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Letter to the Editor Re Excluding pregnancy from COVID-19 trials: Protection from harm or the harm of protection?
The authors should be applauded for highlighting the ethical issues in the potential exclusion of pregnant women from COVID-19 trials. Other recent pregnancy related vaccine trials for fetal benefit have been important for neonatal infectious risk prior to the recommended timing for routine vaccination.
The decreased preventative uptake of childhood vaccination due to parental misunderstanding of benefit and risk requires that pregnancy related vaccine trials showing efficacy and safety of directed vaccine are completed within appropriate boundaries.
Viral infections during pregnancy have the potential long-term teratogenic outcomes for the neonate depending on the virus, gestational age, and maternal immunological status. Exclusion of pregnant women from vaccine trials will only add to the fiction that vaccination has a greater risk than the safer outcome of preventive reality.Competing Interests: None declared.References
- Ann Kinga Malinowski, John Snelgrove, Nan Okun. Excluding pregnancy from COVID-19 trials: Protection from harm or the harm of protection?. CMAJ 2020;192:E634-E634.
- Halperin SA, et al. A RCT of the Safety and lmmunogenicity of Tetanus, Diphtheria, and Acellular Pertussis Vaccine Immunization during Pregnancy and Subsequent infant Immune Responses. Clin Infect Dis 2018; 67(7):1063-1071