Misinformation thwarts Covid-19 vaccination for women in Tanzania

03Nov 2021
Jenifer Gilla
The Guardian
Misinformation thwarts Covid-19 vaccination for women in Tanzania

As health experts and leaders in Tanzania continue to mobilize for every citizen to be vaccinated against coronavirus, rumours that the vaccines can cause infertility have been rife.

Part of the message that spread on social media claims that coronavirus vaccine accumulates in the ovaries.

Is it true?

Speaking with The Guardian,  Dr. Paul Kazyoba,  the Director of Research Coordination at the National Institute of Medical Research (NIMR) says that there is no research evidence that the Covid-19 vaccine affects the reproductive system of any gender.

He urges women who are planning to conceive should get the vaccine early to protect the body against serious side effects when they become infected with the virus.

The World Health Organization (WHO) recommends that pregnant people who are at high risk of exposure such as those living in an area where community transmission rates are high, or who work in high-risk settings such as healthcare workers, should consider vaccination because of the higher risk of severe COVID-19 infection in pregnancy and the increased risk of premature birth.

The WHO however stops short of a full recommendation, not because of any specific safety concerns about the vaccine, but because of a lack of data in pregnant people.

Additionally, the WHO stated that breastfeeding people should be vaccinated because there is no evidence that being vaccinated while breastfeeding has any negative effect on the parent or child, and in fact breastfeeding can transmit valuable antibodies to the baby through the breast milk, further protecting them against COVID-19.

The WHO does not recommend pregnancy testing prior to vaccination. WHO does not recommend delaying pregnancy or terminating pregnancy because of vaccination.

Concerns about the vaccine and pregnancy have seen fewer pregnant people taking the jab. Those intending to get pregnant have also been reluctant to take the vaccine based on unfounded fears that their fertility would be impacted.

Giving the Covid-19 vaccine statistics  on August 29, 2021 , the Minister of Health, Community Development, Gender, Elderly and Children, Dr. Dorothy Gwajima, said a total of 304, 603 Tanzanians were vaccinated while only 103, 127  which is equivalent to 33.9 percent, were women.

As a woman who is planning to have more children now and in the future, Happy Daniel was unhappy when the special committee designated by President Samia Suluhu Hassan to research and report on the safety of the vaccines failed to explain the concerns she has about the vaccine, pregnancy and fertility presented by  Prof Said Aboud is the chairman of the special committee.

She was also expecting to hear from the experts how pregnant women will be prioritized in the vaccination so as to protect them from Covid-19 infections, but that did not happen.

“You know there are rumours spreading that the COVID-19 vaccine affects the female reproductive system that if you get vaccination you will not be able to conceive, I was expecting the report to talk about this information as well but nothing was spoken,” said Happy.

Due to unexpected answers from the report, Happy and many other women who fall into this category have made a decision that they think is appropriate based on their goals.

“Why should I bother taking vaccination when the report did not talk about the safety of the vaccine for the reproductive system. I don’t have any kids yet and I hope to get one in the future so let those who have kids get the vaccine,” she insists.

But there are other pregnant women like 25 year old Amina Kibaraza who are anxious to get the vaccine but are frustrated that the health facilities are not willing to give them the jab.

“I am worried about what will happen to me and my baby if I contract COVID-19 infections because I know that I am not allowed to get vaccination just because l am pregnant,” says Amina.

Will pregnant women get vaccinated?                                           

Speaking on the issue of pregnant women Dr Kazyoba argues that the current Covid-19 vaccine guidelines in Tanzania have excluded pregnant women from the group who need to be vaccinated because doctors need to be more confident about the safety of the vaccine for the group, it does not mean they will not be vaccinated.

“ Research is being done  to see if the  vaccines are safe for pregnant women in the country. If we are satisfied that they are not harmful to them, we will allow them to take  the vaccine, '' said Dr. Kazyoba

However, The U.S. Centers for Disease Control and Prevention updated its recommendations in early August, strengthening its advice that people who are pregnant or breastfeeding should be vaccinated against COVID-19 since they  are more likely to get severely ill with COVID-19 compared with non-pregnant people.


Stakeholders comment

Experts and health professionals think that it is important for pregnant women and those planning to conceive to be vaccinated in order to be safe.

Dr. Neelum Ismail, a family doctor from Agakhan Hospital, urges pregnant women to get vaccinated to ensure immunity in their bodies to reduce the risk of severe sickness from covid-19.

"It is important for them to get a vaccination so that by the time they become pregnant they will have immunity that will reduce the severity of coronavirus because these viruses do not discriminate, so this vaccine is very important for this group," said Dr. Ismail

During pregnancy, the body undergoes a lot of changes, some of which can affect the strength of the immune system. Pregnancy depresses the body’s natural immunity as a whole, and decreases lung capacity – which makes this a prime breeding ground for Covid-19 complications.  “Research from groups around the world has shown that pregnant women with COVID-19 are at higher risk of hospitalization and severe disease than are women of the same age who are not pregnant. The good news is that babies are mostly spared a severe respiratory infection, and do not often get sick,” the report says.

