One drugmaker, Pfizer, will try to answer the question with a clinical trial of its coronavirus vaccine on pregnant women, the company announced last week. The results are not expected for months.
In the meantime, how can pregnant women decide whether to get the Covid-19 vaccine? What about those trying to conceive or those nursing?
We have CNN’s medical analyst, dr. Leana Wen, asked for advice. Wen is not just an emergency physician and public health expert; She is also a mother to a 3-year-old boy and a ten-month-old girl who were born during the pandemic.
Dr. Leana Wen: Technically it is not, but it is an option for pregnant women. This is why: the initial clinical trials did not include anyone who was pregnant or breastfeeding. Some women did become pregnant during the trials, but because the research was not intended to study the effect of the vaccine on pregnancy, there was not enough data for the Food and Drug Administration to cover the shot for pregnant individuals. not authorized.
CNN: If the vaccine is not specifically tested during pregnancy, why would pregnant women take it?
Win: Pregnant women have a higher risk of serious complications due to Covid-19. There is a higher risk of being admitted to hospital and ending up in the ICU for pregnant women compared to non-pregnant women. The risk is further increased for pregnant patients with underlying medical conditions.
CNN: How do you recommend a pregnant woman make this decision?
Win: Here are the two things I want to address to my patients to consider. First, what is your risk for exposure to Covid-19? Suppose my patient is a nurse or respiratory therapist treating Covid-19 patients. That person has a great deal of exposure to occupations and vaccinating them can significantly protect her during her pregnancy. Maybe she has a spouse who is in a high-risk profession, or she lives in a household where she cannot physically distance herself from a family member with exposure risk. It would be an advantage to get the vaccine now.
Second, what is your risk of having serious consequences if you contract Covid-19? Pregnancy alone already puts a person at risk for serious illnesses, and if you have other underlying medical conditions, you have a higher risk because the risk is additive. Conditions such as chronic lung, kidney or heart problems; diabetes; high blood pressure; and sickle cell disease can exacerbate the effects of coronavirus. Patients who are pregnant and with these underlying medical conditions can significantly benefit from the vaccine.
The bottom line is that any risk of adverse effect of the Covid-19 vaccine is theoretical and that the risks of Covid-19 infection are not. Based on what we know about the vaccine, there is no reason to believe that it will have a detrimental effect on the pregnancy or the long-term health of the mother or baby. Lack of evidence does not mean that it cannot exist, but this type of theoretical, very low risk must be weighed against the actual and potentially very high risk of a serious consequence of Covid-19.
This is why many health workers who are pregnant have received the vaccine.
CNN: What about breastfeeding women?
Win: We do not have data to unequivocally say that the vaccine is absolutely safe for people who are breastfeeding. However, there is no physiological reason why it would not be safe. Vaccines that are considered of concern are those that contain live virus. The Covid-19 vaccines currently authorized in the United States – and those that are here in clinical trials – do not contain any live virus. In fact, if anything, the vaccines can further benefit the baby. Recent research suggests that protective antibodies can be transmitted to the baby through breast milk.
CNN: You were pregnant at this time last year. Would you have received the vaccine if it was available to you when you were pregnant or breastfeeding?
Win: I am a healthcare professional who sees patients with high risk exposure to work, and I also have asthma. So yes, I would have received the vaccine if it had been available when I was pregnant. When the vaccines were approved, I stopped nursing. As soon as I stopped nursing, I joined a vaccine trial. If I was still a nurse and had the opportunity to get the vaccine, I would not hesitate to take it.
CNN: What would you say to people who want to wait until there are clinical trials proving that the vaccine is safe for pregnant and breastfeeding women?
Win: I would say that it is also a reasonable choice. Everyone has to make the best decision for themselves. Much has been written about the ethics of vaccines during pregnancy. On the one hand, it makes sense not to include pregnant women in the first vaccine trials, out of concern for them and their babies. On the other hand, it is not fair to deny a whole group of people the benefit of vaccinations. Most health workers, for example, are women of childbearing age.
Many other vaccines have not actually been tested specifically during pregnancy, but are given regularly because the proven benefits outweigh any theoretical risk. I think every patient should make the right decision for himself and his family in consultation with their healthcare provider.
It is important to note that pregnant women and nurses are not in preferred vaccination groups, only on the basis of pregnancy or postpartum. Otherwise, if no preference is given to being vaccinated (for reasons such as a high-risk occupation or an existing health condition), they, like all other people, should wait their turn to be in the appropriate groups.
CNN: There is misinformation about the vaccine and fertility. Can you clear it up?
CNN: What would you say to women who are thinking about getting pregnant or getting pregnant? Should they get the vaccine?
Win: If they are in priority groups to receive the vaccine and can do so, I would say they should do so. There is no reason to hold. Of course, they should always consult with their healthcare provider, especially if they are planning medical procedures. For example, if they are planning IVF procedures – they may not want to set up their vaccines on the exact same day as their procedures to prevent concomitant side effects.
Remember that the vaccines are very effective in preventing diseases – especially serious diseases – of Covid-19, but they are not 100% effective, and we do not yet know if those who received the vaccine can transmit the virus. Even after receiving the vaccine, people still need to be careful.
For pregnant patients, this means that they can breathe a little easier when they go to their antenatal visits, but they should definitely still wear masks and adhere to physical distance guidelines in public places.
For women who are breastfeeding, they will have good immunity, but they will not know if their babies are doing it. It is therefore important to keep physical distance for their babies. And for all, an abundance of caution is a good idea until more people can be vaccinated and we are closer to achieving herd immunity.