As the United States continues to see low vaccination rates among pregnant women, UC San Diego Health experts take a look at the latest research
As the holidays and winter approach, concerns about COVID-19 infections increase. But despite increased access to vaccines and boosters, one group continues to have low vaccination rates. Only one-third of pregnant women are fully immunized in the United States, and rates are even lower for pregnant women of color. These numbers recently prompted the Centers for Disease Control and Prevention (CDC) to call for “urgent action” on the issue, after it officially recommended vaccination during pregnancy in August.
So what is preventing this group, which is at increased risk of serious infection, from getting vaccinated? For many parents-to-be, this may seem like one of the first big decisions they’ll make for their child, and this pressure can keep even the most pro-scientific parents stuck.
Jasmine Faniel, a patient at UC San Diego Health, shared these concerns with her obstetrician earlier this year. Faniel and her partner Glenn, an aviation technician for the US Navy, were excited to add to their family this fall, but weren’t sure if she should be vaccinated right away. They were acutely aware of the potential consequences of COVID-19 after killing several friends from the disease. But as a stay-at-home mom to her 9-year-old daughter, Faniel also feared taking risks that could affect her children.
“I asked if it was safe to take it during pregnancy and the doctors said it depended on the pregnant person, but they didn’t really have the full data,” Faniel said, recalling a first visit to the doctor last spring. This initial uncertainty was also accompanied by strong social pressures. While so many people still doubted the safety of vaccines during pregnancy, Faniel feared being judged by others who might disagree.
“I felt like if something were to happen to the baby and they found out I had the vaccine, everyone would think it was because of the vaccine,” she said, “so I felt the pressure of that, definitely.”
But Faniel knew she was making an active and important choice for her health anyway. As she continued to speak with her doctors through the spring and summer, she also began to see more frequent stories of unvaccinated parents dying amid the Delta surge. After several months of reflection, she was finally ready to make her choice.
“These stories really hit me because my kids are everything to me, and I just couldn’t imagine making a simple mistake and walking out of their life,” she said.
On a sunny day in August, pregnant Faniel was vaccinated against COVID-19. When asked how she feels about her choice now, she seems relieved.
“I feel happy because I know that if I were to get COVID-19, my chances of survival would be higher,” she said. “I just feel safer knowing my baby has a fighting chance, having the antibodies to fight it all if exposed to it. And I’m just grateful to have access to that because other countries don’t have the same opportunities as us. »
After a turbulent year, Faniel and her companion welcomed a healthy baby boy into the family at the end of October.
“It’s fine,” she said. “It is finally here !”
For those still deciding whether or not to get vaccinated, our experts at UC San Diego Health are here to weigh in on all the latest research and recommendations.
COVID-19 infections are more severe in pregnant women
“As the second trimester begins, women become more short of breath,” said Dr. Cynthia Gyamfi-Bannerman, chair and professor of obstetrics, gynecology, and reproductive sciences at UC San Diego Health. “As the uterus grows, it basically compresses the diaphragm and your lung capacity decreases, so when you have a respiratory infection it’s actually harder to fight.”
Gyamfi-Bannerman was one of the first healthcare workers in the United States to report the results of pregnant women infected with COVID-19. She explains that pregnant women are more likely to be admitted to the intensive care unit (ICU) and require intubation and respiratory support. They also have a 70% increased risk of death from COVID-19 compared to non-pregnant people.
Doctors have seen this play out with other respiratory infections before, like the flu, which is why pregnant women are constantly encouraged to get the flu shot. Pregnancy actually weakens the body’s immune system, so the sooner these antibodies are present, the better.
COVID-19 infections increase pregnancy risks
“With infection, we’re seeing an increased risk of stillbirth and a doubling of incidents of preterm birth, so mothers are delivering earlier than expected,” said Christina Chambers, perinatal epidemiologist and professor of pediatrics at UC. San Diego School of Medicine. and the Herbert Wertheim School of Public Health and Human Longevity. Chambers’ research team recruited more than 2,500 pregnant and breastfeeding people in a series of studies on COVID-19 infections and vaccines.
