A growing number of local governments have been putting pregnant women on the priority list for COVID-19 vaccinations following the death of a newborn earlier this month after the mother, who was infected with the coronavirus, was forced to give birth at home due to a shortage of hospital beds.
The woman in her 30s gave birth to the baby prematurely on Aug. 17 at her home in Kashiwa, Chiba Prefecture. At least nine hospitals turned away the woman, who had moderate symptoms, as they were all unable to take in a pregnant patient. The baby boy, born in the 29th week of pregnancy, was pronounced dead after being rushed to a hospital.
Since the start of the vaccine rollout in February, pregnant women have not been the focus of the government's campaign to get people vaccinated, based on a lack of data from clinical trials, and that is not going to change for now.
But the health ministry changed its policy this week to a more proactive tone, calling on local governments to pay “special consideration” to opening up vaccine reservations for pregnant women and their partners as soon as possible.
"Pregnant women and lactating individuals can get the vaccine," a ministry leaflet says. "There have been no reports that the vaccine has an adverse impact on pregnancy, the fetus, breast milk or genitals. Regardless of the stage of pregnancy, vaccination is recommended."
Following the ministry's move, Koto Ward in Tokyo has announced it will prioritize inoculations for expecting mothers, with the group given preferential access to reservations from Friday to Sunday. Vaccinations will be administered through Oct. 17.
Other cities that have made similar moves include Hadano and Isehara in Kanagawa Prefecture, Chiba and Funabashi in Chiba Prefecture, and Kuki and Konosu in Saitama Prefecture. Aichi Prefecture will also vaccinate pregnant women as well as their partners without reservations at prefecture-run mass vaccination centers, Gov. Hideaki Omura said Monday.
Infected pregnant women are at an increased risk of severe illness compared with other people, in addition to having a higher risk of experiencing a preterm birth, experts say.
“Data from the Japan Society of Obstetrics and Gynecology has shown that pregnant women infected with COVID-19 in the third trimester or after 28 weeks are at an increased risk of severe illness,” said Dr. Tetsuo Nakayama, a project professor at Kitasato Institute for Life Sciences and director of the Japanese Society of Clinical Virology. “As for the fetus, there is no higher risk of miscarriage reported, but the possibility of premature birth is higher.”
The recent policy shift came after the U.S. Centers for Disease Control and Prevention (CDC) on Aug. 11 recommended the vaccine to all pregnant women age 12 and older, saying its analysis did not find an increased risk of miscarriage among nearly 2,500 pregnant women who received a messenger RNA COVID-19 vaccine before 20 weeks of pregnancy. The CDC had previously not recommended they get the vaccine.
The CDC also endorsed the vaccine for breastfeeding mothers and those who are trying to get pregnant now or who might become pregnant in the future, adding that there’s no evidence any vaccines, including COVID-19 vaccines, cause fertility problems.
Three days later, the Japan Society of Obstetrics and Gynecology revised their stance, recommending the mRNA-based vaccines to all pregnant women and their partners, given that about 80% of pregnant women’s infections come from their partners. Previously, it had said they could get the vaccine after consultation with a doctor.
As hospitals are overwhelmed with COVID-19 patients, there are fears that tragic cases like the one in Chiba could only increase, especially in areas with high numbers of virus cases. Even if infected patients call for an ambulance, experts say many hospitals in hot spots such as the Tokyo metropolitan area are “virtually full” and hospitals are struggling to admit patients due to staff shortages.
“Premature babies do not have sufficiently developed lungs and they may need oxygenation,” Nakayama said. “The first five minutes (after birth) is the most critical time frame to conduct lifesaving measures. Otherwise, the babies could suffer from aftereffects or die.”
As a countermeasure, internal affairs minister Ryota Takeda said Monday that the Fire and Disaster Management Agency would ask prefectural governments to provide a list of medical facilities that can accept pregnant women who have tested positive for COVID-19.
Up until now, whenever there’s an emergency call from a COVID-19 patient, including from a pregnant woman, fire departments have had to call public health centers, which would then make arrangements to admit the patient to hospital — a time-consuming process.
From now on, whenever the fire departments determine there’s a need for an emergency gynecological procedure on a pregnant COVID-19 patient, they will be able to directly make such arrangements with hospitals to expedite their admission, he said.
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