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. 2022 Oct 12;75(8):1462-1466.
doi: 10.1093/cid/ciac362.

Prioritizing Pregnant Women for Coronavirus Disease 2019 Vaccination in African Countries

Jean B Nachega  1   2   3 , Nadia A Sam-Agudu  4   5   6 , Mark J Siedner  7   8 , Philip J Rosenthal  9 , John W Mellors  10 , Alimuddin Zumla  11   12 , Michel P Hermans  13 , Mukanire B Ntakwinja  14 , Denis M Mukwege  14 , Eduard Langenegger  15 , Lynne M Mofenson  16 ; African Forum for Research and Education in Health (AFREhealth) Research Collaboration on COVID-19 and Pregnancy
Affiliations

Prioritizing Pregnant Women for Coronavirus Disease 2019 Vaccination in African Countries

Jean B Nachega et al. Clin Infect Dis. .

Abstract

Coronavirus disease 2019 (COVID-19) in pregnancy is associated with excess maternal and infant morbidity and mortality in both African and higher-resource settings. Furthermore, mounting evidence demonstrates the safety and efficacy of COVID-19 vaccination for pregnant women and infants. However, national guidelines in many African countries are equivocal or lack recommendations on COVID-19 vaccine in pregnancy. We summarize key data on COVID-19 epidemiology and vaccination among pregnant African women to highlight major barriers to vaccination and recommend 4 interventions. First, policymakers should prioritize pregnant women for COVID-19 vaccination, with a target of 100% coverage. Second, empirically supported public health campaigns should be sustainably implemented to inform and support pregnant women and their healthcare providers in overcoming vaccine hesitancy. Third, COVID-19 vaccination for pregnant women should be expanded to include antenatal care, obstetrics/gynecology, and targeted mass vaccination campaigns. Fourth, national monitoring and evaluation of COVID-19 vaccine uptake, safety, surveillance, and prospective outcomes assessment should be conducted.

Keywords: COVID-19; SARS-CoV-2; pregnancy; sub-Saharan Africa; vaccination.

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Conflict of interest statement

Potential conflicts of interest. J. B. N. reports grants from NIH/FIC paid to her institution and unrelated to this work (grant numbers 1R25TW011217-01, 1R21TW011706-01, and 1D43TW010937-01A1). N. S. A. reports grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, unrelated to this work and paid to institution (grant number R01HD089866) and an NIH/FIC award through the Adolescent HIV Prevention and Treatment Implementation Science Alliance for the Central and West Africa Implementation Science Alliance. P. J. R. reports grants or contracts unrelated to this work and paid to institution (grant numbers 5R01AI075045-12, 5R01AI139179-04, and 5R01AI117001-07). A. Z. reports grants or contracts unrelated to this work and paid to institution: Pan-African Network on Emerging and Re-Emerging Infections (PANDORA-ID-NET, https://www.pandoraid.net/) funded by the European and Developing Countries Clinical Trials Partnership and the European Union Horizon 2020 Framework Program for Research and Innovation. J. W. M. reports research grants unrelated to this work and paid to the University of Pittsburgh from the NIH to the Pitt-Ohio State Clinical Trials Unit (grant number UM1 AI068636), the University of Pittsburgh Virology Support Laboratory (grant number UM1 AI106701), the I4C Martin Delaney Collaboratory for an HIV Cure (grant number UM1 AI126603), the REACH Martin Delaney Collaboratory for HIV Cure (grant number UM1 AI164565), and the National Cancer Institute through Leidos (contract numbers HHSN261200800001E and 75N91019D00024), US Agency for International Development, Gilead Sciences, and Janssen Pharmaceuticals; consulting fees from Gilead Sciences (scientific advisory board), Accelevir Diagnostics (consulting agreement), and Merck (consulting agreement); shares from Abound Bio, and share options with Co-Crystal Pharma and Infectious Diseases Connect; a consulting agreement with Xi-an Yufan Biotechnologies; and employment with the University of Pittsburgh. M. J. S. reports grants unrelated to this work and paid to institution (Massachusetts General Hospital): NIH/National Institute on Aging (grant number R01AG059504-03) and NIH/National Heart, Lung, and Blood Institute (R01 HL141053-04). L. M. M. reports consulting fees from the World Health Organization as a consultant on COVID-19 in pregnancy and mother-to-child SARS-CoV-2 transmission (this contract is now completed) and payment from Virology Education for a continuing education talk on SARS-CoV-2 in pregnancy and possibility of mother-to-child SARS-CoV-2 transmission. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

References

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