World Indonesia's pregnant women at risk of dying with COVID-19 and aren't prioritised for vaccination
Will we all need COVID vaccine booster shots?
How do boosters work and how can we celebrate Eid safely this year?A booster vaccine is designed to strengthen our body’s immune response to an antigen or “foreign invader” that it has been primed to respond to by a previous vaccine. These are commonly used to protect against diseases such as tetanus and polio, where, after time, our immunity against the antigen wanes. Boosters are usually a shot of the same vaccine again, just given at a later date.
Gesti Wira Nugrayekti tested positive for coronavirus the day before she prematurely gave birth to a baby boy named Salman earlier this month.
Three weeks later, COVID-19 took her life.
The 25-year-old resident doctor suffered through her last weeks, unable to see her newborn, husband Sunni Nugraha Priadi, or 18-month-old daughter Maryam except through video call.
Mr Priadi said Dr Nugrayekti spent the final days of her life fighting — but afraid and in pain.
Her passing highlights thewhich is seeing higher numbers of healthcare workers and pregnant women fall ill and in many cases die.
Team Biden Somehow Failed to Hire Someone to Fight Vaxx Disinfo
As early as last autumn, public health experts and political leaders were sounding the alarm that conspiracist campaigns posed a dire threat to a future nationwide vaccination program—a threat that necessitated the appointment of a “disinformation czar” to counter anti-vaccine messaging. The incoming Biden administration initially intended to heed those calls by placing a disinformation expert on the White House COVID-19 Response Team, according to multiple members of the transition team, but never followed through.
Indonesia has recorded well over 3 million cases of COVID-19 and around 85,000 deaths, but experts believe the actual figures are likely to be higher given low rates of testing.
The Indonesian Obstetrics and Gynaecology Association (POGI) reported that over the past year, at least 536 of those cases were pregnant women and 3 per cent of them had died.
The Australian Health Department website notes that if a pregnant woman contracts COVID-19 they're at a higher risk of severe illness and their foetus is also more likely to be born prematurely or needing hospital treatment.
While Indonesia's POGI last month recommended that pregnant women should be vaccinated, the Indonesian Health Ministry only allows breastfeeding mothers to be vaccinated.
As the pandemic wears on, some Americans could need booster shots
Some health officials now think a third shot could help older and immunocompromised people. Israel is already offering a third Pfizer shot for immunocompromised residents — though millions of Palestinians in the West Bank and the Gaza Strip have yet to be vaccinated — and Pfizer has previously suggested that a booster shot could be needed in the US. Regulatory questions abound Though the US currently has tens of millions of surplus Covid-19 vaccine doses on hand, making a third Pfizer or Moderna shot available to millions of immunocompromised or elderly Americans likely won’t be a quick process.
Dr Nugrayekti, who was both a physician and pregnant, had not been vaccinated.
"The research previously said pregnant women should not be vaccinated," Mr Priadi said, adding that the expert advice had subsequently changed.
"All pregnant women should be vaccinated."
The Indonesian Health Ministry did not respond to the ABC's request for comment.
Pregnant women left off vaccination priority lists
There are concerns pregnant women in lower-income countries like Indonesia are not receiving enough prenatal care, leading to a failure to diagnose COVID-19 and other conditions.
Caroline Homer, the Burnet Institute's co-director for maternal, child and adolescent health, said more women were choosing to give birth at home in order to avoid the risk of getting infected at the hospital.
"[They think] I'll have an elective cesarean section, I'll be in and out as quickly as I can to make sure that there's the least amount of risk,' [which is] driving the kind of practice that we know isn't safe long term," she said.
Mandate the vaccine, not masks
Vaccines are the solution to Covid-19. Let’s make the most of them.With the rise of the delta variant and a rapid increase in Covid-19 cases, the US Centers for Disease Control and Prevention is calling on vaccinated people to wear masks indoors again in places where the virus is quickly spreading. At least some school districts will likely require masks this fall. Local governments, from Massachusetts to California, are reviving mask mandates.
Professor Homer said pregnant women were more likely to require hospitalisation or oxygen therapy if they became infected and should be monitored closely.
