As America continues to roll out vaccines across the country many questions are coming up. With the limited experience with our current vaccines some of these questions do not have easy answers. One such question is; “Is Covid-19 vaccine safe for pregnant women?” Answers to questions like this are usually answered by having trials that focus on answering them. In the area of pregnancy though, this has never been a simple matter. Concerns for adverse fetal outcomes unfortunately makes it difficult to get such studies done in a timely manner. Many approved drugs and vaccines on approval are deemed to be unsafe in pregnancy. In truth though what that means is there is not enough information available to support a safety recommendation in pregnancy.
Challenges With Making Decisions In Pregnancy
So what must a pregnant woman do? In the case of Covid-19 vaccine the CDC still recommends that pregnant women should consider getting the vaccine. The decision though is an individual one. This decision is not a very easy one for a pregnant woman or couple to make. A pregnant woman making such a decision is thinking about how to safeguard the health of two persons. Most pregnant women that I have spoken to including those who are contemplating conception are struggling with this decision. I have also had to contend with similar decisions in my personal life.
When my wife was pregnant with our sons we dealt with similar questions. The first pregnancy was the most difficult decision for us. In our case our most difficult decision was on amniocentesis. After much discussion we decided it was a risk that offered us no benefit but potential heartache. Deciding on whether to abort a baby was going to be a difficult decision for us. Once we determined that we just took that test off our list. For those who do not know what this test is for, I can give you a short lecture. Amniocentesis uses a needle and syringe to draw fluid from around the growing baby to do genetic testing for congenital abnormalities.
This allows the prospective parents the possibility of an abortion should the unborn baby has a congenital condition.
What Information Is Available on Safety of Covid-19 Vaccines in Pregnancy?
Today’s pregnant women have to decide to get the Covid-19 vaccine not knowing if it can hurt the unborn child. At this time we know that 23 women who got the Pfizer vaccine became pregnant during the trial. The babies born to these individuals did not appear to have suffered any harm from the vaccine. This is reassuring but it is still not enough to to make clear recommendation on the vaccine in pregnant women. This is therefore a decision that every woman who finds herself in that situation would need to make. The American College of Obstetricians Gynecologist recommends that pregnant women be offered the vaccine based on their risk profiles.
To make that decision you may need to ask yourself whether your risk of contracting Covid-19 is high. That means an essential worker who cannot work from home will need to think more deeply about this. One other question is “what will happen if I get Covid-19 whilst pregnant? “. This question has no easy answer for the individual. On the population level though, over the past year many obstetricians have reported many cases of severe Covid-19 in pregnant women. These reports go counter to the overall trend that suggest more severe cases in men compared to women. What is becoming obvious is that pregnancy appears somehow to change the clinical course of Covid-19 in women. At this time most experts do not fully understand the science of Covid-19 in pregnancy. The fact that Covid-19 affects black and other minority women more than whites makes this problem even more concerning for our minority families.
What Is The Going Expert Opinion on Covid-19 Vaccination Among Pregnant and Lactating Mothers
In the light of all these issues many experts will suggest that women who are pregnant get the Covid-19 vaccine. This recommendation is even stronger when one is a healthcare worker or an essential worker and do not have the luxury of social distancing in the occupational setting. Our experts also encourage breastfeeding for lactating women who have received the vaccine. There are women who are still considering conception, in this group many are still unclear what advice to give. The recommendation for pregnant women is based on projected risk benefit analysis. In the case of lactation most believe the likelihood of any vaccine parts in breast milk to be very unlikely. However with women attempting conception the FDA will need to complete review of the Developmental and Reproductive Toxicity (DART) studies. This data was not available when the FDA reviewed the vaccines for issues the EUA.
To all my readers who are considering these questions I would suggest to always think about the baby first. The baby is very important because our children are the custodians of our future. We must do our very best to protect them from harm. The best protection for a baby will always be a healthy and strong mother. I would advice that our mothers protect themselves, this is because they are the best protection for the babies.
I would end by saying my sister, if you are pregnant or trying to get pregnant safeguard your health first with the Covid-19 vaccine. The course of a pregnancy can sometimes be unpredictable and you need all the preparation necessary.
By Dr. Leonard Sowah an Internal Medicine Physician in Baltimore, Maryland
