More than 26 million doses of the Pfizer or Moderna COVID-19 vaccine have now been administered in the United States, but questions about who should get it first – and who should avoid it altogether – continue to circulate.
This week, the World Health Organization made the waters further muddy with interim guidance, saying the vaccine is “currently not recommended” for pregnant women unless they “run the risk of being exposed a lot.” The decision is in conflict with that of the Centers for Disease Control & Prevention, which insists the vaccine is safe for pregnant women and says it is unlikely to pose a risk.
Dr Myra Wick, an obstetrician-gynecologist at the Mayo Clinic, says she is currently following the guidance of the American College of Obstetricians and Gynecologists (ACOG), which persists in its view that the vaccine should be offered to all pregnant women. . Dr Christopher Zahn, ACOG’s Vice President of Practice Activities, tells Yahoo Life that the organization’s remains steadfast in leading that both COVID-19 vaccines currently FDA-approved should be made available to pregnant individuals who prefer the vaccine. to receive. ‘
So why are the WTO and CDC in conflict? Here’s what you need to know.
The WHO does not recommend the vaccines for pregnant women due to lack of data
In an email to Yahoo Life, a WHO spokesman expanded their view and shared a similar explanation for the Pfizer and Modern vaccines. “The available data on mRNA vaccination of pregnant women are insufficient to determine the efficacy of vaccine or the risks of vaccines during pregnancy,” the WHO wrote. “Further studies are planned in the coming months among pregnant women. As data from these studies are available, vaccination recommendations will be updated accordingly. ”
Despite requests from ACOG and others, pregnant women were not included in the clinical trials of any vaccine. The WHO believes that until the collection of data on pregnant women is collected, taking a vaccine for many people may be a choice that carries more risks than benefits. “At present, WHO does not recommend vaccinating pregnant women,” WHO told Yahoo Life. “This position will be reviewed and may evolve as more data becomes available.”
The CDC and ACOG disagree, noting that mRNA vaccines do not contain live viruses
On its website, the CDC specifically states that ‘pregnant women can receive safely inactivated vaccines’, citing the flu shot and Tdap, a pertussis vaccine, which Wick says is given regularly and safely. The organization notes that the type of vaccine used is important. “Although studies have not yet been done, experts believe that mRNA vaccines such as COVID-19 vaccines are unlikely to pose a risk to pregnant people,” the CDC wrote in a tweet on December 29.
Vaccinations against MRNA (abbreviation for messenger RNA) work by encoding the vein protein on the surface of SARS-CoV-2, the virus that causes COVID-19, and using it to elicit an immune response. Wick says it raises her confidence about its safety. “Mechanically, there is no reason to think they are going to be harmful,” she says. ‘People are worried about’ Is it going to integrate into my genome? “It’s not. It stays in the part of the cell where the DNA is not housed … so mechanically it looks like it has to be safe. ”
Zahn and ACOG echo this sentiment. “Both the Pfizer-BioNTech and Moderna vaccines are not live virus vaccines,” says Zahn. ‘They do not enter the nucleus and can not cause any genetic changes. The safety of these vaccines has been demonstrated in clinical trials with non-pregnant individuals, and similar results are expected in pregnant individuals. ”
The vaccine has not been specifically tested on pregnant women, but in the trials
Although neither Pfizer nor Moderna intentionally included pregnant women in its clinical trials, both companies had more than a few. According to reports, 23 women in the Pfizer trial and 13 in the Moderna trial were either unknowingly pregnant at the time the trial began, or became pregnant during the trial.
Of the pregnant women in the Pfizer trial, 12 received the vaccine and 11 the placebo. No pregnancy-related side effects were reported in the vaccine group, but two miscarriages occurred in the placebo group. Among the Moderna group, six of the pregnant women allegedly received the vaccine and seven received placebo. None of those who received the vaccine reported side effects regarding their pregnancy. In the placebo group, one woman experienced a miscarriage and another opted to have an abortion.
According to a CDC report this week, at least 15,000 pregnant women have received the vaccine so far. The organization is closely monitoring adverse effects, but says the safety data collected so far is “reassuring and in line with what was observed from the pre-approved clinical trials.”
The WTO’s view is that, without data, the risks of the vaccine could outweigh the benefits
It seems that the concentration of the WHO’s new guideline is central in the absence of data, that pregnant women may put themselves at risk. ‘WHO recommends not to use [the COVID-19 vaccine] ‘during pregnancy, unless the benefit of vaccinating a pregnant woman outweighs the potential vaccine risks, such as in high-risk health workers and pregnant women with comorbidities who place themselves in a high-risk group for severe COVID-19,’ writes the organization. “Information and, if possible, advice on the lack of safety and efficacy data for pregnant women should be provided.”
The side effects of vaccines reported are probably not dangerous for pregnant women
It has now been well established that both Pfizer and Moderna vaccines are likely to produce temporary side effects – mostly pain, fatigue and headaches. Experts believe the reactions are a good sign, showing that the vaccine is causing an immune response. ‘
Ob-gyns pays close attention to these reactions, Wick says, but those described are no danger to pregnant women. “We are concerned about high fever, but most fever reported is low, and it is safe to take Tylenol to reduce fever during pregnancy,” she says. “Most other side effects – muscle aches and headaches – are not pleasant, but are not harmful to mother or baby.”
Instead of worrying about the risks of the vaccine, doctors and experts say the focus should be on the known dangers of COVID-19 during pregnancy.
A study of more than 1,200 pregnant women released Thursday by the Society for Maternal Fetal Medicine found that pregnant women who experience a severe case of the virus are more likely to die from the infection, as well as more likely to experience. pregnancy complications such as preterm birth, C-section, postpartum hemorrhage and high blood pressure.
Wick treated patients this way firsthand, which is why it indicates that all pregnant women talk to their healthcare provider about whether the vaccine is right for them. “Women who are pregnant and who contract COVID are at greater risk of being admitted to hospital, needing ICU care, and even having to be intubated,” says Wick. ‘There is definitely an increased risk – especially for those who have a greater risk to the environment or have [health conditions] which may make them more vulnerable. They should consider vaccination because we have no reason to think it is unsafe. ”
Zahn agrees. “Each person should make the best decision for themselves, in conjunction with their clinical care team, if possible, based on the information and data currently available,” he tells Yahoo Life. “For now, some may decide that the risks outweigh the benefits, but ACOG believes that pregnant people deserve autonomy and should be given the choice to be vaccinated in the face of a potentially life-threatening virus and in the absence of credible data. which would suggest that it would cause harm. ”
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Originally published