Myth vs. fact: Should pregnant women get a COVID-19 vaccine?
For pregnant women, contemplating whether to get a coronavirus vaccine may be a big decision, especially as questions and myths continue to persist around the shot’s safety.
That’s why figuring out whether to get a coronavirus vaccine is a different situation for each expectant mother, said Eliza Kay, a certified personal midwife based in Columbus. Midwives are health care professionals who work with women before, during and after they go into labor and give birth.
Kay encourages women to think critically about whether to get the vaccine, to do their own research, talk to medical professionals and consider their own lifestyle and risk factors.
“It’s tricky,” Kay said. “Part of midwifery is encouraging people to make the correct decisions for themselves. Overall, that’s the model we go by.”
Ohio opened COVID-19 vaccines to pregnant women March 4 and further opened eligibility to all adult Ohioans on March 29.
As more women contemplate getting the shot, The Dispatch asked Britton Rink, a doctor of maternal and fetal medicine at Mount Carmel, and Jason Melillo, a doctor of obstetrics and gynecology for Ohiohealth, what women should consider when making a decision about the vaccine.
Can the vaccine cause infertility?
The short answer: No.
Rink:
There is nothing to suggest the vac
cine causes infertility and no reports of adverse effects occurring in pregnant women, Rink said.
“There have been no increased risk or negative outcomes for babies either. … I think that’s a very powerful source of information,” Rink said.
Melillo:
“There’s a medical term for this,” Melillo said. “It’s hogwash.”
The myth that any of the COVID-19 shots can cause infertility was largely started by a German physician who has a very negative, unsubstantiated view of vaccinations, he said.
Some of the genetic code in the Pfizer and Moderna vaccines are similar to a protein that can be found in the placenta. The myth, which Melillo said likely took off on social media, was that the protein could spread within a woman’s body and cause her to become infertile.
“The risk is at best highly theoretical and nothing that’s been proven,” Melillo said.
Are pregnant women at higher risk for severe COVID-19?
The short answer: Yes.
Rink:
Being pregnant can put women in a high-risk category for COVID-19, Rink said.
In fact, some early data suggests that the virus increases the chance of complications for an expectant mother by “threefold,” she said. That could mean a higher chance for a mother giving birth before her baby reaches full term or a mother having a still-born baby, Rink said.
“All of these things support pregnancy being an independent risk factor for COVID severity,” Rink said. “I think that is an important consideration.” Melillo:
Expectant mothers are more likely to develop severe cases of the virus.
But behind rumors that women aren’t at risk is what Melillo called “a kernel of truth.” When the pandemic began, Melillo said doctors largely expected pregnancy to be a big risk factor but so far, pregnant women “did not get hit as hard as expected.”
That doesn’t mean there’s no danger though.
It seems that pregnant women who develop COVID-19 symptoms are more likely to suffer complications while giving birth. That could include everything from prematurely giving birth to developing a blood clot, which could lead to a stroke, Melillo said.
Is it dangerous to breastfeed after getting the vaccine?
The short answer: No.
Rink:
Early information indicates there’s no risk in breastfeeding after getting the vaccine, Rink said.
It’s not well established yet, but a vaccinated mother may actually pass on some of COVID-19 antibodies to her baby through breast milk, which Rink said is common for some other diseases as well.
“We have to look at our long history of vaccinating women ... in theory this vaccine fits that same story,” Rink said. “There are likely secondary benefits.” Melillo:
“The opposite is probably true,” Melillo said.
Some reports are starting to emerge that a vaccinated mother may actually be able to pass on some temporary protective antibodies to her baby through breastmilk, Melillo said.
Right now, only Ohioans age 16 and older can get the vaccine, so a newborn is not eligible. Immunity passed on from a mother to a baby may be a good workaround until a shot is approved for babies, Melillo said.
Can it alter a baby’s DNA?
The short answer: No.
Rink:
The question of whether someone’s DNA could be changed by a vaccine may seem like a far-fetched one to ask, but it’s not, Rink said.
“I think people are smart to think about the model of the vaccine,” she said.
While vaccines from Moderna and Pfizer use genetic material to create proteins that protect against the virus, Rink said “there’s no risk of genetic modification.”
While there’s no risk of the vaccine changing someone’s DNA, it’s important that patients ask questions and become informed of what the shots do to someone’s body, Rink said.
While they may not cause genetic changes, the COVID-19 vaccines have been reported to sometime cause mild side effects, including head and body aches and fatigue.
Melillo:
The Pfizer and Moderna vaccines both use something called messenger RNA, material that provides instructions to each person’s body on how to prevent a spike on the surface of the coronavirus from attaching to someone’s cells.
While MRNA in the Moderna and Pfizer vaccines is considered genetic material, it cannot change someone’s genetic makeup, Melillo said.
“That is biologically impossible,” he said. “They are two totally different things. My assumption is people jumped the gap between RNA and DNA.”
Should pregnant women still get vaccinated if they had the virus?
The short answer: Yes, but it’s their call.
Rink:
Patients should stay up-to-date on the most recent information published by the Centers for Disease Control and Prevention when looking for an answer to this question, Rink said.
That’s because the answer, Rink said, can be a moving target.
Deciding whether to get a COVID-19 vaccine is a personal choice and there are no known dangers or complications for pregnant women who have already had the virus, according to the CDC as of March 22.
Melillo:
The fact is that “we don’t know how long natural immunity lasts yet,” Melillo said.
It’s unlikely, Melillo said, that COVID-19 will be something like the chicken pox, a disease which only infects people once. Instead, it could prove to be endemic and resurface over time, he said.
“There’s a lot of people who believe we’re probably going to end up doing a COVID booster a year or two out,” he said.
Was the vaccine tested on pregnant women?
The short answer: No, but researchers are studying it now.
Rink:
The vaccines were not originally tested on pregnant women but trials on expectant mothers are in the works, Rink.
Aside from trials, Rink said the CDC has created a program in which vaccine recipients can report their outcomes.
Pregnant women are encouraged to report their experience, that way more information can be collected on how the vaccine affects them, Rink said. The program is called V-safe and is actually open to all Americans and not just pregnant women.
Rink hopes there will soon be more data available rather than just from the CDC survey.
“We hope for more data so we can dig deep into some particular issues,” Rink said.
Melillo:
Typically, pregnant women are excluded from vaccine trials as a precaution in case a shot did prove to be unsafe. That’s why they were mostly left out of the COVID-19 vaccine trials, Melillo said.
But some women who signed up for the trials became pregnant while participating.
Pregnant women who get the vaccine are also being asked to alert doctors if they have any adverse reactions. Thus far, nothing significant has been reported, Melillo said.
Where should pregnant women turn to for more information?
The short answer: Their doctors. Rink:
“I would encourage women, if they do have concerns, to talk with obstetrician, who can provide patient resources and guidance for families in health and decision making,” Rink said.
Melillo:
“The most trusted source of information for any pregnant women is her physician,” Melillo said. “Dr. Google is not a great source for information.” mfilby@dispatch.com @Maxfilby