The roll out of the 3rd dose (booster) of Covid-19 vaccines is still taking place in Jakarta. The booster vaccination is aimed for people with certain criteria, such as aged 18 years and older, elderly aged 60 years and older, receiving dose 2 for a minimum of 6 months, and having a booster vaccine ticket on the Peduli Lindungi application. From these general criteria, you might notice that we have not mentioned whether pregnant or breastfeeding women can get the booster vaccine or not. Then, how is the implementation of booster vaccines for this particular group? Here's the explanation.
Pregnant or Breastfeeding Women Are Recommended To Get Vaccines
If you look at other countries, the CDC (Centers for Disease Control), the Department of Health and Human Services of The United States acknowledges that people who are pregnant or breastfeeding should be vaccinated against Covid-19. The CDC still has not issued specific recommendations for booster vaccination. However, a booster recommendation has been conveyed when recommending vaccination in general to pregnant people through the Covid-19 Vaccination and Pregnancy telebriefing. Dr. Dana Meaney-Delman, Chief of Infant Outcomes Monitoring Research and Prevention Branch at the CDC, stated that receiving the Covid-19 mRNA vaccine during pregnancy reduces the risk of infection, severe illness, and death from Covid-19 in pregnant people. Because, when a person receives Covid-19 mRNA vaccines, his/her body builds antibodies that protect himself from the virus. In pregnant people who have been vaccinated, these antibodies are also found in umbilical cord blood, which indicates that the antibodies are also transmitted to the infant in the womb. However, further research is still needed to determine whether antibodies protect the infant from Covid-19 or not.
The CDC's recommendations regarding vaccination for pregnant people are also supported by research. Internal CDC research involving 20 paediatric hospitals in 17 states from July 2021 to mid-January 2022 showed that infants under six months whose mothers were vaccinated were 61% more likely to be not hospitalized when infected for Covid-19. Of the babies who contracted Covid-19 and were hospitalized, 84% of them were born to mothers who were not vaccinated against Covid-19. Meanwhile, 88% of infants in the ICU with high-severity Covid-19 were those whose mothers were also not vaccinated either before or during pregnancy. There was also one case of death in a baby whose mother had never received the Covid-19 vaccine.
From this study, it can be concluded that getting Covid-19 vaccines during pregnancy can help protect babies from being hospitalized due to Covid-19. Therefore, the CDC suggests pregnant people to be vaccinated against Covid-19 for primary course and get their booster shots when it’s time. Vaccination can be done at any time. However, if a pregnant woman has been vaccinated during her first trimester, she is entitled to a booster dose while she is still pregnant. This recommendation for primary or booster vaccination also applies to people who are breastfeeding, people who are planning to become pregnant, or will become pregnant. Regarding people who are breastfeeding, the CDC states that antibodies obtained from the Covid-19 vaccination can be transferred to children through breast milk, so that the baby is also protected.
What If People Who Are Pregnant Are Not Vaccinated?
Not getting vaccinated before or at the time of pregnancy doesn’t only make babies prone to being hospitalized if they have Covid-19. Quoted from the Australian Government Department of Health, pregnant people who are not vaccinated will harm themselves and their babies. Because, she will be more vulnerable to hospitalization, treatment in the Emergency Unit (ER), and even the use of a ventilator (breathing aid). The baby is also potentially more susceptible to premature birth, stillbirth, or treatment in a hospital unit for newborns. The only way to avoid all these possibilities is to be vaccinated against Covid-19, either before or during pregnancy.
Provisions of Booster Shot for Pregnant People in Jakarta
After a brief look at some international research, it can be concluded that Covid-19 vaccination for people who are pregnant or breastfeeding is highly recommended even in other countries. Just like in Jakarta, pregnant people are advised to get a booster vaccine for Covid-19. Provisions regarding booster vaccination for pregnant people still refer to Circular Letter HK.02.01/2007/2021 which also regulates primary vaccination course for pregnant people or screening processes in the implementation of Covid-19 vaccination.
Based on the circular letter, there are several provisions for the implementation of both booster and primary vaccinations for pregnant people, which are:
The Covid-19 vaccines used for pregnant people are Moderna, Pfizer, and Sinovac, subject to availability.
The first dose of vaccination is given in the second trimester of pregnancy.
If the infant age is less than 13 weeks, the vaccination is postponed.
The second dose is given according to the interval of the type of vaccine used.
The screening process for pregnant people and children 12-17 years is carried out separately.
This provision does include primary vaccination, but the implementation of booster vaccination for pregnant people still refers to the same provisions.
What about people who are breastfeeding? Covid-19 vaccination is declared safe for people who are breastfeeding based on the Circular Letter of the Indonesian Ministry of Health regarding the Implementation of COVID-19 Vaccination Number HK.02.02/11/368/2021. Vaccines that are administered into the body of people who are breastfeeding will not pose a risk to the child, instead it will help protect themselves through breast milk. After being vaccinated, they are still safe to breastfeed. Skin-to-skin contact between people who are breastfeeding and the baby has a greater benefit than the risk of contracting Covid-19. If someone who is breastfeeding confirmed positive for Covid-19, she can still breastfeed her child by implementing health protocols, because the virus is not detected in breast milk.
In conclusion, people who are pregnant or breastfeeding may, and are even recommended to be given a Covid-19 booster shot. You can read the Covid-19 booster vaccination guide here. If you are a pregnant or nursing mother and have not been vaccinated with a booster shot, register immediately via the Jakarta Tanggap Covid-19 website or JAKI. The JAKI application can be downloaded via the Google Play Store ataupun Apple App Store.
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