But Tiara Marthias, a health policy researcher at Gadjah Mada University in Yogyakarta, said health workers weren't provided with a lot of guidance on how to monitor expecting mothers for COVID or how to look after those who were already infected.
She said many pregnant women were missing out on important care during a time when their immune systems are compromised.
According to Dr Marthias's research, 52 per cent of pregnant women who died with COVID-19 over the past year were asymptomatic.
"That's very worrying," she said, adding there was a lack of government regulations on vaccines.
"We have to include pregnant women, and women who are breastfeeding in the vaccination priority list, and then [we have to] bring these services closer to the women."
Even with precautions Delta variant poses a threat
Dr Nugrayekti was admitted to study anesthesiology at Airlangga University in Surabaya in January, shortly before finding out she was pregnant.
Pregnant Doctor Says Seeing Expecting Mothers Intubated Made Vaccination Decision 'Easy'
"Some of these patients are at a higher risk of pre-term delivery, among other pregnancy complications, when they have COVID in pregnancy," Dr. Jane Martin said.Martin, who is a maternal fetal medicine fellow at Ochsner Baptist Medical Center in New Orleans, received her first vaccine dose at 34 weeks of her pregnancy and the second dose three weeks later.
Her husband, who she married in 2019, had relocated from Jakarta to support her dream of becoming a specialist.
He said she was very intelligent, having jumped ahead two years in high school.
"She was so dedicated to her family, to her studies, to her work," he said.
"My beloved wife is gone. I don't want a second Gesti."
Airlangga University described Dr Nugrayekti as "one of the best" medicine students.
She also volunteered to treat
She had taken precautions throughout her pregnancy, including taking leave to avoid being in contact with COVID patients.
Mr Priadi had worn a mask around his wife to protect her health, and said the couple would always wash their clothes and shower immediately after arriving home.
But it was a brief meeting with university colleagues, including one who unknowingly had the Delta variant of COVID-19, that saw her contract the virus.
"If I had known this would have happened, I would have stopped her from going," her husband said.
"This Delta variant is very dangerous for everyone."
Ida Fahmi Hidayati was Dr Nugrayekti's best friend.
"When Gesti was sick, I was very optimistic that she would recover because Gesti is a tough kid and as far as I know she rarely gets sick," Ms Hidayati told the ABC.
Some pregnant women yet to take up COVID-19 vaccine despite change in health advice
The Pfizer vaccine is recommended at any stage of pregnancy, according to Australian health advice, but some women say that message isn't being communicated to them by their GPs.The 29-year-old registered to get the Pfizer vaccine the day she found out she was eligible.
"She was a very tough, outgoing and active person."
'The thought of losing the baby was so scary'
Indiana Alawasilah, a 33-year-old mother of three from Bandung, tested positive for COVID last year during the third trimester of her pregnancy.
She was in self-isolation for 50 days before being allowed to see her obstetrician.
"I worried about the baby [during this time] and the thought of losing the baby was so scary," she said.
Her husband and their two daughters also tested positive.
While her husband has since recovered, at the time, she said she was constantly worried about losing him, as his symptoms were severe.
Ms Alwasilah was one of the lucky women who recovered from the virus and tested negative a few weeks later.
She was able to deliver her baby safely at the hospital but needed oxygen support and her blood pressure monitored.
Ms Alwasilah said she felt very lucky to have given birth last year, instead of now when
"Life is indeed difficult during this pandemic, but I've experienced that God still blesses us with some unexpected happiness," she said.
Mr Priadi hopes his wife's story is a wake-up call for other Indonesians to take the risks posed by the Delta variant seriously.
He also questioned whether young doctors still in training should be
"They are at war. If they want to or not, they have to go to the front line," he said.
"Resident doctors who are pregnant shouldn't have to go in [to hospitals or campus]. They should be able to do everything online."
New York City issues vaccine mandate for indoor events, confuses entire country .
New York City will soon require that people show proof of vaccination to eat indoors and go to concerts, but it’s not launching another app.The initiative marks the first time a major US city has issued a vaccine mandate like this, and it immediately confused the public.