All pregnant and postpartum women (up to 45 days after delivery) have been included by the Ministry of Health in the priority group for vaccination against Covid-19. The measure is present in a technical note from the folder sent to the states and municipalities. No specific dates have been set yet for the group immunization, but the estimate is that the first dose will be applied by the end of May.

The decision to include pregnant women in the vaccination campaign, according to the technical note, took into consideration possible risks and benefits, the pandemic situation in the country, and data showing an increased risk of hospitalization of patients with Covid-19 in this group. The Ministry of Health states that, although the safety and efficacy of the Covid vaccines have not been evaluated in pregnant women, other vaccines developed with inactivated virus, such as CoronaVac, are already widely used by this women group in the National Vaccination Calendar. The agency also conducted a survey that gathered recommendations from national and international institutions favorable to the pregnant women immunization.

According to the note, the vaccination of pregnant and postpartum women should occur together with the vaccination of people with comorbidities (such as diabetes, hypertension, and other risk factors) and people with disabilities, but respecting two phases: in the first phase, pregnant and postpartum women with comorbidities should be vaccinated, regardless of age. The second includes all pregnant women, regardless of pre-existing conditions.

Pregnant women with comorbidities must prove the situation by means of exams, reports, or prescriptions. The Ministry of Health indicates that vaccination should take place regardless of gestational age and that postpartum women who are breastfeeding should not interrupt the practice.

The technical note defines that vaccination can be performed with any immunization platform inactivated virus (Coronavac, for example), viral vector (Oxford/AstraZeneca) or mRNA (Pfizer), respecting the recommended intervals between doses. Pregnant women who have been vaccinated against the flu should respect the minimum interval of 14 days to be immunized with the Covid-19 vaccine first dose.

Order recommended by the Ministry of Health for the vaccination of people with comorbidities, people with disabilities, and pregnant and postpartum women:

Phase 1 (dates depend on local organization)

People with Down syndrome, regardless of age;

People with chronic kidney disease on renal replacement therapy (dialysis) regardless of age;

Pregnant and postpartum women with comorbidities, regardless of age;

People with comorbidities aged 55 to 59;

Permanently disabled people registered in the Continuous Cash Benefit Program (BPC) from 55 to 59 years old.

Phase 2

People with comorbidities of other age groups, with prioritization criteria by age (people 50 to 54 years, 45 to 49 years, 40 to 44 years, 30 to 39 years, and 18 to 29 years);

People with permanent disabilities registered in BPC;

Pregnant and postpartum women regardless of pre-existing conditions.

Source: Payroll de São Paulo.