alert on under-vaccination of pregnant women

“All the professionals concerned (…) must raise awareness [les femmes enceintes] vaccination before and throughout pregnancy monitoring. » This note from the Directorate General for Healthsent Tuesday February 22 to all health professionals, seems to arrive very late, more than a year after the start of the vaccination campaign against Covid-19.

Although most obstetrician-gynaecologists, midwives and doctors did not wait for these recommendations to inform and vaccinate their patients, this alarm signal follows a very worrying observation. As of January 6, 29.8% of pregnant women had not received any vaccine dose, according to a study published on February 17 by Epi-Phare. On the same date, 92% of women aged 18 to 39 had yet received at least one injection.

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This significant under-vaccination is even higher during the third trimester of pregnancy (41.7%), as well as among the youngest and most disadvantaged pregnant women. “This result is the consequence of a greater possibility of being vaccinated before pregnancy for women in the first trimester of pregnancy at the start of 2022 compared to those who began their pregnancy in the spring of 2021”, points out the report.

Especially since vaccination against Covid-19 was, until July 21, 2021, not recommended for women before their second trimester of pregnancy. Since then, numerous international studies have demonstrated the benefit of getting vaccinated at all stages of pregnancy in order to protect yourself from the increased risk of complications linked to Covid-19. An increased risk that also concerns their newborns, who are more exposed to premature deliveries, caesarean sections or death at birth.

“In Denial of Gravity”

Two parallel surveys conducted in France in the first quarter of 2021 shed light on the reasons for this under-vaccination. A first study showed that many of them were reluctant to this vaccination, in particular for fear of side effects on the fetus, subjectively greater than fear of the consequences of an infection. But the role of health professionals is also decisive. According to another surveyat the start of the vaccination campaign, about half of them did not intend to prescribe the vaccine to their patients.

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“The adherence of caregivers has greatly increased since then, but fears still persist in the first trimester: if ever their patient had a miscarriage after a vaccine injection, some professionals fear that it will turn against them”, explains Philippe Deruelle, lead author of the study. A classic way in France of approaching obstetrics through risk, according to the obstetrician-gynecologist, for whom “this late awakening by the authorities shows that perinatality is today largely forgotten in France”.

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