Արդյո՞ք COVID-19-ի պատվաստանյութն անվտանգ է հղի կանանց համար
Հիմնական կարևոր կետերը
- COVID-19 -ի վիրուսի դեմ պատվաստանյութն առաջարկվում է և ցանկալի է ստանան հղի կանայք և որոշ ռիսկի խմբում գտնվող անձինք (բուժաշխատողներ, առաջին գծի հիմնական աշխատողներ):
- Ներկա պահին բավարար քանակությամբ հետազոտության տվյալներ չկան այն մասին, թե պատվաստանյութը ինչպես է ազդելու հղի կանանց վրա, քանի որ այս փաստի մասին կլինիկական փորձարկումներ չեն իրականացվել:
- Ըստ CDC-ի և ԱՀԿ-ի ուղեցույցների տվյալների հղի կանայք կարող են պատվաստվել:
- Moderna- ն և Pfizer-BioNTech- ը իրականացնում են վերահսկողություն կլինիկական փորձարկումներին մասնակցող հղի կանանց նկատմամբ։ CDC- ն նաև ֆինանսավորում է Դյուկի համալսարանում իրականացվող հետազոտությունները հղի կանանց ներգրավածությամբ, ովքեր ցանկություն են հայտնել ստանալ COVID-19 վիրուսի հանդեպ պատվաստանյութը:
Ըստ Ամերիկյան մանկաբարձության և գինեկոլոգների քոլեջի (ACOG) վերջին առաջարկությունների, այն հղի կանայք, ովքեր դիմում են Իմունականխարգելման պրակտիկայի խորհրդատվական կոմիտեին (ACIP) պետք է ընդգրկվեն առաջնահերթ խմբերի ցուցակում և պետք է կարողանան ստանալ COVID-19 պատվաստանյութը:
Հղի կանանց շրջանում կլինիկական փորձարկումներ չեն եղել, բայց այն պլանավորվում է իրականացնել խոշոր հետազոտական կազմակերպություններում, ինչպիսիք են ՝Pfizer-ը BioNTech-ը, Moderna-ը, Janssen-ը, AstraZeneca- ը և Novavax-ը , հայտնում է բժիշկ Իվոն Մալդոնադոն, ով հանդիսանում է Սթենֆորդի համալսարանի բժշկական դպրոցում մանկաբուժության և առողջության հետազոտությունների պրոֆեսոր: Այդ կլինիկական փորձարկումների իրականացման նպատակն է պարզել արդյո՞ ք պատվաստանյութն անվտանգ է հղի կանանց համար և նաև արդյո՞ ք այն օրգանիզմում առաջացնում է նույն պաշտպանող իմունային պատասխանն, ինչ ոչ հղի կանանց մոտ:
Թերևս զարմանալի չէ, որ տվյալների սղությունը հանգեցրել է Հիվանդությունների վերահսկման և կանխարգելման կենտրոնի (CDC) և Առողջապահության համաշխարհային կազմակերպության (ԱՀԿ) հակասական կարծիքների ի տարբերություն Իմունականխարգելման պրակտիկայի խորհրդատվական կոմիտեի (ACIP) , որ հղի կանայք չեն մտնում COVID-19 վիրուսի դեմ պատվաստանյութ ստացողների առաջարկվող առաջնահերթ խմբերի ցուցակի մեջ :
Հիվանդությունների վերահսկման և կանխարգելման կենտրոնը (CDC) խորհուրդ է տալիս հղիներին խորհրդակցել իրենց բժշկի հետ և միասին կշռադատել ռիսկն ու օգուտները նախքան COVID-19 պատվաստանյութ ստանալը:
Առողջապահության համաշխարհային կազմակերպությունը (ԱՀԿ) խորհուրդ է տալիս հղի կանանց պատվաստանյութ չստանալ, եթե նրանք իրենց աշխատանքի բնույթով չեն ենթարկվում COVID-19 վիրուսով վարակվելու մեծ ռիսկի ազդեցությանը կամ եթե նրանք չունեն ուղեկցող քրոնիկ հիվանդություններ:
Կշռադատեք պատվաստման ռիսկերը և օգուտները
