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Guest Opinion | Jennifer McNulty, M.D.: Pregnant Women Should Get Vaccinated Against COVID-19

Published on Thursday, August 26, 2021 | 5:56 am
 

Los Angeles County recently reported a 300% increase in hospitalized COVID infected severely ill pregnant people comparing the last week of June 2021 to the last week of July 2021.  

The increase in rates of seriously ill COVID infected pregnant persons mirrors the increased rates in the non-pregnant population in Los Angeles County, California and the nation as a whole, in July and August.  Seriously ill pregnant COVID infected women are unfortunately largely unvaccinated.  At Huntington Hospital, the number of COVID infected pregnant patients has also increased in recent weeks consistent with what has happened in LA County as a whole.

I give the same advice to my own patients, as do all the experts at the Centers for Disease Control (CDC), the American College of Obstetrics and Gynecologists (ACOG), the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), American College of Nurse-Midwives and the American Society of Reproductive Medicine, which is that ALL pregnant people and women of reproductive age should be vaccinated for COVID 19.  This includes, in addition, not only women who are already pregnant, but also those who are nursing their infants and those who are planning pregnancy.  

 We know that pregnant women with COVID infection compared to pregnant women without COVID infection are at serious risk for complications.  We know that a woman’s respiratory system is incredibly important to maintain a healthy pregnancy and a pregnant person needs to be able to increase their ventilation to meet the demands of pregnancy including increased consumption of oxygen.  COVID therefore, which causes severe lung damage has been particularly dangerous for pregnant women.  In a new study of over 18,000 COVID infected pregnant women in the US, approximately 1 out of 20 required admission to an intensive care unit and approximately 3 of every 200 women had a breathing tube inserted into their windpipe (were intubated) and were put on a breathing machine (had mechanical ventilation) for respiratory failure. Almost 1 in 20 of these patients delivered at an extremely early gestational age (<32 weeks) compared to just 2 out of 100 women who did not have a COVID infection.  

Vaccination is our very best preventative strategy to avoid these terrible outcomes. In the US, nearly 150,000 pregnant persons have been vaccinated for COVID during their pregnancies and are also registered in the CDC’s V-Safe Registry (the number of women vaccinated during pregnancy is likely much higher however). More than 50,000 pregnant persons in the UK have also been vaccinated. 

The data shows that pregnant people mount the desired protective immune response to COVID 19 because of the vaccine just as well as in non-pregnant women and are no more likely than non-pregnant people to have mild short term side effects such as a sore arm, headache, tiredness, mild fever or chills.   The data shows absolutely no evidence of adverse pregnancy outcomes in vaccinated women such as miscarriage, small babies, or preterm birth.  This is not surprising, because like other safe vaccines in pregnancy (such as for whooping cough, known as the Tdap vaccine, influenza vaccine, and hepatitis vaccine), the COVID vaccine also contains no virus for COVID and cannot give someone a COVID infection. It is encouraging, that maternally produced antibodies to COVID 19 do cross the placenta and breastmilk to the baby. This is much like we already know is true for whooping cough antibodies and influenza antibodies after maternal vaccination, and which provide protection for weeks after birth to the newborn.  This may be of benefit to the newborn in the case of COVID 19 antibodies.  In addition, although there are lots of myths out there, COVID vaccines do not cause infertility, and do not alter your DNA. 

 Further, there are no vaccines that cause long term effects.  Vaccines don’t stay in the body and this is also true for the COVID vaccines.  For example the mRNA contained in the Pfizer and Moderna vaccines are broken down very quickly within a couple days by the muscle cells where the vaccine is injected in your arm.  Your cells make copies of the COVID 19 spike protein, which results in the production of your own protective natural antibodies.  The spike protein that your body produces however is also very short lived, just a few weeks.  But your antibodies stay, providing the needed protection.  Here is a good source of information about COVID vaccines from the Infectious Diseases Society of America:  https://www.idsociety.org/covid-19-real-time-learning-network/vaccines/vaccines-information–faq/

All pregnant people admitted to the Birth Center at Huntington Hospital, as well as their support person are COVID tested right in the Birth Center and are in a completely private area until their tests return negative. We follow all hospital guidelines for the safe care of individuals found to be infected with COVID-19 to protect staff and other individuals, while also providing the complete spectrum of pregnancy related care including labor and birth.  Staff members have undergone extensive training in the care of pregnant women with COVID-19 and the hospital is able to provide the full range of medical and obstetric care up to and including intensive care if needed for pregnant persons with serious COVID-19 infection.  

Jennifer McNulty, MD, maternal fetal medicine, is Medical Director of Obstetric Services at Huntington Hospital. 

References:

http://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=3317

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2782978?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=081121

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vsafepregnancyregistry.html

https://www.gov.uk/government/news/health-chiefs-encourage-more-pregnant-women-to-get-their-covid-19-vaccine 

https://www.scientificamerican.com/article/covid-vaccines-show-no-signs-of-harming-fertility-or-sexual-function/

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