Infected family members should take precautions around newborns
Gyamfi-Bannerman encourages infected parents to stay six feet away from newborns as much as possible, but says breastfeeding is safe as long as the infected mother is masked and practices hand and breast hygiene. With the holiday season approaching, she points out that “now is the time to be permanently masked if you are interacting with a newborn.”
“This pandemic is sort of ongoing,” she said, “but if there’s any concern, it’s just not the time to come visit a newborn.”
Vaccines against covid-19
Historically, most clinical trials have not included pregnant or breastfeeding people
“There’s no good reason for it,” Gyamfi-Bannerman said. “It’s not that there was a pregnancy concern for this particular drug, but it was more historic in that pregnant people are often excluded from clinical trials, and we’ve seen the results of that. ” She notes that many doctors and researchers are advocating to change this policy on clinical trials, and there are now several published studies evaluating the safety of vaccines in pregnant women.
Side effects of the COVID-19 vaccine are similar for everyone, even if you’re pregnant or breastfeeding
“We don’t see anything different with the vaccine; these are the same side effects we see in the general population,” said Chambers, whose research team has studied this question all year. They also did not find any serious side effects in babies when mothers were vaccinated while breastfeeding.
COVID-19 vaccines do not affect fertility
“There’s really no evidence that this vaccine, new technology or not, has the potential to do anything that would interfere with fertility,” Chambers said. “The CDC data does not suggest an increased risk of miscarriage with any of the vaccines, and we are looking at that as well to try to provide reassurance.”
Gyamfi-Bannerman adds that people undergoing in vitro fertilization (IVF) right after being vaccinated showed the same fertility rates as unvaccinated people and had the same pregnancy outcomes.
COVID-19 vaccines do not affect pregnancy outcomes
“We now have quite a bit of data to show that there is no difference in stillbirth rates or preterm birth rates with the vaccine,” Gyamfi-Bannerman said. The latest data from the CDC also shows no evidence of an increase in birth defects after vaccination. On the other hand, the vaccine actually reduces pregnant women’s risk of infection and the severity of symptoms, which include health conditions known to contribute to birth defects.
Antibodies that protect against COVID-19 can be passed from mother to baby
“That’s probably one of the biggest benefits of getting vaccinated during pregnancy,” Gyamfi-Bannerman said. “Antibodies have been found in umbilical cord blood, so they are carried to babies, and babies who have been tested have antibody levels similar to mothers. So it’s really a nice way to protect the newborn and protect yourself.
“We have also shown that when a breastfeeding person has antibodies against COVID-19, these antibodies end up in their breast milk and can potentially protect the infant,” said Lars Bode, professor of pediatrics and director of the Foundation. Larsson-Rosenquist. Center of Excellence in Mother-Milk-Infant Research at UC San Diego School of Medicine. He notes that researchers have yet to confirm that the antibodies are sufficiently absorbed by the baby this way, but studies on this are currently underway.
Official milk banks are safer than buying breast milk from online vendors
In a recent trend, parents have been sharing breast milk with each other and even buying it from online sellers such as Craigslist in a bid to give their babies and toddlers a source of COVID-19 antibodies. This can be especially tempting for people who have trouble breastfeeding, but Chambers and Bode advise parents to err on the side of caution and recommend using official milk banks when possible.
“I strongly recommend that you go through channels that test the milk properly and make sure it’s safe,” Bode said, “otherwise you’re opening yourself up to more issues than you’re likely to get in terms of protection. “
“There are so many questions raised that require us to prove the negative,” Chambers said.
“Show us that there is no increased risk of developing Alzheimer’s disease in 50 years, nor an increased risk that your child will do less well in high school. It’s impossible to answer these questions now and they were never answered for any vaccine before it was rolled out, so I think that’s the biggest misunderstanding.
“I can tell you what I tell my sisters and family members: You should get 100% vaccinated,” Gyamfi-Bannerman said. “If it was me, I would have been vaccinated during the pregnancy. It really is the right thing to do. »