Միևնույն ժամանակ, եթե հղի եք, հնարավորություն ունեք ստանալու COVID-19 պատվաստանյութ, բայց կարևոր է գնահատել հնարավոր օգուտները, ինչպես նաև հնարավոր ռիսկերը `ինչպես ձեր, այնպես էլ ձեր զարգացող պտղի համար: «Դա նշանակում է, որ մենք պետք է մտածենք այն ռիսկերի մասին, որոնք կորոնավիրուսային վարակը կարող է առաջացնել մոր և երեխայի համար, եթե նրանք անպաշտպան մնան կամ եթե նրանք չկարողանան ձեռք բերել բարձր արդյունավետություն ունեցող պատվաստանյութը», – ասում է պրոֆեսոր Քերլի Կրուբիները , ով հանդիսանում է Johns Hopkins-ի համալսարանում պատվաստանյութերի, համաճարակների և նոր տեխնոլոգիաների (կանխարգելում) էթիկայի հանձնաժողովի ղեկավարը։
Միևնույն ժամանակ, կարևոր է ուսումնասիրել անվտանգությանը վերաբերվող ցանկացած ազդանշան կամ մտահոգություն: «Մենք կարող ենք սկսել պատվաստել հղի կանանց հաշվի առնելով այն, ինչ մենք գիտենք ոչ հղի մեծահասակների շրջանում իրականացված հետազոտություններից ստացված անվտանգության մասին տվյալներից , որպեսզի տեսնենք, թե կա՞ն արդյոք անբարենպաստ ազդեցություններ, որոնք մոր և մանկան առողջությամբ զբաղվող մասնագետների մոտ կարող են մտահոգության առիթ տալ հղիության տարբեր փուլերում», – բացատրում է դոկտոր Կրուբիները:
Մենք հավատում ենք, որ հղի կանայք, ովքեր կազմում են առողջապահական աշխատուժի և ընդհանուր բնակչության որոշ մասը, պետք է պաշտպանված լինեն SARs-CoV-2 վարակի դեմ պատվաստանյութի միջոցով, որն ապացուցված է, որ հղի կանանց մոտ անվտանգ և արդյունավետ է:
Բժիշկ Յվոննե Մալդոնադո. «Մենք կարող ենք հաշվի առնել նաև այն փորձերի արդյունքների տվյալները, երբ կանայք պատվաստանյութեր են ստանում նախքան իրենց հղիության մասին իմանալը, ինչը տվյալ պահին կարող է լինել հղիության ընթացքում պատվաստանյութերի անվտանգության մասին տեղեկատվության միակ աղբյուրը», – ավելացնում է նա: «Հղիության ընթացքում տարբեր COVID-19 պատվաստանյութերի անվտանգության պրոֆիլի հետազոտումը շարունակական գործընթաց է ՝ հավաքագրելով ավելի ու ավելի լավ ապացույցներ, որը իր մեջ կներառի պատվաստանյութերը հասարակության լայն շերտերին հասանելի լինելուց հետո ստացված տվյալները»:
Շատ երկրներ այս խնդրի շուրջ ունեն իրենց տեսակետը
Համաձայն Անգլիայի հանրային առողջապահութայն կողմից հրատարակած ժամանակավոր ուղեցույցի, Միացյալ Թագավորությունում հղի կանայք պետք է սպասեն մինչև ծննդաբերության ավարտը, որպեսզի կարողանան ստանալ COVID-19- ի դեմ պատվաստանյութը: Նման մոտեցում ունեն նաև Միացյալ Նահանգների Առողջապահության նախարարությունը, ըստ իրենց կողմից մշակված ուղղեցույցների, անգամ երբ պատվաստումները հասանելի դառնան բոլորին, հղի կանայք պետք է իմունիզացվեն ծննդաբերությունից հետո։
Չնայած ուղեցույցներ հրատարակողներն ընդունում են այն փաստը, որ հղիության հետ կապված «հայտնի ռիսկ չկա », սակայն ինչպես հայտնում են դեղագործական ընկերությունների մեծ մասը, հղի կանանց համար COVID-19 պատվաստանյութի հատուկ կլինիկական փորձարկումներ չեն իրականացվել :
