Pregnant women will have to wait for a COVID-19 vaccine, although they are a group at high risk for complications

• Pregnant women, especially racial and ethnic minorities, are at increased risk of serious complications from COVID-19 and death.

• But they are not among the priority populations for vaccine distribution because they have been excluded from clinical trials, which is typical of vaccine development.

• Until it is known which vaccine candidates are safe and effective for pregnant women and their babies, pregnant women, people trying to conceive and those around them should take extra precautions to protect themselves.

• Visit the Business Insider homepage for more stories.

More than a month after giving birth, Monica Ramirez met her daughter, Emiliana, for the first time. It was via Zoom.

Six weeks after giving birth, mother and baby finally met in person. “It was very emotional,” Ramirez, a school staff member near Los Angeles, told Insider upon seeing the little baby she couldn’t remember giving birth.

Diagnosed with COVID-19 at 29 weeks pregnant, Ramirez was intubated and airlifted to Loma Linda University Medical Center in early July, where Emiliana was born by emergency Cesarean.

Ramirez woke up from a medically induced coma 14 days later, not knowing where she was and thinking she was still pregnant.

She coded twice throughout the test. “This is as far as you go in the game of life and death,” March of Dimes chief medical officer and chief medical officer Dr. Rahul Gupta, who was not involved, told Insider. in Ramirez’s care.

“I feel very blessed to have succeeded,” said Ramirez. “Not everyone has the same result.”

Pregnant women and women of color at higher risk of serious coronavirus complications and death

Pregnant women with COVID-19 are more likely to be admitted to the intensive care unit, put on ventilators, need breathing assistance and die than patients who are not pregnant, according to a report released in November by the Centers for Disease Control and Prevention. .

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Racial disparities exacerbate the problem, with pregnant Hispanic women more likely to contract COVID-19 and black women with the disease more likely to experience serious complications whether or not they are pregnant, according to the report. Hispanic women like Ramirez are also more likely to die from COVID-19 than white women, regardless of their pregnancy status.

While the overall risks are low in pregnant women with COVID-19 – 1.5% of women in the report went to intensive care and 0.15% died – Ramirez’s story illustrates how badly he is essential to protect pregnant women against the virus.

Despite these risks, pregnant women will not be the first to be vaccinated. Most likely, will not even be near the front of the line.

Pregnant people are excluded from early clinical trials to protect them and their future children, but it’s a trap 22

Healthcare workers, residents, and nursing home staff should be prioritized for vaccine distribution, likely followed by other vulnerable populations such as the elderly and essential workers.

Pregnant women are not on this list because we do not yet know if the vaccines are safe and effective for them and their future children.

They have been excluded from clinical trials in the United States since researchers first wanted to know how vaccines behave in healthy, non-pregnant people. Only then can they make recommendations on whether certain vaccines should be tested in expectant parents.

This is typical of any new vaccine, Dr. Jerome Adams, U.S. surgeon general, said in an announcement at a press conference Thursday. He said the COVID-19 vaccine follows all the same safety protocols starting with healthy people before moving on to high-risk populations.

Pregnant women, in fact, were never included in influenza vaccine trials, but were instead considered safe to get the vaccine after years of watching what happened to pregnant women getting the vaccine without knowing what to do with it. ‘they were pregnant or had it anyway, despite the lack of clear advice.

Likewise, some information will be passively collected from women who were unknowingly pregnant while participating in clinical trials or receiving a vaccine from a priority group, such as health workers. (It is unclear how people who know they are pregnant and who are priority populations will be treated.)

But a more active approach to recruiting into clinical trials is also essential, experts say.

“Yes [pregnant people] are not enrolled in a trial, so we can’t do long-term follow-up because the biggest question about trials in pregnant women is what happens to the baby, “Dr. Stephanie Gaw, obstetrician in San Francisco who studies COVID -19 and pregnancy, said today.

“In a sense, not doing these trials on pregnant women, pregnant women are basically still in this very out of control trial: real life.”

Gupta added that not only pregnant women, but anyone could getting pregnant should be a top priority for immunization, as about half of all pregnancies are unplanned. “We have to make sure that we make an active effort … to make sure that women of reproductive age, especially minorities, are able to get vaccinated even before they get pregnant,” he said. .

What pregnant women and those around them can do now

Pregnant women should limit their exposure to people outside their homes and otherwise follow strict prevention protocols, including hand hygiene, social distancing and wearing masks, Adams said. They should also get the flu shot.

The people around them should do the same. “If you are going to be with a pregnant woman, then you owe her to take these steps yourself because what we always try to do during pregnancy is to create a protective cap around mom and baby,” said he declared.

Ramirez, whose uncle died of COVID-19, has the same advice. Although she and Emiliana are home and safe, she still has difficulty breathing and her daughter needs special care. “I want to tell everyone that [the coronavirus] is real, it’s not a hoax, ”Ramirez said. People just need to wear their masks and wash their hands for protection. ”

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