Monday Medical: COVID vaccines and pregnancy
For Steamboat Pilot & Today
STEAMBOAT SPRINGS — The risk of contracting COVID-19 can be especially daunting if you’re pregnant.
Pregnant women are five times more likely to end up in the intensive care unit or on a ventilator than patients who aren’t pregnant. They also are more likely to die of COVID-19 than non-pregnant women of the same age with the virus.
Knowing those risks, many pregnant moms wonder whether they should get vaccinated for the virus. Dr. Jeff Chamberlain, an OB/GYN with UCHealth Women’s Care Clinics in Steamboat Springs and Craig, said that while the decision is a personal one, he supports making sure pregnant women have the choice.
“I strongly recommend that pregnant women and lactating women be given the opportunity to receive the vaccine,” Chamberlain said.
Why is COVID-19 more dangerous in pregnancy?
It’s unclear why COVID-19 poses an increased risk to pregnant women, but it may be due to physical changes that happen in pregnancy.
“The lungs are more susceptible in pregnant women to these types of respiratory diseases, and your immune system is cranked down a little to facilitate the developing body inside of you,” Chamberlain said. “A lot of the pathophysiology of how COVID-19 affects pregnant women isn’t known yet, but there are some things about the way women’s bodies change during pregnancy that make them less suited for fighting respiratory diseases, and they just get sicker.”
That increased risk goes away once the baby is born.
Severe COVID-19 may increase the risk of preterm births, but it does not seem to cause other complications with pregnancy, such as still birth.
Is the vaccine safe in pregnancy?
While trials have shown the vaccine is safe for adults, it has not been tested on pregnant women.
“It’s like a new medicine, and that’s what people can get scared of,” Chamberlain said.
Organizations such as the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine acknowledge that much is unknown about possible impacts of the vaccine on pregnant women and their babies, but recommend that COVID-19 vaccines should not be withheld from pregnant or lactating women.
Pregnant women are encouraged to get other vaccines, such as the flu shot. The Tdap vaccine for tetanus, diphtheria and pertussis is recommended later in pregnancy.
“Babies don’t get their own pertussis vaccine until they’re two months old, but if their mom gets the vaccine at 28 weeks or later, the baby has immunity to cover those two months,” Chamberlain said. “We offer that vaccine routinely to women because of the benefit for the baby.”
Chamberlain said it’s possible that a pregnant woman vaccinated for COVID-19 will passively transfer immunity to her infant.
Chamberlain aligns with advice of the Society for Maternal-Fetal Medicine that pregnant women interested in getting the vaccine wait until the second or third trimester.
“Organ development happens in the first trimester, so after organ development, we’re a little more open to things like medicine or new vaccines,” Chamberlain said.
How should I decide?
If you’re pregnant, Chamberlain recommends talking with your health care provider and considering your personal risk of being exposed to COVID-19.
“We’re all at risk for getting COVID, and you have to balance those risks for yourself,” Chamberlain said. “Pregnant women who are going out in public and working with the public, such as health care workers and teachers, should take that into consideration.”
Your health care provider is a great resource; he or she not only knows your health history but will be aware of the latest research and the many nuances involved with pregnancy.
“Health care providers are used to having conversations with patients about vaccines,” Chamberlain said. “This science is fresh and limited and evolving, but they’re doing the best they can to try to roll out something that will have a big effect on how long this pandemic goes on for.
“We are gently supportive of offering the vaccine to pregnant women. I think the benefits outweigh the risks for what we know so far.”
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