Maternity wards urge expectant mothers to get vaccine
National statistics released last week by the Centers for Disease Control and Prevention revealed that just one-third of pregnant women had received the COVID19 vaccine. In Allegheny County, maternity ward doctors have seen even lower rates, and say misinformation about fertility problems may be to blame.
“I really think the strategy of keeping moms and babies healthier is an absolute priority, and that begins with vaccination,” said Dr. Hyagriv Simhan, executive vice chair of Obstetrical Services at UPMC Magee-Womens Hospital, in a phone interview. “But all the way up, there are interventions, too, that we might make sure pregnant people know about — that they know this is a real problem, not just sort of a theoretical one, but one right here in Western Pa.”
Dr. Grace Ferguson, an OBGYN at West Penn Hospital, said she sees vaccination rates in the one-third range. Even before COVID-19, she said, vaccine hesitancy in pregnant women was common.
“I just have a lot of patients who are trying to tell me about their research about the vaccine, and that’s really frustrating as a health care provider who sometimes does research, like primary scientific research,” Dr. Ferguson said. “I just love and believe so much that you should control your health care, and you should make your own decisions, but it is very hard to watch you make these decisions based on data that is not true. How can I convince you that something is true or not true?”
Dr. Ferguson sees pregnant women who are concerned that the vaccine is still new and might hurt their babies, although the Federal Drug Administration has given its full approval to the Pfizer-BioNTech vaccine. Others simply think COVID-19 isn’t that big of a deal.
Her non- pregnant patients are also hesitant, and often bring up an internet rumor that the COVID vaccine causes infertility.
“That’s like the most common discrete question I get, that’s like ‘OK, is the COVID vaccine going to hurt my fertility?,’ ” Dr. Ferguson said.
“It’s so hard because most pregnant women are young,” she added. “So there’s this sense of, ‘Hey, I’m really healthy, it’s going to be fine, this doesn’t apply to me.’ ”
Over the course of the pandemic, more than 125,000 pregnant adults in the United States have contracted COVID-19, resulting in 22,000 hospitalizations and 161 deaths. According to the CDC, pregnant adults have double the risk of hospitalization from the virus than a nonpregnant individual, and are 70% more at risk of death. To prevent these outcomes, the CDC strongly recommended in a statement on Sept. 29 that pregnant adults receive the vaccine to protect both themselves and their babies.
Dr. Simhan said while a woman is not more likely to contract COVID-19 while pregnant, being exposed to the virus increases the likelihood of getting sick, the severity is worse and the risks for mortality are higher.
At Magee-Womens Hospital, Dr. Simhan said he estimates just 20% to 25% of pregnant patients have gotten the vaccine.
“What we are seeing is because fewer pregnant women are vaccinated, for that reason, they’re more likely to acquire COVID illness if they’re exposed to COVID,” Dr. Simhan said. “So there’s nothing about the biology of pregnancy per se that makes it worse, but it’s a behavioral one, if you will.”
Some of these illnesses result in breathing problems that require hospitalization and extra oxygen, Dr. Simhan said. In some cases, a breathing tube is necessary.
“The changes that happen during pregnancy really predispose, so the immune system changes that lead to critical illness tend to be sort of overboard in a pregnant person,” Dr. Simhan said. “So it’s part of the physiology of pregnancy that actually predisposes pregnant women to get sicker if they get COVID infection or influenza infection.”
According to Dr. Simhan, severe COVID-19 illness in mothers poses a major risk for their child, too.
“The main risk is that the baby is in utero when the mother is critically ill,” he said. “And so things like low oxygen, things like low blood pressure that sometimes happens in critical illness, can affect babies.”
Dr. Simhan said in some cases, COVID-19 infections can result in a stillbirth or premature delivery.
“I just want to reassure the readership that we wouldn’t be offering and recommending this vaccination if we thought that it was harmful for babies,” Dr. Simhan added. “We think it’s not only good for moms, but good for babies, because no baby does well in a sick mom.”
Allegheny County Health Director Dr. Debra Bogen echoed that sentiment.
“The data are really strong that the vaccine is safe during pregnancy and prevents adverse outcomes of pregnancy from infection with COVID,” she said. “We strongly support that ... both pregnant and nursing people should get vaccinated.”
Because the risks for severe COVID-19 illness are greater in pregnant women, hospitals in the area have taken precautions to prevent outbreaks.
West Penn Hospital in Bloomfield, where Dr. Ferguson works, has added its own COVID-19 room in the maternity ward to separate patients. The room is separated from other hospital beds, and has its own ventilation and extra personal protective equipment.
Lately, COVID-19 positive patients have been coming to Dr. Ferguson in “a constant stream.”
“I just got a message that one of my patients that I’m seeing on Friday has COVID,” she said. “She’s 33 weeks, she still needs her routine pregnancy care, and so I was like — ah, I should remember to throw my N95 on my mask for our office visit.
“It used to be that if you got COVID, we would really ask you to stay home and postpone your appointments,” Dr. Ferguson added. “Obviously, if you’re going to deliver a baby, you can’t change that. But now you have COVID, at least the health care providers are vaccinated and boosted, and we’re just putting on our masks and hoping for the best, you know?”