Why do so many pregnant women choose not to get the vaccine?

Nicole Torres’ prenatal visits all start the same way: her obstetrician asks her if she has ever received her Covid-19 vaccine.

Torres, 24, 33 weeks pregnant with her second daughter, did not.

It is not for lack of information. Torres knows that pregnant women are at a higher risk of serious illness if they catch Covid, and she has had discussions with her obstetrician about data showing the vaccine is safe for pregnant women and their babies. She considered getting the vaccine, but alarming claims about the vaccine that she and her husband read online made her wonder if it was the right thing to do.

“It’s so new,” said Torres, of Kissimmee, Fla. “Putting yourself at risk of trying a vaccine is one thing.”

“But a newborn baby,” she added, “this is where it gets a little scary.”

Across the country, obstetricians are fighting an uphill battle in their efforts to convince pregnant women to accept Covid vaccinations. They say misinformation, a false sense of invincibility among patients, and a lack of understanding of vaccines have contributed to the reluctance of pregnant women to get vaccinated.

The need to vaccinate pregnant women is urgent: they are at risk of pregnancy complications from the coronavirus, with some evidence indicating that the virus could increase the risk of stillbirth. They also face a higher risk of requiring intensive care or mechanical ventilation, and nationwide, at least 159 pregnant women have died from Covid since the start of the pandemic, according to data from the Centers for Disease Control. and Prevention.

Still, immunization rates for pregnant women are low: only about 25.1 percent have received at least one dose, according to the CDC, compared to 76.6 percent of all adults in the United States who have received it. .

“I think most pregnant people are generally young and healthy, so they don’t really expect that if they got this infection they could be as sick as we see them,” Dr Brenna said. Hughes, Vice-President. Chair of Obstetrics and Quality in the Department of Obstetrics and Gynecology at Duke University. “It’s surprising to me how few people realize that it can happen to them until it does.”

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Why pregnant women withdraw

Vaccinations are regularly recommended during pregnancy, and other vaccines are better accepted by pregnant women.

From 2019 to 2020, 61.2% of pregnant women were vaccinated against the flu and 56.6% received the Tdap vaccine, or pertussis, according to the CDC. Both injections have been suggested to pregnant women for years, with rich safety data to back it up.

Experts say that while the Covid vaccine is new, its technology – messenger RNA, or mRNA, which is used in two-dose injections – is not. It has been studied in clinical trials for other infections, such as Zika, the mosquito-borne virus that can cause devastating birth defects if a pregnant woman catches it.

This should reassure patients, but Hughes said a lingering concern she expresses is about the long-term effects of the Covid vaccine.

She tells patients that adverse reactions to any vaccine tend to manifest itself in days or weeks, not months or years, and although the Covid vaccine has only started to be administered relatively recently, thousands of pregnant women have now received it, providing a large data set to prove its safety record.

Other patients worry that receiving an adult dose of a vaccine will affect their babies, said Dr Torri Metz, associate professor of obstetrics and gynecology at the University of Utah Health.

She explains that the vaccine allows the mother to make antibodies that will cross the placenta to her fetus.

“It’s very different from giving a vaccine to a baby,” she said.

Beyond questions about safety, some patients have expressed concerns about the unclear messages.

When the pandemic began, the CDC encouraged, but did not recommend, that pregnant women get vaccinated. In August, as hospitals across the country saw an increase in the number of pregnant women critically ill with the coronavirus, the country’s main health agency issued stricter guidelines urging all pregnant women to get vaccinated.

Some patients may have seen this as a change in stance, when in fact the CDC had always supported the vaccine during pregnancy, Metz said.

“They used to say you could get it. Now they say you should get it, ”she said.

The CDC’s recommendation was based on new data that showed no increased risk of miscarriage for women who received at least one dose of the vaccine before 20 weeks.

Yet for many women the myth that the vaccine can interfere with their pregnancy is scarier than the stories they see in the news of unvaccinated pregnant women who have died from Covid.

“They say things like ‘Well I’m just going to be very careful’, and I try to tell them that everyone is very careful, and sometimes that just isn’t enough, especially with the prevalence of the virus. right now, ”Metz said.

Dr Jennifer Thompson, associate professor of obstetrics and gynecology at Vanderbilt University, said her institution dispelled false rumors about vaccines through documents and town halls on social media.

As a high-risk obstetrician, she cares for patients with many different medical conditions, and whenever a patient chooses to be vaccinated, she says she feels relieved.

“Yes, the majority of patients overall have milder disease, but we don’t know just from looking at you if you’re going to be someone who is going to be so sick that you will end up in intensive care,” he said. she declared. “It’s just sad when we see so many people sick with Covid or admitted to intensive care when we have something that can prevent that.”

For Torres, the Florida mother who is unsure whether she should get the vaccine before the birth of her second daughter, the thought of requiring hospitalization due to complications from Covid is terrifying. But the fact that doctors repeatedly suggested she get the shot didn’t have the intended effect on her – or other pregnant women she’s spoken to.

“I don’t like to feel pressured,” she said. “I have met other pregnant women who are quite advanced and who say they have stopped going for their regular OB exams because they are fed up with hearing about the vaccine.”