Statements from obstetric societies urge pregnant women to get vaccinated against Covid-19

The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine (SMFM), from the start of the vaccine deployment, advocated vaccination against Covid-19 for pregnant women, considering pregnancy or breastfeeding . As I covered in a December 2020 post for Forbes, the widespread misinformation associating Covid-19 vaccines with infertility or pregnancy loss has unfortunately added an unnecessary layer of concern for pregnant women or those considering pregnancy regarding these vaccines.

These two national societies issued statements supporting the safety and efficacy of vaccines in this population as soon as the vaccines became available. However, disinformation often has more cultural power and momentum than scientific data, and sadly, many continue to not receive the vaccine.

Today, the two companies updated guidelines on vaccination against Covid-19 and pregnant patients, focusing specifically on provider tools for counseling patients. Obstetricians and gynecologists have a unique doctor-patient relationship, which often begins in early adulthood for many women. During pregnancy, this connection intensifies, with the frequency of visits ranging from every four weeks to every week or even more often. This gives the physician and patient ample opportunity to discuss the importance of vaccination and to address concerns as they arise. This often requires more than one, or even two, conversations.

ACOG provides practitioners with an infographic to give to pregnant patients and recommends that practitioners make it available along with leaflets for pregnant and breastfeeding patients. In addition, considering having obstetrics offices as vaccine delivery sites would likely increase the incidence of pregnant and postpartum women receiving the vaccine. US Surgeon General Dr. Vivek Murthy points out that the doctor / patient relationship can have a significant impact on a patient’s choice to receive a vaccine. At the ACOG Clinical and Scientific Meeting in 2021, he said: “Over 80% of people say they would turn to their doctor or another healthcare professional who cares for them for make a decision as to whether or not they should get a vaccine. “As obstetricians are the most consulted specialists in many people’s lives, advice on a more personal level can make a big difference.

The SMFM also indicates that provider counseling has a significant positive impact on patient vaccination. This advice may include sharing important data that pregnancy itself is an independent risk factor for serious Covid-19 infections. There is a triple risk of admission to an intensive care unit (ICU) and a more than double risk of requiring ECMO, or extracorporeal membrane oxygenation, an extremely high risk last resort to support oxygenation of the patient. a person when the lungs are too severely not responding to mechanical ventilation alone. The risk of death from Covid-19 infection during pregnancy is almost doubled compared to one who is not pregnant. Covid-19 infection during pregnancy also carries an increased risk of prematurity and fetal death.

To date, more than 139,000 pregnant women have enrolled in the Centers for Disease Control and Prevention (CDC) v-Safe program, where people themselves report any problems after vaccination against Covid-19. Published data is available for 35,000 pregnant women who were vaccinated against Covid-19 between December 2020 and February 2021. The incidence of vaccine-related problems such as arm pain and fever was no different from that of the general population, and the incidence of pregnancy- related problems did not differ from the general population of pregnant women as a whole.

Advice on the three different vaccines available (Pfizer / BioNTech and Moderna, both using mRNA technology) and Janssen Biotech / Johnson & Johnson (adenoviral vector technology) should be discussed, including the rare but real risk of TTS, or thrombosis with thrombocytopenia syndrome, as well as CVST, or cerebral venous sinus thrombosis syndrome. These two events were observed in women aged 18 to 59 years, between 6 and 15 days after vaccination. None of these women were pregnant. Women under 18 are currently only eligible for the Pfizer / BioNTech vaccine, which is currently approved for people 12 years of age and older. The other two are currently approved for people aged 18 and over.

For many people, the decision to get vaccinated against Covid-19, especially when pregnant, pregnant or breastfeeding, is not made in one conversation. Although safety and efficacy studies continue to demonstrate the great need for vaccination in this population, including data showing that newborns receive some protection by antibodies via umbilical cord blood and even milk maternal, many women remain unvaccinated. As we go through these days and weeks of the highly infectious Delta variant wreaking havoc around the world, ongoing conversations with trusted doctors are a critical way to provide protection to this vulnerable population and others.