#COVID vaccine in pregnancy- there have been no trials in pregnant women. With any vaccine, safety & efficacy 1st needs to be established in healthy adults before trials are undertaken in pregnant women. Animal studies need to show no teratogenic effect 1/ https://www.smh.com.au/national/australian-government-experts-mull-over-covid-vaccine-in-pregnancy-20210111-p56t97.html

2/ before starting trials in pregnancy. But what should happen during a pandemic particularly when >70% of healthcare workers are women of childbearing age & high risk? Trials will have some safety data on pregnant women who were vaccinated before they knew they were pregnant. 3/

3/ All approved vaccines need to have phase IV (post licensure) safety data in pregnancy collected. But the gold standard is a clinical trial. Pfizer/BioNTech are starting RCT with mRNA vaccine in pregnant & lactating women in Feb. Protocol under development. Timeline unknown 4/

4/ mRNA technology is new for vaccines so important to have these studies done. In high transmission areas pregnant women are having to make decisions about whether to get vaccinated or not with no data to support their decision making. 5/

5/ Pregnant women with #COVID are at higher risk of a poor outcome compared to nonpregnant women. Most #COVID in pregnancy data from high income countries. Support to improve perinatal outcomes for many #LMICs needed already. No skilled birth attendants, no oxygen, no ICU 6/

Here is a great thread on how, during #COVID, to build back better (better health systems) to improve maternal & newborn health in #LMICs & ensure systems are strengthened to improve care overall 7/ https://twitter.com/oladapo_olufemi/status/1348263337952485378