A reasoned approach towards administering COVID-19 vaccines to pregnant women

There are over 50 SARS-CoV-2 candidate vaccines undergoing Phase II and III clinical trials. Several vaccines have been approved by regulatory authorities and rolled out for use in different countries. Due to concerns of potential teratogenicity or adverse effect on maternal physiology, pregnancy has been a specific exclusion criterion for most vaccine trials with only two trials not excluding pregnant women. Thus, other than limited animal studies, gradually emerging development and reproductive toxicity data, and observational data from vaccine registries, there is a paucity of reliable information to guide recommendations for the safe vaccination of pregnant women. Pregnancy is a risk factor for severe COVID-19, especially in women with comorbidities, resulting in increased rates of preterm birth and maternal morbidity. We discuss the major SARS-CoV-2 vaccines, their mechanisms of action, efficacy, safety profile and possible benefits to the maternal-fetal dyad to create a rational approach towards maternal vaccination while anticipating and mitigating vaccine-related complications. Pregnant women with high exposure risks or co-morbidities predisposing to severe COVID-19 infection should be prioritised for vaccination. Those with risk factors for adverse effects should be counselled accordingly. It is essential to support patient autonomy by shared decision-making involving a risk-benefit discussion with the pregnant woman.     

A major increase in snake pipefish (<Emphasis Type="Italic">Entelurus aequoreus</Emphasis>) in northern European seas since 2003: potential implications for seabird breeding success

Since the early 2000s routine fish surveys have recorded increasing numbers of snake pipefish, Entelurus aequoreus, in the northeast Atlantic. Fishermen and divers have also commented on this increase and pipefish have started to appear in the diet of seabirds and other marine predators. This paper collates information from these diverse sources and assesses the current status of snake pipefish. We found compelling evidence of a dramatic increase in the abundance of snake pipefish starting around 2003 and continuing up to the present (2006) and a range expansion northwards to Spitzbergen and the Barents Sea. Since 2004 snake pipefish have been increasingly recorded in the diet of many species of seabird breeding in colonies around the coast of the UK, and in Norway, Iceland and the Faeroe Islands. Information on the nutrient value of snake pipefish is currently lacking but their rigid, bony structure makes them difficult for young seabirds to swallow and there are numerous records of chicks choking to death. Thus, in the case of avian predators during the breeding season, it appears unlikely that increased abundance of snake pipefish will provide a useful alternative prey. The reason for the rapid and dramatic increase in numbers of snake pipefish is currently unclear but such events are characteristic of marine ecosystems and will almost certainly have an effect on food web dynamics.