{"id":38716,"date":"2021-02-01T14:27:31","date_gmt":"2021-02-01T22:27:31","guid":{"rendered":"https:\/\/www.avawomen.com\/?p=38716"},"modified":"2021-06-08T10:55:36","modified_gmt":"2021-06-08T17:55:36","slug":"covid-vaccine-pregnancy","status":"publish","type":"post","link":"http:\/\/www.avawomen.com\/avaworld\/covid-vaccine-pregnancy\/","title":{"rendered":"COVID-19 Vaccination Before, During, and After Pregnancy"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">If being pregnant during a global pandemic were not stressful enough, pregnant women now must wrestle with the decision whether to be vaccinated against COVID-19.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As of this writing, two COVID-19 vaccines, from Pfizer-BioNtech and Moderna are approved in the United States. (More approvals are expected shortly.) Neither has been studied in pregnant and lactating women.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Because of the lack of data, major medical organizations have issued conflicting recommendations for pregnant women. In the U.S. the <\/span><a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/vaccines\/recommendations\/pregnancy.html\"><span style=\"font-weight: 400;\">Centers for Disease Control (CDC)<\/span><\/a><span style=\"font-weight: 400;\">, the <\/span><a href=\"https:\/\/www.acog.org\/advocacy\/advocacy-and-covid-19\/covid-19-vaccines-and-pregnancy\"><span style=\"font-weight: 400;\">American College for Obstetricians and Gynecologists<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/s3.amazonaws.com\/cdn.smfm.org\/media\/2591\/SMFM_Vaccine_Statement_12-1-20_(final).pdf\"><span style=\"font-weight: 400;\">The Society for Maternal Fetal Medicine<\/span><\/a><span style=\"font-weight: 400;\"> all say that pregnant women may choose to get the vaccine when a group to which they belong, such as healthcare workers or teachers, becomes eligible.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The World Health Organization, on the other hand, only <\/span><a href=\"https:\/\/www.who.int\/news-room\/feature-stories\/detail\/the-moderna-covid-19-mrna-1273-vaccine-what-you-need-to-know\"><span style=\"font-weight: 400;\">recommends<\/span><\/a><span style=\"font-weight: 400;\"> vaccination for pregnant women who belong to a group at high risk of exposure, such as healthcare workers.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The disagreement among medical experts and lack of studies has opened the door for a <\/span><a href=\"https:\/\/fivethirtyeight.com\/features\/why-fights-over-the-covid-19-vaccine-are-everywhere-on-facebook\/\"><span style=\"font-weight: 400;\">firestorm of misinformation<\/span><\/a><span style=\"font-weight: 400;\"> targeting pregnant and breastfeeding and reproductive age women, <\/span><a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/vaccines\/facts.html\"><span style=\"font-weight: 400;\">claiming falsely<\/span><\/a><span style=\"font-weight: 400;\">, for example, that these vaccines <\/span><a href=\"https:\/\/www.nytimes.com\/2021\/01\/26\/opinion\/covid-vaccine-rumors.html\"><span style=\"font-weight: 400;\">impair fertility<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Online fear mongering about the vaccine\u2019s unknowns can obscure the threat COVID-19 poses to pregnant women, who are at higher risk of severe illness than women of the same age.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Yuri Edelsen, a Health Minister in Israel, where they recently began vaccinating pregnant women, <\/span><a href=\"https:\/\/www.jpost.com\/breaking-news\/who-dont-use-covid-19-vaccine-on-pregnant-women-656761\"><span style=\"font-weight: 400;\">recently told the Jerusalem Post<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><span style=\"font-weight: 400;\">\u201cI would say, not being a medical doctor, that when I look at these terrible cases of a number of pregnant women who are in serious condition with the coronavirus, I say to myself, probably it is worse to take the little risk of taking the vaccine instead of finding yourself in a terrible situation in the hospital.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To make an informed decision, potentially in conjunction with a trusted healthcare provider, women need accurate information on both the risk of vaccination <\/span><i><span style=\"font-weight: 400;\">and<\/span><\/i><span style=\"font-weight: 400;\"> the risk of COVID-19.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What do we know about the safety of the Pfizer and Moderna COVID-19 vaccines in pregnant women?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">To date, no studies have been done in pregnant women.<\/span> <span style=\"font-weight: 400;\">Moderna and Pfizer-BioNtech both excluded pregnant and lactating women from their clinical trials\u2014a common drug company practice for testing novel treatments.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, Pfizer-BioNtech and Moderna\u2019s trials did include some pregnant women, who did not realize they were pregnant when they enrolled or who became pregnant during the trial. Reassuringly, no harmful effects were seen in these women.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Moderna also tested their reproductive and developmental toxicity vaccine in rats prior to and during pregnancy and found no adverse effects&#8211;but animal studies do not always generalize to humans.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are also biological reasons to believe these vaccines are safe during pregnancy: They do not contain live virus, only so-called messenger RNA (mRNA), so they cannot cause an infection. Nor mRNA does enter the part of the cell that contains its DNA, so these vaccines cannot cause genetic changes.