By Sharon Atieno

Though pregnancy doubles the risk of death, pregnant women with COVID-19 have five times likelihood of dying from the disease in Africa.

This is according to the findings of a one-year study conducted across 22 sites in six African countries, namely Kenya, Uganda, Democratic Republic of Congo (DRC), Nigeria, South Africa and Ghana.

The study dubbed, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis examined three categories of women, pregnant with COVID-19, pregnant without COVID-19 and not pregnant with COVID-19.

The study conducted on 1,315 women, also found that comorbidities which are prevalent in Africa such as sickle cell anaemia, tuberculosis and HIV played a role in increasing comorbidity of pregnant women with COVID-19.

Additionally, it revealed that pregnant women with COVID-19 are likely to deliver by caesarean and more likely to die.

It is against this background, that Prof. Jean B. Nachega, Associate Professor of Epidemiology Infectious Diseases and Microbiology, University of Pittsburg urged African countries to prioritize pregnant women for COVID-19 vaccination alongside other priority groups.

Prof. Nachega, who is also the lead author of the study, was speaking during a cross-border media café held by Media for Environment, Science, Health and Agriculture (MESHA).

“Mounting data have demonstrated that mRNA-COVID-19 vaccines (Pfizer and Moderna) as well as the adenovirus vector vaccines (Oxford/Astrazeneca and Johnson & Johnson-Janssen) as well as inactivated coronoVac COVID-19 vaccine are safe in pregnancy and for breastfeeding women and their infants,” he said.

Additionally, Prof. Nachega noted that the World Health Organization (WHO) had updated its guidelines in 2022 to recommend vaccination of pregnant women.

In the WHO Roadmap for prioritizing use of COVID-19 vaccines, pregnant women have been ranked under high-priority use group two, alongside adults with comorbidities, teachers and other essential workers and disadvantages sociodemographic subpopulations at higher risk of severe COVID-19.

Outlining the dangers pregnant women with COVID-19 are likely to face, the Roadmap notes, “Based on the severity of the risks of COVID-19 disease in pregnancy, WHO has concluded that the benefits of vaccination for pregnant women generally outweigh the risks.”

According to Prof. Nachega, pregnancy is a natural immunosuppression as the body is struggling to accommodate two people. The body needs to build a lot of antibody to fight microbe infections because of this. This is a fragile moment where it is not just COVID-19 but the person is at risk of other viruses, he said.

Additionally, Prof. Nachega observed that vaccine hesitancy is still an issue of concern among pregnant women due to misinformation in social media which claims that the vaccines will make the women infertile or cause harm to the baby.

In South Africa, for instance, a study showed that only 20% of pregnant women are willing to get vaccinated, he stated, adding that it is because of this, that they are starting an implementation study in the country to debunk the misinformation and increase uptake of COVID-19 vaccine among this cohort.

Speaking about the study, Sylvia Nakasi, an advocate and program director at Uganda Network of AIDS Service Organisations (UNASO) said, “We have a basis on which our policy makers can provide guidelines to our community regarding the safety of the COVID-19 vaccine among pregnant women.”

She noted that there is need for wide dissemination and popularization of the data among various stakeholders including policy makers, community health workers and others in order to increase community sensitization and debunk misinformation around these vaccines.

Initial studies carried out on COVID-19 and pregnancy were mainly conducted in Europe, United States and Latin America.