Expectant Mothers Aren't Getting Clear Guidance About COVID-19 Vaccines
It took Parrish Glass and her husband four years and thousands of dollars to conceive a baby through in vitro fertilization.
Now, at long last, the Navy couple is expecting a boy in August. But since they conceived during a global pandemic, they are facing the question of whether Glass should get a vaccine.
“My OBGYN said it’s definitely OK to go ahead and get it when it’s available to me,” Glass said. “But for us, after this four-year journey of infertility, we’ve spent so much money and emotion, put so much physically draining time into this process, so with this one shot we have, there is a huge question of do we want to risk it.”
To be clear, doctors and medical experts agree that the COVID-19 vaccines are likely safe for pregnant women. The American College of Obstetricians and Gynecologists says pregnant women should take them when they’re available, while the CDC says pregnant women can choose to be vaccinated, and recommends a conversation with a primary care doctor.
After initially recommending against it, the World Health Organization recently added a section to its advice for pregnant women. It said based on the science of these vaccines, “we don’t have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women.”
Glass still isn’t convinced. If she weren’t pregnant, she said she’d be happy to get the vaccine, but now she’s going to wait.
“For us, there isn’t enough data, so we’ll let other people be those guinea pigs,” Glass said. “Once we have our delivery, then I’m more inclined to get a vaccine.”
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The reason for the dearth of data is simple: pregnant or breastfeeding women are almost always excluded from drug trials, and the COVID-19 vaccine trials are no exception. Some medical experts say this was a mistake, especially when considering pregnant women are more at risk for serious cases.
“We could have carefully and thoughtfully included them, but that ship has now sailed,” said Dr. Denise Jamieson, an obstetrician at Emory University in Georgia and a member of the COVID-19 expert group with the American College of Obstetrics and Gynecology.
Jamieson said there is talk of opening clinical trials specifically for pregnant women. However, recruiting volunteers for a months-long study in which they could be given a placebo is increasingly difficult as the vaccine becomes more widely available.
What we know about COVID-19 vaccines and pregnant women
While no COVID-19 vaccines were purposefully tested on pregnant women, there is some data available from women who entered trials before they knew they were pregnant and from testing on animals. No significant adverse side effects were found in either case, according to the American College of Obstetricians and Gynecologists.
Also, it's important to note that pregnant women are strongly recommended to receive other vaccines like the flu shot and the whooping cough vaccine. Women typically get a whooping cough booster shot during their third trimester because studies show that it can pass on antibodies to the fetus that will protect the baby.
Thousands of pregnant women are getting the vaccines
While there haven’t been any clinical studies, thousands of pregnant women are now receiving COVID-19 vaccines and they and their babies have stayed safe, said Dr. Joanna Adamczak, a high risk pregnancy doctor and the chief medical officer of Sharp Mary Birch.
“I highly recommend it to my patients,” she said. “I have lots of colleagues who are pregnant and are receiving it.”
Adamczak said the prevailing opinion among her fellow doctors is that refusing the vaccine is the greater risk for pregnant women.
“Pregnant women can get more sick, they have higher rates of ICU admission, not to mention the fact that it can lead to preterm labor,” she said.
That reality is visible every day for Dr. Becky Adami, a maternal-fetal medicine specialist at Sharp Mary Birch, who has been treating pregnant women with COVID-19.
“I’ve seen patients who were admitted to the ICU who were intubated in pregnancy, and that can be really scary, we know there’s a higher risk of mortality,” she said. “Seeing those maternal effects definitely make me think it’s important to be vaccinated to protect yourself, but also for your fetus, there’s an increased risk of preterm delivery.”
Adami is pregnant herself, and when the call came in mid-December offering her a COVID-19 vaccine dose, she didn’t hesitate.
“I got the call that it was available and I said, I’ll come in that day and get it,” she said.
Some choosing quarantine over vaccination
Some women who don’t work in health care and believe they aren’t at risk of contracting COVID-19 are opting to wait until after they deliver to get the vaccine.
Alicia Tembi, a teacher at a private school in Encinitas, could be eligible for the vaccine soon if the state sticks with its current plans to include educators in the next priority group. But regardless, she said she’ll wait until after she delivers her baby in April.
“I’m very pro-vaccine in general, my dad had polio, so I’m definitely pro-vaccine,” she said. “But I’m also data driven, and there is no clinical data that it’s safe to take. That makes me pause and say what are the benefits and risks, and if no one can tell me no risks, I’m going to wait.”
Instead, she said she will protect herself by following all the precautions that have protected her so far. Tembi has been teaching in-person classes since the fall, but said she doesn’t feel at risk of getting sick.
She also isn’t worried about testing positive for the virus when she goes into the hospital for delivery — early on in the pandemic, some hospitals were taking babies from COVID-19 positive mothers for 14 days, but no local hospitals have continued that practice unless the mother is too sick to care for the baby.
Jamieson, the obstetrician from Emory University, said she hopes a lesson learned from the pandemic will be that expectant mothers are given greater opportunity to be involved in clinical trials.
“You’d monitor the pregnancies, and follow the babies that were born to the moms that were vaccinated,” she said. “You need to carefully and thoughtfully follow those women and their babies, but I do think there’s a way to do it.”