Advice for pregnant women considering the coronavirus vaccine

Dr. Leana Wen: Technically it is not, but it is an option for pregnant women. Here’s why: The initial clinical trials did not include anyone who was pregnant or breastfeeding. Some women became pregnant during the trials, but because the research was not intended to study the vaccine’s effect on pregnancy, there was not enough data for the Food and Drug Administration to approve the vaccine for. pregnant women.

CNN: If the vaccine is not specifically tested during pregnancy, why would pregnant women take it?

Magnifying glass: Pregnant women are at higher risk of serious complications from Covid-19. There is a higher risk of being hospitalized and ending up in an intensive care unit for pregnant women compared to non-pregnant women. The risk is further increased for pregnant patients with underlying medical conditions.

CNN: So how do you recommend that a pregnant woman make this decision?

Magnifying glass: Here are the two things I urge my patients to consider. First of all, what is your risk of exposure to Covid-19? Let’s say my patient is a nurse or respiratory therapist who treats Covid-19 patients. This person has significant occupational exposure and getting the vaccine could protect them considerably during pregnancy. Perhaps she has a spouse who is in a high-risk occupation, or she lives in a household where she cannot keep a physical distance from a family member at risk of exposure. That would work in favor of getting the vaccine now.

Second, what is your risk of having a serious outcome if you were to contract Covid-19? Pregnancy alone already predisposes a person to more serious illness, and if you have other underlying medical conditions you are at even higher risk because the risk is additive. Conditions such as chronic lung, kidney or heart problems; Diabetes; arterial hypertension; and sickle cell disease could worsen the effects of the coronavirus. Patients who are pregnant and have these underlying medical conditions could benefit greatly from the vaccine.

The bottom line is that any risk of an adverse reaction from the Covid-19 vaccine is theoretical and the risks of Covid-19 infection are not. From what we know about the vaccine, there is no reason to believe that it will have an adverse effect on pregnancy or the long-term health of the mother or baby. Lack of evidence doesn’t mean it can’t exist, but this kind of very low theoretical risk must be weighed against the actual and potentially very high risk of a serious outcome from Covid-19.

This is the reason why many pregnant healthcare professionals have received the vaccine.

CNN: What about breastfeeding women?

Magnifying glass: We don’t have data to unequivocally state that the vaccine is absolutely safe for people who are breastfeeding. However, there is no physiological reason why it would not be safe. Vaccines of concern are those that contain live viruses. The Covid-19 vaccines currently licensed in the United States – and those in clinical trials here – do not contain any live viruses. In fact, where appropriate, the vaccines could have additional benefits for the baby. Some recent research suggests that protective antibodies could be transferred to the baby through breast milk.

CNN: You were pregnant around this time last year. Would you have received the vaccine if it was available to you when you were pregnant or breastfeeding?

Magnifying glass: I am a healthcare worker who sees patients, I have high risk occupational exposure, and I also have asthma. So yes, I would have received the vaccine if it was available when I was pregnant. By the time the vaccines were approved, I had stopped breastfeeding. As soon as I stopped breastfeeding, I took part in a vaccine trial. If I was still breastfeeding and had the opportunity to get the vaccine, I would have no hesitation in taking it.

CNN: What would you say to people who want to wait for clinical trials to prove the vaccine is safe for pregnant and breastfeeding women?

Magnifying glass: I would say that is also a reasonable choice. Everyone has to make the best decision for themselves. Much has been written on the ethics of vaccines during pregnancy. On the one hand, it makes sense not to include pregnant women in initial vaccine trials out of concern for them and their babies. On the other hand, it is not fair to deny a whole group of people the benefits of vaccines. The majority of health workers are women of childbearing age, for example.

Many other vaccines have in fact not been specifically tested during pregnancy, but are given regularly because the proven benefits outweigh any theoretical risk. I believe that every patient should make the right decision for themselves and their family, in consultation with their health care provider.

It is important to note that pregnant and breastfeeding women are not in priority immunization groups simply because of their pregnancy or postpartum. If they do not have priority to be vaccinated otherwise (for reasons such as a high-risk occupation or pre-existing medical condition), they must wait their turn to be part of the eligible groups, like everyone else.

CNN: There is misinformation about the vaccine and fertility. Can you clarify this?

CNN: What would you say to women who are planning to get pregnant or trying to get pregnant? Should they get the vaccine?

Magnifying glass: If they’re in priority groups to get the vaccine and are able to, I would say they should. There is no reason to hold back. Of course, they should always see their health care provider, especially if they have any medical procedures scheduled. For example, if they are planning IVF procedures – they may not want to time their vaccines on the exact same day as their procedures to avoid simultaneous side effects.

Remember that vaccines are very effective at preventing illnesses – especially serious illnesses – from Covid-19, but they are not 100% effective and we still don’t know if those who have received the vaccine can pass it on. virus. Even after receiving the vaccine, people should still exercise caution.

For pregnant patients, this means they can breathe a little easier during their antenatal visits, but they should definitely wear masks and follow physical distancing guidelines in public places.

For women who are breastfeeding, they will have good immunity, but they will not know if their babies are, so it will always be important to keep a good physical distance for their baby. And for everyone, great caution is a good idea until more people can be vaccinated and we are close to achieving herd immunity.