The health ministry has refused to clarify its policy on pregnant women getting vaccinated, days after obstetricians and gynaecologists strongly urged them to get the jab.
A health ministry spokesperson ignored a series of questions seeking clarity about official advice for pregnant women and COVID-19 vaccination.
But information from the 145 COVID-19 vaccination helpline guides expectant mothers to first consult their doctors and then just turn up for their inoculation.
This was a “recent” development, the person at the other end of the line explained, suggesting that a note from a doctor could be brought along “just in case” but that it was not necessary for pregnant women to receive the vaccine.
Until now, pregnant women were not eligible for the COVID-19 vaccine, with Malta citing European Medicines Agency advice.
In April, Health Minister Chris Fearne had confirmed the authorities would not yet be changing their position.
To date, the vaccin.gov.mt FAQs page states that pregnant women are not encouraged to take the jab at this stage as pregnancy-specific data does not yet exist.
But, on Sunday, the Malta College of Obstetricians and Gynaecologists sent out different signals, strongly advising pregnant women to consider the Pfizer virus vaccine after their 12th week and following consultation.
The doctors said they have taken this stand in view of virus complications being seen in pregnant women. Their guidance comes as an unvaccinated 30-year-old woman, 19 weeks pregnant, is in intensive therapy at Mater Dei Hospital.
“Vaccination is the best way to reduce the chances of contracting COVID-19 in pregnancy and to reduce potential complications to both mother and child,” the doctors insisted.
Vaccination may potentially reduce the risk of admission of the mother to intensive care
“It may potentially reduce the risk of admission of the mother to intensive care, premature birth and stillbirth,” they warned.
Women who were trying to get pregnant could still take the vaccine, with no evidence suggesting it affected fertility, they continued.
Change of advice
The doctors had previously stated that only women with a high risk of exposure to the virus, or with high-risk medical conditions, should be offered the vaccine, in line with the health authorities.
But they have now revised that position, spreading it to all pregnant women.
Their appeal follows the British health authorities’ drive to encourage pregnant women to get vaccinated.
The advice stems from a study by University of Oxford researchers that found the Delta variant increased the risk of severe illness among those hospitalised with virus symptoms.
Britain's Royal College of Obstetricians and Gynaecologists also states that COVID-19 vaccination is recommended in pregnancy.
The World Health Organisation has also stressed the importance of vaccination on grounds that being pregnant has shown to increase the risk of severe disease.
The UK has recommended vaccination of pregnant women since April, following data collected by the US Centres for Disease Control and Prevention that raised no safety concerns.
A study in April also revealed a higher risk to pregnant women and newborns from COVID-19.
But take-up has been very low, the Oxford University paper said, blaming misinformation fuelled by changing advice early in the vaccine roll-out. The findings highlighted the urgent need for an international approach to tackle the misinformation and improve uptake of the vaccine during pregnancy.
Mixed messages from authorities
The health ministry was also asked to comment on the effect of mixed messages that could give rise to doubts about vaccination among pregnant women here.
Advice on pregnancy and the COVID vaccine was regularly updated by the health authorities as more information was available but studies involving pregnant women were limited in the early vaccine trials.
Initially, women were being urged to postpone pregnancy by two months after taking the vaccine. They were also told not to get inoculated if already pregnant.
But after a WHO review – stating no specific reason to believe particular risks would outweigh the benefits of vaccination for pregnant women – the health authorities dropped this advice.
A month later, in February, they no longer advised women to avoid pregnancy if getting vaccinated but highlighted that those at high risk of severe complications from corona-virus should discuss with their doctor first.
Back then, the ministry had said the potential benefits of vaccination could be especially important for certain pregnant women and that there was no need to avoid pregnancy once both doses of the Pfizer COVID vaccine were received.
They became ineligible once again in April.
The health ministry was asked to explain when, why and on what scientific grounds it had changed its position, if this were the case, and whether it was spurred by the Delta variant that may have increased risks for pregnant women.
Last year, when the island went into a quasi-lockdown, pregnant women were among the group of vulnerable people asked to stay at home.
They are now being directed by the Malta College of Obstetricians and Gynaecologists to call 145 or send an email on covid-vaccine@gov.mt for an appointment for the Pfizer vaccine.