COVID Risk for New and Expecting Mothers Raises Questions on Vaccination

The American College of Gynecologists has said that the vaccine should be offered to both pregnant and lactating women.

A lack of clear data on how the COVID-19 vaccines can affect women who are expecting or nursing a baby leaves these women in a difficult position when deciding whether or not to get vaccinated. 

Pregnant women are 5.4 times more likely to be hospitalized for COVID than the general population, 1.5 times more likely to be admitted to the ICU, and 1.7 times more likely to be placed on a ventilator, according to a June 26, 2020 publication by the Centers for Disease Control and Prevention.

Dr. Christopher Morosky, an Assistant professor and OB-GYN at UConn Health, said he understands these concerns, and he said it’s a shame that Pfizer, Moderna and Johnson & Johnson did not study the vaccine’s effects on pregnant women. 

“Unfortunately, companies purposefully did not enroll women who were pregnant in their studies,” said Morosky. “[We] don’t have reliable information about efficacy.” 

Morosky said he believed the companies decided not to enroll pregnant women in the studies “out of an abundance of safety and caution.” 

He also said, however, that there is no reason to expect that the vaccine would cause any kind of harm for pregnant women or their babies, based on their knowledge of how the vaccine functioned. 

Morosky said that the particles of the viral MRNA or DNA are cleared out of the mom’s body within hours of her having received the vaccine dose. 

He explained how it worked: the vaccine particles enter in through muscle, which then makes the COVID into a protein. After that, the body flushes the particles from the vaccine out of the mom’s circulation.  

“I think what’s important for pregnant women to know is that most vaccines are safe in pregnancy,” said Morosky, adding that some vaccines, like the flu vaccine, are recommended. He said the vaccine might even have some benefits, since it could provide the baby with antibodies. 

Risk factors

Morosky said there are a number of factors that account for the increased risk of COVID for pregnant women. During pregnancy, he said, women begin to produce more blood cells and their bodies retain more fluid, pushing the heart to its limits. The immune system also decreases its activity slightly during pregnancy to allow the baby to grow. 

The lungs are also forced to work harder as women’s breath rates increase and the uterus pushes against the diaphragm – Morosky said these changes are one of the reasons that pregnant women tend to be more susceptible to respiratory illnesses in particular.  

While he said there was no evidence that the virus can cause infertility, birth defects or miscarriages, he added that there was some increased risk for preterm births and disorders connected with high blood pressure, such as preeclampsia. 

There is no evidence, he said, to suggest that the virus can cross the placenta, and CDC data shows that out of the few babies who have been born with COVID, the majority had mothers who tested positive for the virus within a week of giving birth. 

Having a conversation

The CDC is currently creating a database of information, known as the v-safe COVID-19 Vaccine Pregnancy Registry, where individuals who got vaccinated while pregnant can opt in to share information about their health during and after the pregnancy. 

In the meantime, the American College of Gynecologists has said that the vaccine should be offered to both pregnant and lactating women. 

Morosky said women should talk with their doctors about whether to get the vaccination. 

“The discussions are long, and should be long, so that women have the information at the end of the day to decide,” said Morosky.

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