.

Sources: https://www.kkh.com.sg/patient-care/Pages/COVID-19-Vaccination.aspx https://specialty.mims.com/topic/covid-19-vaccine-for-pregnant-women--the-data-so-far

What to know if you or someone you know hasn't been vaccinated

We know a lot more about the safety and efficacy of current COVID-19 vaccines now than when we first started. That has allowed the ministry to update its guidance on who should and shouldn’t receive the mRNA vaccines (Pfizer BioNTech and Moderna).

To cut it short - the eligibility criteria has expanded. Check to see if you may belong to one of these groups who can now be vaccinated..

1. Patients who had previous large skin reaction after 1st mRNA vaccine

Localized skin reactions after vaccination are common (around 4% in recent mRNA studies). However, if they develop more than 4 hours after injection, you are still eligible to receive the second dose of the vaccine. These skin reactions, though sometimes may be large, can be treated symptomatically. Patients who experienced a severe allergic reaction or anaphylaxis can proceed with other vaccines like Sinovac instead.

2. Patients with lowered immunity because of treatments, HIV or low platelet counts

These include patients with transplants within 3 months, on aggressive immunotherapy, or cancer patients on treatment (chemotherapy, radiotherapy) within 3 months or planned over the next 2 months. Such patients can be vaccinated in a hospital or community vaccination center after receiving a memo from their treating specialist. Patients with HIV, regardless of CD4 count are also allowed vaccination.

3. Patients who were not fully vaccinated and were infected with COVID-19

If you are such a patient, the current guidance is to get a single dose of vaccination done 3 months from your first day of infection. In the meantime, you can get a Pre-Event Testing (PET) Exemption Notice from the clinic for you to attend events and visit various venues.

4. Patients who have received other non COVID-19 vaccines in the past 2 weeks

This is no longer a strict point though you are encouraged to space out your non-COVID-19 related vaccines if possible.

What should I do?

The best thing you can do is to get vaccinated and encourage those around you who have not to do so. As of 10 Aug 2021, Singapore has achieved full vaccination in 72% of our population. Getting vaccinated may not prevent you from transmitting the virus, but it can certainly reduce the risk of hospitalization and death. The percentage of unvaccinated who became severely ill or died is 8.7%, while that for the fully vaccinated is 0.9%.

If you have not been vaccinated or have an elderly family member or friend who has not been, please book an appointment for your COVID-19 Pfizer BioNTech vaccination at our clinic.

From 18 August 2021, all eligible Singaporeans, Permanent Residents and Long-Term Pass holders aged 12 years old and above can walk in to Intemedical Clinic for first dose vaccination. Vaccination is free for these groups.

Getting your Pfizer BioNTech Vaccine at Intemedical Clinic

Before your visit - Book your appointment through https://www.vaccine.gov.sg/ and select Intemedical Clinic (Kovan) - Both doses must be taken at the same centre - Appointment times are between 1pm - 9.30pm

At your visit - Bring proof of your identification (Eg. NIRC/Passport) - Patients <18 years of age will require parental consent - Patients between 12-13 years of age will need parent/legal guardian to come along - Set aside about 1 hour for the visit including 30 minutes of observation time

After your vaccination - Remember to book your appointment for your 2nd vaccination - Rest and hydrate. Take medications for symptomatic relief for common side effects such as pain over the injection site or fever. If your fever lasts more than 2 days, consult a doctor. - Avoid alcohol for 2 days. Avoid vigorous exercise for 1 week.

Source: MOH Circular No. 101/2021 on 28 Jul 2021

New Travel Requirements for Flights to China

The China Embassy released a new notice on adjustment of requirements for Pre-departure testing for visitors travelling to China. These changes will officially take place as of 17 August 2021.

If you have plans to travel to China, do take note of the following:

1) All travellers will still require the COVID-19 RT-PCR swab test.

2) For travellers who have completed 2 doses of mRNA Vaccines (E.g. Pfizer-BioNTech, Modena, etc.), the venous blood serology test will be changed from IgM antibody serology to Total Serology Antibody against N protein.

3) Travellers who have not been vaccinated or those who have been vaccinated with inactivated vaccines (Sinovac, Sinopharm, etc.) will continue to do serology IgM testing.

4) All travellers to China will need to upload their vaccination certificate to the China Embassy website, if available.

5) The new memo provided to all patients will be as follows:

Prices of COVID-19 tests have been revised as of 1 August 2021 to the following:

COVID-19 RT-PCR SWAB TEST: $125 NETT* VENOUS BLOOD SEROLOGY IgM ANTIBODY/ IgM + IgG Antibody against N PROTEIN: $55 NETT*

ANTIGEN RAPID TESTING: $26.50 NETT*

How to make an appointment with Intemedical?

Appointment Portal: Kovan Clinic / Potong Pasir Clinic

(click and book with instant confirmation!)

WhatsApp: 8879 9404

(available during clinic opening hours, 8am to 12am)

Mobile: 8879 9404

(messaging preferred)

Landline: +65 3165 9251

(please be aware that the phone might be engaged due to high call volume)