December 29, 2021, Update on Pregnancy and the COVID-19 Vaccine
For pregnant women, getting the COVID-19 vaccine as soon as possible is the safest choice to protect them against the virus. The Centers for Disease Control and Prevention (CDC), American College of Obstetricians and Gynecologists (ACOG), Society for Maternal-Fetal Medicine (SMFM) and other professional organizations recommend the vaccine during pregnancy. These organizations also point out that pregnant women have a higher risk of hospitalization and death from COVID-19. Getting COVID-19 while pregnant increases the risk of preterm birth, preeclampsia, low birth weight and stillbirth.
Our advice for pregnant women, or those considering pregnancy is to get the COVID-19 vaccine when it is available.
On December 11, 2020, the U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the Pfizer-BioNtech mRNA vaccine for use against the virus that is causing the illness known as COVID-19. The vaccine has been 95% effective in large-scale clinical trials and has already been approved for use in other countries.
A second mRNA vaccine for the prevention of COVID-19, from manufacturer Moderna (called mRNA-1273), received EUA approval on December 18, 2020. Its efficacy rate is reported to be 94%.
Johnson & Johnson was the third vaccine to receive EUA for the prevention of COVID-19 on February 27, 2021, from the FDA.
New guidelines from ACOG recommend that pregnant and recently pregnant people up to 6 weeks postpartum, including pregnant and recently pregnant healthcare workers, receive a booster dose of COVID-19 vaccine following the completion of their initial COVID-19 vaccine or vaccine series. As United States citizens now have access to a COVID-19 vaccine, it is important for infertility patients and pregnant women to make a plan to get vaccinated.
Is the COVID-19 vaccine safe for pregnant women and parents-to-be?
After carefully studying all information and evidence, the doctors at CU Medicine OB-GYN East Denver (Rocky Mountain) recommend that pregnant women and women trying to get pregnant, receive a COVID-19 vaccination.
The CDC experts say that, based on how mRNA vaccines work, “they are unlikely to pose a risk for people who are pregnant.” This is because mRNA vaccines do not contain the live virus that causes COVID-19, so the shot cannot give a pregnant woman the disease. But the CDC says that the potential risks of the COVID-19 vaccine to a pregnant woman and her fetus are not yet fully known. Unlike the Pfizer and Moderna vaccines, Johnson & Johnson’s isn’t an mRNA vaccine. Johnson & Johnson’s is a viral vector vaccine.
An initial CDC study found that pregnant people are at an increased risk of severe COVID-19 illness, but this segment of the population was not included in the Operation Warp Speed vaccine trials.
The American College of Obstetricians and Gynecologists’ (ACOG’s) COVID-19 working group reports that while pregnant women are typically excluded from most clinical trials, they have been vaccinated for decades with few complications. One ACOG working group doctor, Denise J. Jamieson, MD, MPH, said that because the COVID-19 vaccine uses messenger RNA technology, not a live virus, she anticipates the vaccine should be very safe in pregnancy.
Should I get the COVID-19 vaccine if I am pregnant or thinking about it?
ACOG recommends that everyone who is eligible, including pregnant and lactating individuals, receive a COVID-19 vaccine or vaccine series.
If you have an underlying health condition or are one of the estimated 330,000 healthcare workers who are pregnant or breastfeeding during the initial months of the vaccine’s release, then it is imperative that you make a plan to get vaccinated. If you have concerns about your health condition and a COVID-19 vaccine, make sure you talk to your doctor about inoculation.
If you are pregnant or thinking about getting pregnant, make sure you get your COVID-19 vaccine.
For otherwise healthy people in general, the COVID Task Force of the American Society for Reproductive Medicine (ASRM) does not recommend withholding the vaccine from patients who are planning to conceive, who are currently pregnant, or who are breastfeeding. It does encourage patients undergoing fertility treatment to receive the vaccination based on current eligibility criteria. Because the vaccine is not a live virus, the Task Force says there is no reason to delay pregnancy attempts due to vaccine administration or to defer infertility treatment until receiving the second dose.
At the same time, the ASRM Task Force notes that recent studies suggest that pregnancy poses a higher risk for severe COVID-19 disease along with factors such as obesity, hypertension and diabetes. Therefore, each person should weigh individual risks and benefits with her own doctor before receiving the vaccination.
What are potential risks for pregnant women getting the vaccine?
Because there has been no specific research on the COVID-19 vaccine on pregnant women, no known risks have been documented. However, vaccines pose risks to the population at large in general. One risk is that inoculations can trigger a fever in pregnant women (a dose of acetaminophen is usually the recommended treatment).
Another possible side effect is that, sometimes, ingredients in the vaccine can cause allergic reactions similar to those caused by allergies to bee stings and peanut butter. Reactions can include anaphylaxis, a severe condition that can cause shock, a rapid pulse rate, difficulty breathing, nausea and vomiting. Whether pregnant or not, anyone receiving the COVID-19 vaccine should be monitored for 15 to 30 minutes after receiving the shot to identify any complications.
Will the COVID-19 vaccine make me infertile or miscarry?
Currently, there is no data connecting the vaccine and infertility, and social media posts saying otherwise are “inaccurate,” according to Yale University vaccine expert Saad Omer in a Dec. 11, 2020 The New York Times wire story.
The key ingredient in Pfizer’s and Moderna’s vaccine is genetic material that “teaches” human cells how to produce a protein, called “spike protein.” The human immune system recognizes this “spike protein” as foreign, so it produces antibodies against the protein. These antibodies then linger in the person’s immune system. If that person is subsequently exposed to the coronavirus, then the antibodies help prevent symptoms/infection from developing. These protective antibodies DO cross the placenta and are in the breastmilk, providing protection against COVID-19 to the baby. No placental proteins or genetic material in the vaccine teaches the body how to make placental proteins.
Duke University immunologist and expert in neonatal immunity Stephanie Langel explains in the same The New York Times article that the coronavirus spike and placental proteins have nothing in common, “making the vaccine highly unlikely to trigger a reaction to these delicate tissues.”
Regarding miscarriage, Mary Jane Minkin, MD, of Yale School of Medicine, tells USA Today that there has been no evidence among the 91,466 COVID-19 cases in pregnant women up to May 17, 2021, [updated] that spike protein antibodies attacked any cells in the placenta, which would cause pregnancy complications or miscarriage.
What if I can’t get access to the vaccine?
Regardless of whether you get the COVID-19 vaccine, it is imperative to continue wearing a mask and social distancing in appropriate circumstances.
If you become pregnant during the pandemic, notify your doctor immediately. According to the CDC, of those 91,466 pregnant women in this country tested positive for COVID-19, more than 15,500 had to be hospitalized, and of those, more than 400 were admitted to intensive care and 101 died.
Conclusion: precautions are still the best medicine
As of now in Colorado, all adult residents are eligible to receive a COVID-19 vaccine and boosters when they are eligible. We strongly encourage you to get the vaccine. If you have questions, please reach out to your provider.
For more information online, see information on COVID-19 and the vaccine at American College of Obstetricians and Gynecologists.
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