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Pregnancy: Ethical Issues of Vaccine Refusal

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Hot Topics in Human Reproduction

Part of the book series: Reproductive Medicine for Clinicians ((REMECL,volume 3))

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Abstract

COVID-19 infection during pregnancy causes higher rates of morbidity and mortality of the pregnant individual and of the fetus, as compared to nonpregnant individuals. Approved vaccines are effective in preventing infection and serious illness and are safe both for the pregnant individual and for the fetus.

Ethically, based on the principles of beneficence and non-maleficence, healthcare providers should encourage, council, and recommend to every pregnant individual at any stage of pregnancy to accept the vaccination. In cases of hesitancy, healthcare providers ought to explore the reasons for the hesitancy, explain the reasons in favor of vaccination, alley unfounded fears, refute fake information, and strongly recommend vaccination.

If, despite best efforts to convince vaccination, the pregnant individual refuses, she should not be coerced to be vaccinated based on the principle of autonomy.

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References

  1. Medicines and Healthcare Products Regulatory Agency (MHRA). Information for Healthcare Professionals on Pfizer/BioNTech COVID-19 vaccine. Stepney: Medicines and Healthcare Products Regulatory Agency (MHRA); 2020.

    Google Scholar 

  2. Medicines and Healthcare Products Regulatory Agency (MHRA). UK medicines regulator gives approval for first UK COVID-19 vaccine. Stepney: Medicines and Healthcare Products Regulatory Agency, Government of the UK; 2020.

    Google Scholar 

  3. Oliver SE, Gargano JW, Marin M, Wallace M, Curran KG, Chamberland M, et al. The advisory committee on immunization practices’ interim recommendation for use of Moderna COVID-19 vaccine—United States, December 2020. MMWR. 2021;69(5152):1653–6. https://doi.org/10.15585/mmwr.mm695152e1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Villar J, Ariff S, Gunier RB, Thiruvengadam R, Rauch S, Kholin A, Roggero P, et al. Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection. The INTERCOVID multinational cohort study. JAMA Pediatr. 2021;175(8):817–26. https://doi.org/10.1001/jamapediatrics.2021.1050.

    Article  PubMed  Google Scholar 

  5. Ko JY, DeSisto CL, Simoeon RM, Ellington S, Galang RR, et al. Adverse pregnancy outcomes, maternal complications, and severe illness among US delivery hospitalization with and without coronavirus disease 2019 (COVID-19) diagnosis. Clin Infect Dis. 2021;73(Supplement_1):S24–31. https://doi.org/10.1093/cid/ciab344.

    Article  CAS  PubMed  Google Scholar 

  6. Allotey J, Stallings E, Bonet M, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320. https://doi.org/10.1136/bmj.m3320.

    Article  PubMed  Google Scholar 

  7. Wei SQ, Bilodeau-Bertrand M, Liu S, et al. The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis. CMAJ. 2021;193(16):E540–E48. https://doi.org/10.1503/cmaj.202604.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Chmielewska B, Barratt I, Townsend R, Kalafat E, van der Meulen J, Gurol-Urganci I, O’Brien P, et. al. Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis. Lancet Glob Health. 2021;9:e759–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. CDC Data Tracker, Pregnancy Data, 2021.

    Google Scholar 

  10. Farrell R, Michie M, Pope R. Pregnant women in trials of COVID-19: a critical time to consider ethical frameworks of inclusion in clinical trials. Ethics Hum Res. 2010;42(4):17–23. https://doi.org/10.1002/eahr.500060.

    Article  Google Scholar 

  11. Rasmussen SA, Kelley CF, Horton JP, Jamieson DJ. Coronavirus disease 2019 (COVID-19) vaccines and pregnancy: what obstetricians need to know. Obstet Gynecol. 2021;137(3):408–14. https://doi.org/10.1097/AOG.0000000000004290.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Stafford IA, Parchem JG, Sibai BM. The coronavirus disease 2019 vaccine in pregnancy: risks, benefits, and recommendations. Am J Obstet Gynecol. 2021;224(5):484–95. https://doi.org/10.1016/j.ajog.2021.01.022.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Burd I, Kino T, Segars J. The Israeli study of Pfizer BNT162b2 vaccine in pregnancy: considering maternal and neonatal benefits. J Clin Invest. 2021;131(13):e150790. https://doi.org/10.1172/JCI150790.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. World Health Organization. Questions and answers: COVID-19 vaccines and pregnancy. Geneva: World Health Organization; 2022.

    Google Scholar 

  15. Ayhan SG, Oluklu D, Atalay A, Beser DM, Tanacan A, Tekin OM, Sahin D. COVID-19 vaccine acceptance in pregnant women. Int J Gynaecol Obstet. 2021;154(2):291–6. https://doi.org/10.1002/ijgo.13713.

    Article  CAS  Google Scholar 

  16. Battarbee AM, Stockwell MS, Varner M, Newes-Adeyi G, Daugherty M, Gyamfi-Bannerman C, Tita AT, et al. Attitudes toward COVID-19 illness and COVID-19 vaccination among pregnant women: a cross-sectional multicenter study during August–December 2020. Am J Perinatol. 2022;39(1):75–83. https://doi.org/10.1055/s-0041-1735878.

    Article  PubMed  Google Scholar 

  17. Skjefte M, Ngirbabul M, Akeju O, Escudero D, Hernandez-Diaz S, Wyszynski DF, Wu JW. COVID-19 vaccine acceptance among pregnant women and mothers of young children: results of a survey in 16 countries. Eur J Epidemiol. 2021;36(2):197–211. https://doi.org/10.1007/s10654-021-00728-6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Januszek S, Siwiec N, Januszek R, Kluz M, Lebed R, Toś P, Góra T, Plens K, et al. Approach of pregnant women from Poland and the Ukraine to COVID-19 vaccination-the role of medical consultation. Vaccines (Basel). 2022;10(2):255. https://doi.org/10.3390/vaccines10020255.

    Article  CAS  PubMed  Google Scholar 

  19. Beauchamp TL, Childress JF, editors. Principles of biomedical ethics. 8th ed. New York: Oxford University Press; 2019.

    Google Scholar 

  20. Skirrow H, Barnett S, Bell S, Riaposova L, Mounier-Jack S, Kampmann B, Holder B. Women’s views on accepting COVID-19 vaccination during and after pregnancy, and for their babies: a multi-methods study in the UK. BMC Pregnancy Childbirth. 2022;22(1):33. https://doi.org/10.1186/s12884-021-04321-3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. de Menezes Succi RC. Vaccine refusal—what we need to know. J Pediatr. 2018;94(6):574–81. https://doi.org/10.1016/j.jped.2018.01.008.

    Article  Google Scholar 

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Correspondence to Avraham Steinberg .

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Steinberg, A. (2023). Pregnancy: Ethical Issues of Vaccine Refusal. In: Schenker, J.G., Birkhaeuser, M.H., Genazzani, A.R., Mettler, L., Sciarra, J.J. (eds) Hot Topics in Human Reproduction. Reproductive Medicine for Clinicians, vol 3. Springer, Cham. https://doi.org/10.1007/978-3-031-24903-7_3

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  • DOI: https://doi.org/10.1007/978-3-031-24903-7_3

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