CDC urges COVID-19 vaccines during pregnancy as delta rises

ATLANTA – The Centers for Disease Control and Prevention on Wednesday urged all pregnant women to get vaccinated against COVID-19, as hospitals in hot spots across the United States are seeing a worrying number of unvaccinated mothers seriously ill with the virus.

Pregnant women are at higher risk of serious illness and pregnancy complications from the coronavirus, possibly including miscarriages and stillbirths. But their vaccination rates are low, with only about 23% having received at least one dose, according to CDC data.

“Vaccines are safe and effective, and it has never been more urgent to increase vaccinations as we face the highly transmissible delta variant and see severe consequences of COVID-19 in unvaccinated pregnant people. “said CDC director Dr Rochelle Walensky. A declaration.

The updated guidelines come after a CDC analysis of new safety data on 2,500 women showed no increased risk of miscarriage for those who received at least one dose of Pfizer or Moderna vaccine before 20 weeks of pregnancy. pregnancy. The analysis revealed a miscarriage rate of about 13%, within the normal range.

The CDC’s advice echoes recent recommendations from top obstetrician groups. The agency had previously encouraged pregnant women to consider vaccination, but stopped before a full recommendation. The new advice also applies to nursing mothers and women who are planning to become pregnant.

Although pregnant women were not included in the studies that led to the approval of the COVID-19 vaccines, experts say the real experience of tens of thousands of women shows that the injections are safe for them. and that when given during pregnancy, they may offer some protection to newborns.

The new direction comes amid an increase in COVID-19 cases, hospitalizations and deaths in the United States, driven by the highly contagious delta variant.

Some health officials believe the variant may cause more serious illness – in pregnant women and others as well – than earlier versions of the virus, although this is still under investigation.

National figures show that the latest increase in the number of cases among pregnant women is lower than it was during the epidemic’s winter peak. But in some hospitals in states with low immunization rates, the number of sick expectant mothers is surpassing previous outbreaks, before vaccines are available.

“This is by far the worst we have seen in the pandemic,” said Dr. Jane Martin, an obstetrician at Ochsner Baptist Medical Center in New Orleans. She added, “It’s disheartening and exhausting. I feel like it doesn’t have to be like that.”

At the start of the pandemic and with each outbreak, Ochsner had a few pregnant patients who were very sick with the virus, although their numbers have declined in recent months.

“A week or two ago that pace changed dramatically,” said Martin. “We admitted several seriously ill pregnant patients every day”, most of them requiring intensive care.

Martin said she has cared for at least 30 pregnant patients hospitalized with COVID-19 in the past two weeks. Most were not vaccinated.

Experts say the lifting of mask rules and other social distancing precautions and the rise of the delta variant have contributed to the disturbing trend. But also, the vaccines were only made available to women of childbearing age and those under 65 in the spring.

Early in her pregnancy, Tennessee kindergarten teacher Sara Brown decided to wait until the baby was born to receive the injections. There was not yet much safety data on immunization during pregnancy, and at 36 she was young, healthy, and “thought if I got it it would probably just be a bad cold.” “.

But what appeared to be a sinus infection in June turned into severe COVID-19, taking him to an intensive care unit in Nashville for five days, on oxygen and struggling to breathe.

His daughter Suzie was born healthy on August 2. But it was a painful experience.

“Not being able to catch your breath is a feeling of panic, knowing that I had a life in me that could also suffer,” she said.

At Vanderbilt University Medical Center, where Brown was treated, there were no infected pregnant patients in early July. Now the hospital admits four to five per week, all unvaccinated, said obstetrician Dr. Jennifer Thompson. About 20% of those patients are treated in the intensive care unit, up from 11% in previous relapses, she said.

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Vaccinating people is the only way out.

–Dr. Jane Martin, obstetrician at Ochsner Baptist Medical Center in New Orleans

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For some critically ill pregnant patients with COVID-19, organs begin to fail and doctors induce labor early or deliver by cesarean section as a last resort, said Dr. Jeannie Kelly, an obstetrician at Washington University Medical Center in St. Louis.

About 20% of all patients admitted for labor and delivery last week to St. Louis hospital are infected, more than double the rate in the COVID-19 outbreak in Missouri last year , she said. About a third of these women are seriously ill.

About 105,000 pregnant American women have been infected with COVID-19 and nearly 18,000 have been hospitalized, according to the CDC. About a quarter of these received intensive care and 124 died.

Changes in bodily functions associated with pregnancy may explain why the virus can be dangerous for expectant mothers. These include reduced lung capacity and anti-disease immune system adjustments that protect and help the fetus to grow.

The risks are disproportionately high for black and Hispanic women, who are more likely to face health care and economic inequalities that increase their chances of getting sick.

Some studies suggest that the virus may also increase the risk of premature birth and stillbirth, and in rare cases, it appears to have passed from mother to fetus.

Martin, the New Orleans obstetrician, noted that local hospitals are also treating a growing number of children and babies sick with COVID-19, some of whom may have been infected after birth from unvaccinated mothers.

Martin was pregnant when she got the vaccine last winter. She gave birth to a healthy baby girl a week after the last injection.

“Vaccinating people is the only way out,” she said.

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