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In short, \u201cbased on how mRNA vaccines work, experts believe they are unlikely to pose a specific risk for people who are pregnant,\u201d according to the <\/span><a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/vaccines\/recommendations\/pregnancy.html\"><span style=\"font-weight: 400;\">Centers for Disease Control, (CDC)<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">We have a long history of safely vaccinating women during pregnancy. Pregnant women <\/span><a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/need-extra-precautions\/pregnancy-breastfeeding.html\"><span style=\"font-weight: 400;\">routinely<\/span><\/a><span style=\"font-weight: 400;\"> receive the flu vaccine\u2014because they are at higher risk of severe illness from the flu\u2014and the tetanus, diphtheria, and pertussis (Tdap) vaccine, in order to pass on protective antibodies against pertussis (whooping cough) to their babies.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What are the current recommendations regarding COVID-19 vaccination for women who are lactating or trying to conceive?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">For women who are lactating and those actively trying to conceive, ACOG <\/span><a href=\"https:\/\/www.acog.org\/clinical\/clinical-guidance\/practice-advisory\/articles\/2020\/12\/vaccinating-pregnant-and-lactating-patients-against-covid-19\"><span style=\"font-weight: 400;\">strongly recommends vaccination<\/span><\/a><span style=\"font-weight: 400;\"> when they become eligible.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What are the risks of COVID-19 for pregnant women?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/www.cdc.gov\/mmwr\/volumes\/69\/wr\/mm6944e3.htm\"><span style=\"font-weight: 400;\">latest CDC data<\/span><\/a><span style=\"font-weight: 400;\"> suggests that relative to other women of the same age, pregnant women are at higher risk of severe COVID-19, including for hospitalization, admission to the ICU (intensive care unit), ventilation and respiratory support, and death.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Fortunately, these risks, although elevated compared to women who are not pregnant, remain low. Approximately 1 in every 100 pregnant women with symptomatic COVID-19 are admitted to an ICU and 3 in 1000 received invasive ventilation. The rates <\/span><a href=\"https:\/\/www.acog.org\/covid-19\/covid-19-vaccines-and-pregnancy-conversation-guide-for-clinicians\"><span style=\"font-weight: 400;\">may be higher<\/span><\/a><span style=\"font-weight: 400;\"> for pregnant women with other conditions that raise the risk of severe COVID-19, such as obesity, cardiovascular disease, and Type 2 Diabetes.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What are the risks of COVID-19 for fetuses and newborns?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The good news is that the vast majority of newborns born to women with COVID-19 <\/span><a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/need-extra-precautions\/pregnancy-breastfeeding.html\"><span style=\"font-weight: 400;\">test negative<\/span><\/a><span style=\"font-weight: 400;\"> for SARS-COV-2, the virus that causes COVID-19. Among the few that test positive for SARS-COV-2, most have no or only mild symptoms; a few have been admitted to the NICU. Among those who tested positive, it remains unclear whether these babies contracted COVID-19 from their mother during pregnancy or after delivery.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">We do know, however, that COVID-19 can spread from the mother to the <\/span><a href=\"https:\/\/hms.harvard.edu\/news\/placental-protection\"><span style=\"font-weight: 400;\">placenta<\/span><\/a><span style=\"font-weight: 400;\">. A <\/span><a href=\"https:\/\/www.contemporaryobgyn.net\/view\/maternal-covid-19-infection-and-placental-abnormality\"><span style=\"font-weight: 400;\">recent study<\/span><\/a><span style=\"font-weight: 400;\"> of pregnancy outcomes following maternal infection (the majority of which were asymptomatic) found increased inflammation or impaired blood flow across the placenta in over 20% of pregnancies.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">COVID-19 infection also appears to raise the risk of <\/span><a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/cases-updates\/special-populations\/pregnancy-data-on-covid-19\/what-cdc-is-doing.html\"><span style=\"font-weight: 400;\">preterm delivery<\/span><\/a><span style=\"font-weight: 400;\"> (before 37 weeks). Pregnant women with COVID-19 appear to have an <\/span><a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/cases-updates\/special-populations\/birth-data-on-covid-19.html\"><span style=\"font-weight: 400;\">elevated risk of preterm delivery<\/span><\/a><span style=\"font-weight: 400;\"> (12.9% of those with COVID-19 delivered early versus 10.9% of those without COVID-19).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Not everyone will read these risks and unknowns the same way. Women will have to weigh their risks of exposure, their risks for severe disease, chance of transmitting the infection, and concerns about the lack of safety data during pregnancy to make the right choice for themselves.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>If being pregnant during a global pandemic were not stressful enough, pregnant women now must [&hellip;]<\/p>\n","protected":false},"author":10027,"featured_media":38727,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[8325,36],"tags":[9427],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v17.3 (Yoast SEO v18.8) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>COVID-19 Vaccination Before, During, and After Pregnancy - Ava<\/title>\n<meta name=\"description\" content=\"Two COVID-19 vaccines are approved in the United States. (More approvals are expected shortly.) 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