The COVID vaccines are rolling out and becoming increasingly available to the public—but there’s still some speculation and concern about the safety of the vaccines. Data is still being made available since it’s new, and you always want to be cautious and informed about what you put in your body. That’s even more important during a pregnancy.
When you’re pregnant, you have your whole list of do’s and don’ts that include foods, medicines, you name it. Now let’s add the COVID vaccine into the mix—is it safe? What about after pregnancy and while you’re breastfeeding? Is it safe then? Do we even know yet?
We spoke to Dr. Elizabeth Newsom, an OB/GYN at Medical City Dallas, about the vaccine and pregnancy, and whether she would recommend it to her patients.
The vaccine is still being rolled out and, of course, there will be more and more data available about it as time goes on. But what data is there so far about the vaccine and pregnant women? There has been a great deal of attention on the safety of the COVID-19 vaccines and pregnancy as well as lactation. The information up to this point is reassuring.
The original studies of both Moderna and Pfizer vaccines excluded pregnant, breastfeeding women and children as part of the scientific standard for new vaccine studies. However, 36 women incidentally became pregnant between the two studies, with no evidence of adverse effects to their pregnancies.
During the phase 1A roll out, approximately 15,000 pregnant women have been vaccinated with no red flags. Animal studies (on rats) conducted by Moderna add to the safety evidence for pregnancy.
Additionally, live-virus vaccines are not used in pregnancy. The mRNA COVID-19 vaccine being used is not a live virus.
Are there any guidelines set for pregnant women as they consider getting the vaccine or waiting? For example, if they’re in their first trimester, is it safer than receiving it in their third? The guidelines from professional organizations recommend COVID-19 vaccination for pregnant and breastfeeding moms. This includes the ACOG—the American College of Obstetricians and Gynecologists—as well as SMFM—the Society for Maternal Fetal Medicine. There is no specific recommendation right now regarding trimester for vaccination.
What should pregnant women consider in regard to getting the vaccine? Should they have a conversation with their OB/GYN first? Yes, women should discuss the COVID-19 vaccine or any medical concerns with their physician. [It’s about] the risk versus benefit.
Multiple consistent studies show pregnant women are more likely to develop severe illness from COVID-19 illness including hospitalization, admission to the ICU and mechanical ventilation compared to similarly aged women who are not pregnant. Women who delivered with COVID-19 illness were more likely to suffer pregnancy complications as well, including preterm birth, preeclampsia, thrombotic events (blood clots) and death.
Current evidence shows that pregnant women vaccinated in the third trimester can pass antibodies to their baby that may help protect them for the first few months of his or her life.
Do we know yet what risks or symptoms there might be in pregnant women receiving a dose? The risks to a pregnant woman are likely to be very similar to a non-pregnant person, including sore arm, redness at the injection site, feeling “flu-ish” and, in rare cases, severe allergic reactions such as anaphylaxis. All patients with severe reactions were treated and recovered. There does not appear to be any unique risks of vaccination associated with pregnancy, while there are specific risks of COVID-19 in pregnancy.
What about women who just had a baby? Are the recommendations different? For women who have recently had a baby, there is no difference in recommendations than for the general population.
Is it safe to get the vaccine while breastfeeding? The current recommendation is that breastfeeding women should also be vaccinated, although pregnancy is not considered 1B priority.
The bottom line is that available COVID-19 vaccines appear to be extremely effective and safe. I do empathize with the reluctance I sense from many of my patients. I have a sister who is currently six months pregnant, and I have recommended COVID-19 vaccination for her as soon as she is eligible, just as I have recommended to my patients.
Since everything is still new and obviously science progresses with more data, I’m assuming there’s more research being done. Is that correct? There is absolutely continued research ongoing. The Vaccine Adverse Effects Reporting System (VAERS)—the CDC vaccine safety arm—is collecting information on vaccine reactions including pregnancy-related effects. [There’s also] a group of researchers out of the University of Washington that are doing a voluntary registry for patients vaccinated while pregnant or lactating. Anyone can sign up.
Image courtesy of iStock.