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“There really is no theoretical reason to believe that it will harm the mother or her unborn child and we are very confident that it will bring tremendous benefits to the mother and the baby,” Beigi said, president of UPMC Magee-Womens Hospital in Pittsburgh.
Only a few people, such as those with severe allergies, a history of anaphylactic shock, or who are with advanced cancer would probably be wise to avoid the vaccine. Any worried pregnant woman should speak to her OB-GYN, experts say.
“US regulators and medical experts have made it clear that all eligible pregnant women should have a choice to receive the vaccine,” said Dr. Christopher Zahn, vice president of practical activities at ACOG.
An international controversy
It’s a strong and clear message, a message OB-GYNs and medical associations hope to reach pregnant women and their families who may be confused about the conflicting recommendations issued this week by the World Health Organization.
But any “potential vaccine risk” mentioned by the WHO is purely speculative, doctors tell CNN, compared to the known risks of Covid-19 to pregnant women and their babies.
“Lack of data does not equate to risk of harm – especially when basic science and biology do not suggest a plausible reason why harm could occur,” said Dr Kjersti Aagaard, maternal medicine specialist and fetal at Texas Children’s Hospital and Meyer’s Professor of Obstetrics and Gynecology at Baylor College of Medicine.
Doctors who spoke to CNN said there are decades of safety data showing no harm to a pregnant woman or her baby from inactivated vaccines – and they believe the data should apply to Moderna and Pfizer vaccines, which are not made from a live virus. .
Instead, they’re mRNA vaccines, which teach cells in the body to make a piece of protein that triggers an immune response. As soon as the instructions are issued, “the cell breaks down and gets rid of mRNA,” according to the CDC.
Therefore, WHO’s concerns are “more focused on hypothetical risks at the expense of recognizing the clear benefits of vaccination,” Beigi said. “It can be very confusing for a woman, which is unfortunate, very unhappy.”
The risks of Covid-19 during pregnancy are high
At the start of the pandemic, it did not appear that Covid-19 affected women or their babies during pregnancy. As the data came in, that belief changed dramatically.
“Pregnant women are up to five times more likely to be hospitalized, three to four times more likely to need intensive care unit care, and two to three times more likely to require life-saving measures, such as get a breathing tube or get put on advanced survival, ”said Aagaard, who has a doctorate in immunology.
“And although the data is not yet complete, there is at least a small risk of maternal death and stillbirth and premature birth with Covid-19 disease during pregnancy,” Aagaard continued. “Black and Latin American women have a particularly increased risk of serious illness and death from Covid-19. These are the facts.
Why would pregnancy put women at greater risk? One of the reasons is a decrease in a woman’s lung capacity as the baby grows.
“You can develop respiratory compromise, to the extent that you can’t recover from it,” Aagaard said. “For every pandemic we have experienced in the past 100 years, there has been an increased risk to pregnant women when these pandemics are associated with serious respiratory illness.
Plus, Aagaard said, a pregnant woman’s heart pumps 1.5 times harder than it normally would to provide enough blood for the baby and the placenta.
“So this hyperaction of the heart, which we call higher cardiac output, also puts pregnant women at risk for heart failure problems, which can be a manifestation and a potential cause of death from Covid-19 disease.” , she said.
Pregnant women may also be more likely to have an over-enthusiastic immune system, which can lead to the so-called cytokine storm that signals more serious illness and negative results, Aagaard said.
And finally, there is an increased likelihood of blood clotting during pregnancy, which Covid-19 is known to make worse.
“Humans, like all placental mammals, are at risk of bleeding to death after the placenta separates from the lining of the uterus,” Aagaard said. “So 4½ million years of evolution are behind us, helping us to clot a little more efficiently when we’re pregnant.”
Benefits for baby?
While this study did not examine whether the antibodies created by vaccination would also cross the placenta, the concept has been used in maternal medicine for some time.
Pregnant women are given both an inactivated influenza vaccine and a vaccine called TDAP, which protects both mother and baby from tetanus, diphtheria, and whooping cough, also known as pertussis.
“Wouldn’t it be great if we could so beautifully transition our developing fetus out into the Covid-19 protected world?” Said Aagaard. “If we could arm this baby with his own memory cells it would be a double, which we always hope for.”
A different accent
While US and WHO officials are clear about the lack of safety data in their guidelines, a WHO spokesperson said the agency was placing more emphasis on “advice that can inform decisions of immunization programs “during” current limitations in the global vaccine supply “. The position of the CDC and the United States centers on “individual decision-making”.
“Due to the lack of data on the presence or absence of risks associated with vaccination during pregnancy, WHO could not at this time provide a general recommendation for the vaccination of pregnant women, except among those which belong to the highest priority groups for which vaccination is now recommended in countries, ”the spokesperson told CNN via email.
“I think the fact that they say we don’t recommend it will have an effect in a lot of countries,” said ACOG’s Beigi, “in that the medical leaders in those countries are going to be much more reluctant. “
Zahn, also from ACOG, agreed.
“We are concerned that the conflicting recommendations will undermine the confidence of all patients considering this potentially life-saving vaccine,” Zahn said. “We strongly encourage immunization programs to follow the advice of US health authorities and medical experts so that pregnant women do not face barriers to immunization.”
Trials of various sizes are currently underway, and doctors are highlighting the scores of pregnant women who have received Covid-19 vaccines since the start of their deployment – with no known side effects. That makes good sense, Texas Children’s Aagaard said.
“Not only have I been in obstetrics for a few decades, but my doctorate is in immunology,” Aagaard said. “And I really can’t figure out what the biology or the science would be to explain why a pregnant woman or her fetus would be at greater risk than a non-pregnant woman.”
While appreciating the “nuance” that the WHO uses to prioritize, Aagaard said she remains confident in “our ability to walk and chew gum at the same time”.
“We are fully capable of vaccinating everyone who needs it, including everyone who is most at risk. This includes pregnant women, who make up around 3% to 5% of the world’s female population at any given time, ”Aagaard said.
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