Federal and local health officials say pregnant women should have the choice if they would like to be vaccinated for COVID-19 when a vaccine is available to them.
While more research is needed to determine potential effects of Pfizer and BioNTech’s COVID-19 vaccine on pregnant and breastfeeding individuals, health experts say there isn’t any known increased risk from the vaccine compared to non-pregnant individuals.
On Sunday, Dec. 13, the American College of Obstetricians and Gynecologists (ACOG) recommended the COVID-19 vaccine should not be withheld from pregnant or lactating individuals who meet criteria for vaccination based on the CDC’s recommended priority groups determined by the Advisory Committee on Immunization Practices.
Pfizer’s COVID-19 vaccine, which became the first to be granted emergency use authorization by the U.S. Food and Drug Administration, was not tested in pregnant women during the vaccine trials. However, 23 pregnancies occurred in trial participants and further surveillance is needed to determine possible effects.
The first available COVID-19 vaccine doesn’t include the actual live coronavirus. Instead, it’s made with messenger RNA, or mRNA, which instructs the body to make some harmless spike proteins to train the immune system to recognize and fight the real virus if it comes along. This type of vaccine does not enter the nucleus and does not alter human DNA in vaccine recipients, according to the ACOG. As a result, mRNA vaccines cannot cause genetic changes.
The Pfizer vaccine, which requires two doses 21 days apart, proved to be 95% effective at preventing COVID-19 disease in the trial’s more than 18,000 participants who received the vaccine, according to data from the FDA.
In West Michigan, Spectrum Health Dr. Russell Lampen said there’s no theoretical reason the COVID-19 vaccine would be dangerous for women who are pregnant or breastfeeding, or to a developing baby.
“They will have the option and certainly we’ll offer it to pregnant and breastfeeding women if they’re in an applicable group to get vaccinated,” Lampen said. “Conversely, pregnant women are at greater risk (of severe COVID-19 infection) so I think it’s important to offer it.”
According to the ACOG, pregnant women are at an increased risk of more severe illness if infected with COVID-19. Although the risk for severe COVID-19 is low, increased risk for ICU admission, need for ventilation, and death has been reported in pregnant women with symptomatic COVID-19.
Earlier this month, a 33-year-old mother died in Detroit after giving birth to her healthy son, her brother told KCBS-TV in Los Angeles. A native of Los Angeles, Erika Becerra was diagnosed with COVID-19 while eight months pregnant and living in Detroit. Her labor was induced on Nov. 15, and she was put on a ventilator after giving birth to a healthy son.
Becerra died 18 days after giving birth. Her family told KCBS-TV that she had no known underlying conditions. Her husband, 1-year-old daughter, and newborn son all tested negative.
Pregnant patients interested in getting the COVID-19 vaccine should review available information about the safety and efficacy of the vaccine and to consult their doctor, according to the ACOG. They should consider factors like the level of virus in the community, the potential efficacy of the vaccine, the risk and potential severity of maternal disease, including the effects of disease on the fetus and newborn, and the safety of the vaccine for the pregnant patient and the fetus.
“While a conversation with a clinician may be helpful, it should not be required prior to vaccination, as this may cause unnecessary barriers to access,” reads an ACOG advisory. “Pregnancy testing should not be a requirement prior to receiving Pfizer-BioNTech vaccine.”
As more doses of Pfizer’s COVID-19 vaccine become available to the general public in the coming months, the FDA hopes to know more about use of the vaccine in several “special population” groups including pregnant women and children.
Healthcare workers, as well as staff and residents of long-term care facilities, are the top priority group to receive vaccination first. They’ll be followed in 2021 by other non-health care essential workers and people with higher risk for severe COVID-19 illness.
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