“There is really no theoretical reason to believe that it will harm the mother or her unborn child, and we are very confident that it will offer the mother and baby significant benefits,” said Beigi, president of UPMC Magee- Womens Hospital in Pittsburgh.
Only a few people, such as those with severe allergies, a history of anaphylactic shock or who it is suffering from advanced cancer, will probably be advised to avoid the vaccine. A pregnant woman with concerns should talk to her OB-GYN, experts say.
“U.S. regulatory bodies and medical experts have made it clear that all eligible pregnant individuals should have the choice to receive the vaccine,” said Dr. Christopher Zahn, ACOG’s vice president of practice activities, said.
An international controversy
This is a strong and clear message that OB-GYNs and medical associations hope will reach pregnant women and their families who may be confused about conflicting recommendations put forward by the World Health Organization this week.
But any “potential vaccine risks” mentioned by the WHO are purely speculative, doctors tell CNN, compared to the known risks of Covid-19 for pregnant women and their babies.
“The absence of data does not equate to the risk of harm – especially if science and basic biology do not suggest a plausible reason why harm can occur,” said Dr. Kjersti Aagaard, a medical-fetal medicine specialist at Texas Children’s, said. Hospital and Meyer Professor Leader in Obstetrics and Gynecology at Baylor College of Medicine.
Doctors who spoke to CNN said there were dozens of safety data that did not harm a pregnant woman or her baby due to inactivated vaccines – and they believe the information should also apply to the Moderna and Pfizer vaccines, which not made from a live virus. .
Instead, it is mRNA vaccines, which teach the body cells how to make a piece of protein that triggers an immune response. Once the instructions are delivered, “break down the cell and get rid of the mRNA,” according to the CDC.
Therefore, the WHO’s concern is ‘more focused on hypothetical risks at the expense of recognizing the clear benefits of vaccination’, Beigi said. “It can be very confusing for a woman, who is sorry, very sorry.”
The risks of Covid-19 during pregnancy are significant
At the outset of the pandemic, Covid-19 did not appear to have adversely affected women or their babies during pregnancy. However, as the data rolled in, faith changed dramatically.
“Pregnant women are up to five times more likely to be admitted to hospital, three to four times more likely to have to be cared for in an ICU, and two to three times more likely to need life-saving measures, such as a breathing tube. to get or to sit on advanced life support, ”said Aagaard, who has a doctorate in immunology.
“And although the data are not yet complete, there is at least a small risk of maternal death and stillbirth and preterm birth with Covid-19 disease during pregnancy,” Aagaard continued. “Black and Latino women have a particularly increased risk of serious illness and death due to Covid-19. These are the facts.”
Why would pregnancy put women at greater risk? One reason is the reduced lung capacity for the woman as the baby grows.
“You can develop breathing problems, to the extent that you can not recover from them,” Aagaard said. “For every pandemic we’ve had in the last 100 years, there has been an increased risk for pregnant women if the pandemics are associated with serious respiratory illnesses.”
In addition, Aagaard said that the heart of a pregnant woman pumps 1.5 times harder than it would normally be to give enough blood for the baby and the placenta.
“So that the over-action of the heart, which we call a higher heart output, also puts pregnant women at risk for having heart failure problems, which can be a manifestation and possible cause of death due to Covid-19 disease, she said.
Pregnant women may also be more likely to have an over-enthusiastic immune system, which can lead to the so-called cytokine storm that indicates serious illness and negative outcomes, Aagaard said.
And lastly, there is an increased likelihood of blood clotting during pregnancy, which is known to worsen Covid-19.
“Humans, like all placental mammals, are at risk of bleeding to death after the placenta has separated from the uterine wall,” said Aagaard. “So 4½ million years of evolution are on our backs, which helps us solidify a little more effectively when we’re pregnant.”
Benefits for baby?
Although the study did not investigate whether vaccines created by vaccination would also cross the placenta, the concept has been used in maternal medicine for some time.
Pregnant women receive both inactivated flu vaccine and one called TDAP, which protects both mother and baby from tetanus, diphtheria and whooping cough, also known as whooping cough.
“Wouldn’t it be great if we could switch our developing fetus so nicely to be protected from the Covid-19?” Aagaard said. “If we can arm that baby with his own memory cells, it’s a two-way street, that’s what we’re always hoping for.”
Another emphasis
Although both U.S. and WHO officials are clear about the lack of safety data in their guidelines, a WHO spokesman said the agency places more emphasis on ‘guidance that can inform immunization program decisions’ during ‘current restrictions on global vaccine supply’. The CDC and the US position are focused on ‘individual decision making’.
“Due to a lack of information on the presence or absence of vaccination-related risks during pregnancy, the WHO could not at present give a broad recommendation for the vaccination of pregnant women, except among those in the highest priority groups for whom vaccination is now recommended in countries, ”the spokesman told CNN by e-mail.
“I think the fact that they say we do not recommend it will have an effect in many countries,” Beigi of ACOG said, “because the medical leaders of those countries will be much more reluctant.”
Zahn, also from ACOG, agreed.
“We are concerned that the conflicting recommendations will undermine the confidence of all patients considering this potentially life-saving vaccine,” Zahn said. “We strongly encourage vaccination programs to follow the guidance of U.S. health authorities and medical experts so that pregnant individuals do not face barriers to vaccination.”
Trials of various sizes are currently underway, and doctors point to the number of pregnant women who have received Covid-19 vaccines since they started rolling out – with no known side effects. That makes a lot of sense, Texas Children’s Aagaard said.
“Not only have I been in obstetrics for several decades, but my doctorate is in immunology,” Aagaard said. “And I really can not imagine what the biology or science would be why a pregnant woman or her fetus would be at greater risk than a non-pregnant woman.”
While appreciating the ‘nuances’ that the WHO uses to prioritize, Aagaard said she is confident in ‘our ability to walk and chew gum at the same time’.
“We are fully capable of vaccinating everyone in need, including everyone at greatest risk of injury. This includes pregnant women, who make up about 3% to 5% of the world’s female population at any given time,” said Aagaard.