“Please get vaccinated,” Chief Medical Officer Dr Thomas Dobbs said at one of two press conferences this month that addressed the subject. “You have to protect yourself, you have to protect your baby.”
The Mississippi situation is probably not unique, as the Centers for Disease Control and Prevention says deaths from Covid-19 among pregnant women in the United States appear to have increased in August. But Magnolia state health officials have spoken particularly about it.
Eight pregnant women have died from Covid-19 in Mississippi since July 25, bringing the state’s pandemic total to 15, Dobbs said Thursday.
The 15 were between 23 and 40 years old, none were fully vaccinated and only one was partially vaccinated, Dobbs said.
At least 12 of the fetuses survived, often by emergency cesarean section, and some were severely premature, said Dr. J. Martin Tucker, professor and chair of obstetrics and gynecology at the University of Mississippi Medical Center. He spoke for the 12 cases in which his system was involved; information on the other three cases was not available.
Mississippi is also analyzing information on 72 stillbirths – a fetus dying in the womb after 20 weeks – that has affected pregnant women infected with Covid in the state since the start of the pandemic, Dobbs said. This appears to be double the usual stillbirth rate.
All of this has prompted Mississippi health officials to implore pregnant women to get the vaccine – and noting that the CDC and others now fully recommend that pregnant women get the vaccine at any stage of pregnancy – after the highly contagious Delta variant pushed the state’s daily case count to their highest level ever this summer.
And the state health department says some vaccine donors may not have helped the cause: It has received anecdotal reports that some pharmacies have refused immunization requests from pregnant women, Dobbs said. . In response, the health ministry last week issued a standing order to vaccinate pregnant patients, he said.
The prescription reassures pharmacies “that it is acceptable and recommended for pregnant women to be vaccinated at any stage of pregnancy,” Dobbs said.
Mississippi still lags the country as a whole on immunization: 41.7% of the state’s population was fully vaccinated as of Thursday, while 54.2% of the US population was, according to the CDC .
In the United States, only about 25.1% of pregnant women between the ages of 18 and 49 had received at least one dose of a vaccine during pregnancy as of September 11, according to the CDC.
“We can do better than that, and we should be doing better,” Tucker said.
Covid-19 deaths among pregnant women appear to have increased, CDC says
Nationally, 155 deaths of pregnant women with confirmed laboratory evidence of Covid-19 have been reported to the CDC since the start of the pandemic until Monday.
However, because only a third of case reports include information on pregnancy status and because it takes two to four weeks for jurisdictions to confirm a case of Covid-19 in a pregnant woman and report it to the CDC, that number is likely an undercount, CDC spokesman Scott Pauley wrote in an email to CNN.
The frequency of these deaths could increase nationwide. The CDC received reports of 15 deaths of pregnant people with Covid-19 in August last week – the highest number reported to the agency in a single month, Pauley wrote. The August number could increase as the delayed reports arrive.
The CDC does not break down these deaths by state due to the small overall number and privacy concerns. He also doesn’t know how many of the 155 were unvaccinated, Pauley wrote.
The risks of Covid-19 for pregnant women
Pregnant women, compared to non-pregnant women, are at greater risk of serious Covid-19 disease – and hospitalization, of being placed in intensive care units, of being placed on mechanical ventilation and of dying, Tucker told CNN in an interview last week.
Tucker is also president of the American College of Obstetricians and Gynecologists, which cites several studies making these points in its notice to obstetrician-gynecologists.
As to why, Dobbs partially highlighted changes in the physiology and immune responses of pregnant women, and noted that other diseases also generally put pregnant women at greater risk.
The Delta variant may present a more pronounced challenge, in part because of its higher viral loads and increased transmissibility, he said.
“We’re still in the early days of analyzing what’s going on with Delta, but… Delta is different, and Delta is deadly, and we have tools to prevent hospitalization and death,” including vaccination for the prevention and monoclonal antibodies for treatment, he said.
Pauley of the CDC said vaccinating pregnant women is “more urgent than ever,” due to “the increased circulation of the highly contagious Delta variant, low vaccine uptake in pregnant people and increased risk of serious disease. and pregnancy complications related to Covid -19 in pregnant women. “
CDC recommends Covid-19 vaccines for pregnant women
As health officials urge pregnant women to be vaccinated against Covid-19, they remind them that groups, including the CDC, last month reinforced the recommendation of the Covid-19 vaccine for pregnant women.
The CDC is now saying categorically that they should get the vaccine, based on the latest safety data. Previously, the guidelines were vague: pregnant people “may” get the vaccine.
“Vaccination against Covid-19 is recommended for all people 12 years of age and over, including those who are pregnant, breastfeeding, trying to get pregnant now or who could become pregnant in the future,” says the new guide .
“The evidence for the safety and effectiveness of vaccination against Covid-19 during pregnancy has increased. These data suggest that the benefits of receiving a vaccine against Covid-19 outweigh the known risks or potentials of vaccination during pregnancy, ”adds the CDC in the updated guidelines. .
At the end of July, ACOG and another leading organization that represents obstetricians and gynecologists also recommended that anyone who is pregnant be vaccinated against Covid-19.
ACOG and the Society for Maternal-Fetal Medicine said their recommendations were based on safety evidence from thousands of pregnant women.
Studies show vaccine to be safe and effective in pregnant women
The CDC said in August that a new analysis of information from its V-SAFE database, used to track side effects and vaccine safety, found no increased risk of miscarriage in people who received the drugs. Pfizer / BioNTech or Moderna vaccines against the coronavirus before 20 weeks of pregnancy. There were also no safety concerns for those vaccinated in late pregnancy – for themselves or for their babies.
The miscarriage rate among vaccinated pregnant women was around 13%, which is consistent with the rate one would expect in unvaccinated pregnant women, Sascha Ellington, team leader for unvaccinated women, told CNN in August. emergency preparedness and response in the reproductive health division of CDC. 11. Responding to the myth that the vaccine could cause fertility problems, she said: “There is no evidence that the vaccine has an effect on fertility.”
In a separate analysis, Dr Elyse Kharbanda of the HealthPartners Institute in Minneapolis and colleagues said they looked at different data from the CDC and also included that Covid-19 vaccines do not increase the risk of miscarriage.
They looked at data from eight health systems in the United States covering 105,000 pregnancies through June. Women who miscarried were no more likely to have been vaccinated, they found. The results were the same whether the women received the vaccine from Pfizer or Moderna, they said in a September letter to the Journal of the American Medical Association.
Too few pregnant women have received the Johnson & Johnson vaccine to be able to assess the risk, they said.
In Israel, a separate study published this month showed that Covid-19 vaccines are just as effective in protecting pregnant women as anyone else.
A study by Israeli researchers of thousands of pregnant women showed that those who were fully vaccinated with Pfizer’s vaccine from December 20 to June 3 were 97% protected against symptomatic infection, similar to the rate in the general population to period, they reported in the journal Nature. Medication. The study did not cover the period following the generalization of the highly contagious Delta variant.
Jacqueline Howard of CNN contributed to this report.
