One of the lingering questions about the COVID-19 vaccines has been how safe they are for pregnant women.
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Historically, public health agencies have been slow to endorse vaccines for pregnant and breastfeeding women because of the potential risk and rigorous safety precautions needed to evaluate the vaccine in these groups.
But a new study of the COVID-19 vaccine given to pregnant patients has yielded good news about the vaccine’s safety and effectiveness in protecting both the patient and their child. To learn more about the study and how this affects pregnant patients, we spoke with Ob/Gyn Oluwatosin Goje, MD.
Promising data from new study
The study, published in late March by the American Journal of Obstetrics and Gynecology, looked at 131 patients: 84 were pregnant, 31 were lactating and 16 were not pregnant.
All of these patients received both doses of an mRNA COVID-19 vaccine (either Pfizer or Moderna). Once the vaccine took full effect, their antibodies were measured against those of 37 pregnant women who had been infected by COVID-19.
Not only did the study find that the vaccines generated a “robust” antibody response at the same rate as non-pregnant patients, but it also found that the level of antibodies in the vaccinated pregnant patients was higher than that of the infected pregnant patients.
Good news for pregnant patients
Dr. Goje calls the results “exciting,” saying that it builds upon what we already knew. “What makes it so exciting is that some people had the idea that getting infected gave them the same immunity as the vaccine,” she says. “But this study tells us that no, you have a more robust immunity from the vaccine.”
Why the results matter
There are two big reasons why the results of this study (and others) are so important.
Keeping pregnant patients and babies safe
First, it confirms there’s no risk to the health of either the patient or their baby if they receive the vaccine. “Pregnant patients always want to make sure nothing is impacting the health of their babies,” Dr. Goje says.
Additionally, the data so far suggests that side effects caused by the vaccine in pregnant patients are comparable to non-pregnant patients. “From the data, we know the normal side effects that they experience, it does not put the baby at risk,” she adds.
Dr. Goje also points out organizations like the American Society for Reproductive Medicine and the American College of Obstetricians and Gynecologists have repeatedly called for pregnant patients to be vaccinated.
“Doctors have stated emphatically, time and time again, that folks can get the vaccine and plan for a family,” she says. “They can get the vaccine and conceive, and even if they get the first dose and get pregnant, they can go ahead and get the second dose, too.”
And as for how to handle the side-effects, again, there’s little difference in how to deal with them if you’re pregnant. “Fever is something you don’t want in pregnancy but acetaminophen (i.e., Tylenol) is proven safe for pregnant patients to take at the prescribed dose,” she points out.
“There’s still much to learn from long-term studies, but staying hydrated and bed rest help recovery,” she adds.
And the Centers for Disease Control and Prevention (CDC) is doing what they can to follow the long-term effects of the vaccines on everyone, including pregnant patients. Dr. Goje points to the CDC’s v-safe app and registry, important tools to track short- and long-term effects of the vaccines.
The v-safe app allows anyone to use text massaging and web surveys to send their reactions to the vaccines to the CDC for collection and the CDC reports nearly 80,000 pregnant patients registered as of April 5, 2021.
And the v-safe COVID-19 Vaccine Pregnancy Registry is a separate program specifically aimed at tracking those reactions in pregnant patients in the long term.
“So far, the CDC has documented that reactions and side-effects for pregnant patients are comparable to non-pregnant patients,’ Dr. Goje says. The registry, she adds, will allow researchers to better understand any differences over time.
The second big reason these results are so important is that with the positive news, there’s more encouragement for pregnant patients to get vaccinated and help protect themselves, their child and others.
“Traditionally, pregnant patients have not been enrolled in clinical trials, including with the COVID-19 vaccines,” Dr. Goje says. “So there’s uncertainty for pregnant patients and it’s hard for some of them to make an informed decision about whether or not to receive the vaccine without having that data.”
The transparency in the data, especially this new research, though, is encouraging, she says. “Pregnant patients who declined earlier opportunities to receive the vaccine could become more comfortable,” she adds. “And it has to do with three things: transparency about the vaccine, the continuous availability of data from research and registries and educating patients about the vaccine.”
Any fears that the vaccine contains any part of a live virus are unfounded. The Moderna and Pfizer vaccines are mRNA vaccines, meaning they carry material that helps your body reproduce the “spike” protein found on the COVID-19 virus. That harmless protein is what triggers your body’s immune response. The vaccine does not cause an increased risk of interfertility, miscarriage, stillbirth or birth defects.
Dr. Goje notes that it’s especially important for pregnant patients to receive the vaccine because they are at an increased risk for severe illness compared to non-pregnant patients. “They had increased rates of hospitalization, increased ICU stays and in an increased risk of being intubated compared to non-pregnant patients, according to the CDC,” she says.
And if a pregnant patient has comorbidities like diabetes or obesity, she says, that patient is at an even higher risk of severe illness. “And pregnant patients who get very sick also have an increased risk of having a pre-term birth which puts the baby at a higher risk of being put into the neonatal ICU,” she adds.
Dr. Goje also reemphasizes the data that says the immunity can also be passed from mother to child. “Although the data is limited, this is protection for both the mother and for the baby,” she says.
The bottom line
According to Dr. Goje, it’s important for pregnant patients to fully understand the data and the science behind the vaccine. “There’s a lot of misinformation out there but it’s getting better,” she says.
“Patients should always have an open discussion with their healthcare provider than to decline the vaccine outright,” she continues. “It’s okay to ask questions. Ask them, get them answered and, hopefully, embrace the protection both for mother and child.”