The back and forth about the COVID-19 vaccine’s safety during pregnancy “can be disconcerting,” says one expectant physician. 

By Alexis Jones
February 05, 2021
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After the year-long, and unfortunately ongoing, global pandemic due to the novel coronavirus, finally a vaccine is being distributed. But the chatter around it's safety has caused concern for many, especially pregnant women. 

On January 25, the World Health Organization recommended against the use of the vaccine during pregnancy except for those who are at high risk of exposure or have comorbidities. But just days later, the group reversed its decision. "While pregnancy puts women at higher risk of severe COVID-19, very little data are available to assess vaccine safety in pregnancy. Nevertheless, based on what we know about this kind of vaccine, we don't have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women," the WHO said in the updated statement. Since then, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, announced during a roundtable at an International AIDS Society conference that the FDA has followed 10,000 pregnant women after getting the vaccine and they have shown "no red flags," per USA Today.

Still, the back and forth "can be disconcerting," says Brittne Halford, a Boston-based physician. That's why she and two other pregnant health care workers are sharing their thoughts around getting the vaccine.

Brittne Halford, MD, 34, Boston-based physician, 28 weeks pregnant

I'm an internal medicine physician who works primarily in the hospital every day, and as of right now, I'm planning to wait until after delivery to get vaccinated. But this is an ongoing decision and one that I've based on my ability to limit my exposure. While pregnant, my shifts have been shorter or I've been assigned those early in the day. During my last week on service, I only saw patients who were COVID negative and had effectively screened out for the virus. My colleagues also gave me the opportunity to work from an office by myself, so I'm not even exposed to them as potential vectors. But many people do not have the luxury of their work environment being as supportive as mine to make these kinds of accommodations. And if that's the case, and your risk for exposure to COVID is so high, either in your work environment, or living environment—which we know is the case for many Black and brown communities—it's important to consider your risk-benefit analysis for getting the vaccine. The truth is, vaccines have been the most impactful in preventing infectious diseases in communities abroad. And I, like many pregnant women, know that there is a higher risk for us—a higher risk of me being admitted to the ICU, a higher risk of me requiring intubation, a higher risk of me requiring ECMO, which is extracorporeal membrane oxygenation. And also, being a Black woman, there are known pregnancy-related mortality and morbidity disparities between Blacks and whites or non Blacks. So there's this constant oscillation and self introspection for me. I will get the vaccine. It's just a matter of when. This landscape is ever changing. And as more data come out, especially around how the vaccine affects the fetus, I'll feel more comfortable getting vaccinated. I'm so open to changing my mind. But until then, I'm doing everything in my power to minimize risk and take every precaution to protect myself and my baby. And you should do the same. Do what's best for your individual risk level, whether that means waiting until after delivery or getting the vaccine while pregnant. 

Maggie Romano, PA, 32 years old, Chicago-based physician's assistant, 15 weeks pregnant

I work in a plastic surgeon's office as a physician's assistant doing injectables—so Botox and fillers. Mask wearing has actually made patients more open to procedures around their mouth and lip area since it won't be visible, and we have to be really close to the face while injecting. Shields and goggles tend to fog, so while I'm wearing a mask during these procedures, my patients are not, and my eyes are often exposed. Not to mention, I'm 15 weeks pregnant and conceived through IVF, so I'm definitely higher risk. After miscarrying last summer and going through IVF treatments, I'd do anything to make sure that the pregnancy goes through safely. In talking to my doctor and midwife, we decided that it was best for me to get the vaccine in the second trimester when the baby's done developing its major organs. I got my first dose at 13 weeks, and I'm due for my second vaccine in a week and a half.  So far, I haven't experienced any major symptoms other than arm soreness and fatigue. For pregnant moms worried about getting vaccinated, I think it's really important to assess how much exposure you're getting to people outside your bubble. For me, the exposure was constant and my patients were maskless. For you, that may not be the case. Or maybe you're still just apprehensive. That's why I, along with many other health care workers, have already signed up to be a part of the ongoing vaccine research, including Washington University's COVID-19 Vaccine in Pregnancy & Lactation study, as I'm also breastfeeding a 23-month-old right now. I know that more data means pregnant moms will feel more comfortable and confident in the vaccine. I hope that in seeing health care workers go first, others will feel better about their own decision. 

Sarah Scherschel, RN, 28 years old, Located outside of Seattle, Washington, 31 weeks pregnant

My grandmother passed away from COVID in December, which was incredibly frustrating and demoralizing to think that she had made it since March without getting the virus, only to pass away a month before [a vaccine] was made available. I got the vaccine for her, for me, my unborn baby, and my husband, so that we can see our families again and have that interpersonal connection. I got it to protect my co-workers, patients, neighbors, and community. On New Year's Eve, at 26 weeks pregnant, I was given the first dose of the Pfizer vaccine. And I got my second dose, just a few weeks ago, when I was 29 weeks pregnant. I'd done extensive research at that point around how the vaccine was developed, how it works, and the safety and efficacy of vaccines. I relied on sources like The American College of Obstetricians and Gynecologists, the American Society for Reproductive Medicine, and the Society for Maternal Fetal Medicine, which provide information and recommendations based on the COVID vaccine and being pregnant, breastfeeding, and even trying to conceive. I was also careful about interacting with vaccine-related social media posts that didn't come from trusted and accurate sources, like Dr. Natalie Crawford, reproductive endocrinologist specializing in infertility, Dr. Marta Perez, an OBGYN, and Dr. Purvi Parikh, immunologist and allergist, who all share information that's accessible and easy to understand whether you work in the medical field or not. I talked with my doctor and other members of my family who work in health care. And when it came down to it, the consensus was mutual that getting COVID while pregnant was more risky to my overall health than getting the vaccine, which has theoretical risks. If I got stuck with COVID and I couldn't take care of my baby, that would be a really hard pill to swallow. For those concerned about side effects, the worst that I experienced was a sore arm. But it was no worse than getting a flu vaccine. That dissipated after about 48 hours. My second dose was the same, and I experienced some fatigue. But again, I felt completely fine 40 hours later and was back to normal. In between doses and after my second dose, I had appointments with my OBGYN to check in and there were no concerns about maternal or fetal health after the vaccine. Ultimately, I think we can all agree that this vaccine is going to help us on the path back to normalcy. And I'm happy to be a part of that positive change to make sure that we can become a healthier society again.  

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