Փորձագետները ստիպված կլինեն շարունակել ուսումնասիրությունները, որպեսզի օգտագործելով առկա հետազոտությունների ապացույցները և տվյալները պարզեն, թե որն է լավագուն տարբերակը հղիների համար, որ երկրի արտադրության պատվաստանյութն է ավելի բարձր արդյունավետությունն ունի և հաստատում է ստանում շատ երկների առողջապահության նախարարությունների կողմից:
Անգլիայի հանրային առողջապահության կողմից հրատարակած ուղեցույցում նշվում է. «Չնայած առկա տվյալները չեն փաստում հղիության որևէ անվտանգության կամ վնասի մասին, սակայն անբավարար ապացույցներ կան հղիության ընթացքում COVID-19 պատվաստանյութերի սովորական օգտագործումն առաջարկելու համար: Պատվաստումը պետք է հետաձգվի մինչ հղիության ավարտը: Եթե կինը պարզում է, որ հղի է պատվաստանյութի կուրս սկսելուց հետո, նա պետք է ավարտի իր հղիությունը նախքան առաջարկված գրաֆիկն ավարտելը»:
Այնուամենայնիվ, կրծքով կերակրող մայրերը և ծննդկանները կկարողանան պատվաստում ստանալ: Անգլիայի հանրային առողջապահության ներկայացուցիչները ասում են, որ այն հղի կանայք, ովքեր մտնում են COVID-19 վիրուսի բարդությունները զարգացնելու բարձր ռիսկի խմբի մեջ `առողջության տարբեր գործոնների պատճառով (օրինակ` ունեն որևէ քրոնիկ ուղեկցող հիվանդություն), պետք է ծննդաբերությունից հետո հնարավորինս շուտ պատվաստվեն։
Որոշ պատվաստանյութեր հղիության ընթացքում կարող են ավելի անվտանգ լինել, քան մյուսները
Հնարավոր է, որ որոշ պատվաստանյութեր ավելի արդյունավետ լինեն հղիների համար, քան մյուսները: Փորձագետները ստիպված կլինեն շարունակել ուսումնասիրել առկա բոլոր ապացույցները` պարզելու համար, թե որն է լավագույն ընտրությունը հղիության համար, հատկապես եթե առկա է պատվաստանյութերի տարբեր ընկերությունների կողմից ներկայացված ավելի շատ արտադրանքներ: «Այս պահին կան տարբեր կոմիտեներ, որոնք ունեն տարբեր հետազոտությունների արդյունքների տվյալներ հղիության, մանկաբարձության, մանկաբուժության և էթիկայի վարակիչ հիվանդությունների բնագավառից, և նրանք գնահատում են առկա բոլոր ապացույցները` որոշելու թե որ մի պատվաստանյութը ունի առավելություն այլ պատվաստանյութի նկատմամբ »:
Ինչ է սա նշանակում ձեզ համար
Համաճարակի ժամանակ հղի լինելը մեծ անհանգստության առիթ է, և մենք գիտենք, որ ցանկանում եք ձեռնարկել բոլոր միջոցները, որոնք անհրաժեշտ են ձեր չծնված երեխային պաշտպանելու համար: Ցավոք, հղի անձանց համար COVID-19 պատվաստանյութի անվտանգությունն ապահովելու համար բավարար կլինիկական ապացույցներ չկան, ուստի պատվաստվելու որոշումը հիմնականում ընկնում է ձեր վրա: Միևնույն ժամանակ, դուք պետք է շարունակեք չափազանց զգույշ լինել դիմակ կրելու, սոցիալական հեռավորություն պահպանելու հարցում և COVID-19 հանրային առողջության բոլոր արձանագրություններին հետևելու հարցում:
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