Pregnant women agonize over unknowns of the vaccine
For the first eight months of her pregnancy, Yadira Rivas, a nurse coordinator at Neighborhood Health of Virginia, relied on masks and gloves to protect her from the coronavirus that is rampant among her patients.
Recently, she’s been considering another option — getting vaccinated. But after consulting with her obstetrician, Rivas decided to wait to get a shot until after her baby is born.
“One thing that the provider did mention is that it is worse to have the covid than to have the vaccine,” she said. But with no safety data available for pregnant women, Rivas thinks she would have chosen to wait even if she were far earlier in her pregnancy. “Just to stay safe,” she said.
The same conundrum faces millions of women across the country, among them many health-care workers like Rivas who are being offered vaccines not yet tested on pregnant or lactating women.
“There’s a lot of confusion,” said Jane Frederick, a fertility specialist in Newport Beach, Calif. “I have questions from people who are pregnant and questions from people anticipating getting pregnant: ‘Doctor, what do I do?’ “
With the exception of the smallpox vaccine, which can cause a rare but serious infection of the fetus, vaccines have been safe and enormously beneficial for pregnant women and their babies. Experts say the safety of the new mRNA vaccines, which do not contain live virus, would probably be similar in pregnant and nonpregnant people. What’s more, pregnant women face the potential of severe illness from covid-19, which may also increase the risk of preterm birth and other serious outcomes for both mother and infant. Experts also warn against lumping the two distinct biological phases of pregnancy and lactation together.
The Centers for Disease Control and Prevention has concluded that “people who are pregnant and part of a group recommended to receive the coronavirus vaccine, such as health-care personnel, may choose to be vaccinated.” The CDC also says that “mRNA vaccines are not thought to be a risk to the breastfeeding infant.”
The American College of Obstetricians and Gynecologists similarly says that “covid-19 vaccines should not be withheld from pregnant individuals who meet criteria for vaccination.” It also recommends the vaccines be offered to lactating women. But ACOG adds that because of the lack of data, “the potential risks to a pregnant individual and the fetus are unknown.”
All of which leaves the process of weighing the pros and cons up to the individual in consultation with her doctor.
“The medical community has done a good job of saying, ‘We don’t know,’ “said Daryl Stoner, an obstetrician with Einstein Physicians Women’s Associates for HealthCare outside Philadelphia. “That drives people crazy. They want to be told it’s safe.”
Doubts erupted in online pregnancy forums such as What to Expect, with views ranging from women saying they “would not risk putting my baby in danger” and counseling others to wait for more data or wait out the pandemic, to health-care workers declaring they were “absolutely getting it.” In some Facebook groups, where anti-vaccine advocates have fanned false worries about many vaccines, the fears are heightened. Many linked to Britain’s policy, advising against immunizing pregnant women until more is known about mRNA vaccines.
The differing messages concern many American vaccine experts like Ruth Karron, director of the Center for Immunization Research at the Johns Hopkins Bloomberg School of Public Health, who praised the way U.S. regulatory agencies and professional groups have handled the situation, while emphasizing the need for more research.
From the outset, “we and many others were beating the drum for thinking about pregnant women,” said Karron, who is a leader of the PREVENT project, which pushes for including pregnant women’s interests in the development of vaccines against emerging pathogens such as Zika, Ebola and now covid-19.