While the overall risk of experiencing a severe course of COVID-19 is low, people who are pregnant have an increased risk of getting severely ill if they contract COVID-19. Those severely ill from COVID-19 are at an increased risk of hospitalisation, would require extracorporeal membrane oxygenation (ECMO) treatment (where blood is pumped outside of your body to a heart-lung machine that removes carbon dioxide and sends oxygen-filled blood back to tissues in the body to give the heart and lungs an opportunity to rest and heal.

A study conducted by Weill Cornell Medicine and NewYork-Presbyterian researchers, published on April 28 in Obstetrics & Gynecology found that women who receive COVID-19 mRNA vaccines produced by Pfizer-BioNTech or Moderna while in their third trimester of pregnancy generate a strong immune response and pass protective antibodies through umbilical cord blood to their babies.

Researchers studied 122 women who received the two-dose Pfizer or Moderna mRNA vaccine during pregnancy and analyzed the antibody response mounted upon vaccination. They also assessed the presence of antibodies in the cord blood of babies born to these women at the time of birth. The research demonstrated that 99 percent of newborns had protective antibodies after their mothers received both vaccine doses, and 44 percent of babies had antibodies after one dose. Recent studies say 99% of the babies born to fully vaccinated mothers are born with Covid-19 antibodies.

Dr. Kazobya said citizens are living in fear, loss of trust and confidence because of misinformation on Covid-19 which cost health institutions such as NIMR which use great force to bring people back to a positive understanding of the vaccine offered especially Johnson and Johnson vaccine which is provided now.

"I urge people who create these rumors and post them online to stop because these information are spreading so fast and most of citizen’s ability to distinguish whether the person who posted is an expert or not is low,” said Dr. Kazyoba

However, the doctor insisted Tanzanians should listen to and trust the health professionals in this issue of vaccination as they have done a great job in this.

"If you see the vaccines are allowed to be used, know there are institutions and specialists who have worked hard to prove to the leaders that they are effective, and they are done with the aim of protecting the nation from the severity of the disease because we will continue to live with this disease for a long time,” says Dr. Kazyoba

Tanzania has joined countries that are using the World Health Organization's Corona Control Program (WHO) to combat the epidemic by receiving doses of vaccines 1, 058, 400 Johnson and Johnson from the United States under the COVAX program.

A recent modelling study across 118 of the world's countries estimated that between 8.3 percent and 38.6 percent more pregnant women could die each month. In countries like the Democratic Republic of Congo and Nigeria, this would add an additional 1,280 and 6,700 maternal deaths to the already staggering 16,000 and 67,000 respective maternal deaths each year.


What are the facts?

There have been numerous fact checks such as this one from UNICEF and this one from Full Fact, debunking the claim that Covid-19 vaccines affect women’s fertility. There is no evidence to support this claim.

Tanzania’s government directives to not vaccinate pregnant women is not an indication that the vaccine affects fertility. Numerous countries waited to start vaccinating pregnant women. This was because of a data gap on the effects of vaccines on pregnant women as they were not part of the early vaccine trails. Vaccine trials routinely exclude pregnant women, because there could be adverse effects for both mother and baby.There is growing evidence that getting vaccinated could help protect your baby against COVID-19 too. You can find out more in these studies looking at the impact of the COVID-19 vaccines on pregnant and lactating mothers and here.For those who are pregnant or intending to be pregnant, experts say there is no reason for them to be concerned about the vaccines. Here is why:

  • None of the approved COVID-19 vaccines use the live virus that causes COVID-19, so they cannot make anyone sick with COVID-19.
  • All COVID-19 vaccines that have been approved have been studied on pregnant animals. In these studies, there have been no harmful effects to animals’ unborn babies.
  • Data from small studies into the Pfizer and Moderna vaccines have shown that vaccination has no adverse impact on pregnancy.
  • These studies have also shown that COVID-19 vaccines are expected to be as effective for pregnant women as for non-pregnant women of the same age.

Given the current evidence — and the increased dangers of COVID-19 for pregnant women — the World Health Organisation has recommended that:

  • Pregnant women living in areas where COVID-19 transmission is high are prioritized in their country's vaccination campaigns.
  • Pregnant women at high risk from COVID-19 talk about their vaccination options with their healthcare provider.

Countries around the world have adopted varying policies on COCID-19 vaccination in pregnancy with 41 countries recommending against it. Currently, 91 countries have policies that allow for at least some pregnant people to receiv e COVID-19 vaccines —45 countries broadly permit or recommend vaccines in pregnancy according to the Johns Hopkins University's COVID-19 Maternal Immunization Tracker which provides a global snapshot of public health policies that shape access to COVID-19 vaccines for pregnant and lactating people. It is hoped that Tanzania may soon join the list of countries permitting the vaccines as the  public health authorities and recommending bodies get more evidence to develop guidance on COVID-19 vaccines and pregnancy.