Although there is very little data on how pregnant and breastfeeding mothers will respond to a COVID-19 vaccine, professional organizations and individual doctors say that the benefits are very likely to outweigh the risks.
Pregnant women seem to have the same chances of catching COVID-19 as anyone else. But I can do worse if I do.
According to a November study by the U.S. Centers for Disease Control and Prevention, pregnant women are more likely to be admitted to an intensive care unit, reach a ventilator, and die of COVID-19 than women who are pregnant. same age. and health status that are not pregnant.
To date, none of the large clinical trials with vaccines have included pregnant or breastfeeding mothers, which is “incredibly disappointing,” said Dr. Geeta Krishna Swamy, an obstetrician / gynecologist at Duke Medical Center who helped write. vaccination guidelines for Americans. College of Obstetricians and Gynecologists (ACOG).
Pfizer and BioNTech, which make the first vaccine approved for use in the United States, say they are testing animals to ensure their safety before starting studies in pregnant women early next year. Moderna, whose vaccine was approved this week, has completed toxicology studies in rats, and a review by the Food and Drug Administration has concluded that it is not harmful to fetal reproduction or development.
Swamy, who was vaccinated Monday, said data from both vaccines assured her that unless a woman is able to isolate herself at home during pregnancy, the known risks of catching COVID-19 are likely to outweigh the theoretical risk. vaccination. The vaccine has proven to be safe, she said, and “is probably one of the most effective vaccines I’ve ever had.”
The risk, Swamy said, “can never be zero without data,” but so far there is nothing to suggest that pregnant women and their unborn children will not be safe.
Most people will not have access to the vaccine for months because the vaccine is produced, there will probably be more data until most pregnant women have access to a vaccine.
But a large percentage of first-line health care staff are women of childbearing age and are therefore facing this decision right now, being the first group of people to receive the vaccine.
“Personally, I feel comfortable recommending to those women that the risk-benefit balance suggests that you should get vaccinated,” Swamy said. “If a woman says I don’t want to get vaccinated, I think it’s absolutely, positively her choice, just as it’s her choice to get vaccinated.”
Swamy said he has even less to worry about vaccinating nursing mothers. For the vaccine to harm a breastfed baby, she said, it should pass from one arm into the breast tissue and then into breast milk and then be digested by the baby. “This is an important task that we are asking the vaccine to do,” she said. “The vaccine doesn’t work if you swallow it.”
The Academy of Breastfeeding Medicine shares its comfort with the COVID-19 vaccine for breastfeeding women, writing in their new guidelines that a vaccine “would be unlikely to have biological effects” on a breastfed infant.
A woman who is vaccinated during pregnancy is likely to provide at least protection to her unborn child, with protection that probably lasts several months after birth, Swamy said. Breast milk supplementation probably provides even long-lasting antibodies.
Both vaccines had a similar safety and efficacy of over 94% in large clinical trials that intentionally excluded pregnant women, although 23 women in the Pfizer-BioNTech study and 13 in Moderna remained pregnant during the study. These groups were too small to judge safety or efficacy, and anyone who became pregnant after the first shot did not receive a second.
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The guidelines of the group of obstetricians and gynecologists conclude that, in the absence of specific data, a pregnant woman should make an individual decision on vaccination. “ACOG recommends that COVID-19 vaccines not be withheld from pregnant women,” the guidelines say. Breastfeeding women should also have access to the vaccine, according to the group.
Pregnant women, the guidelines suggest, should base their decision in part on how much virus circulates in their community, as well as on the risks of COVID-19 infection. A conversation with a clinician may be helpful, according to the guidelines, “but should not be required prior to vaccination, as this may cause unnecessary barriers to access.”
A study from the University of California, San Francisco, which followed pregnant women after testing positive for COVID-19, found that a quarter continued to have symptoms of the disease for eight or more weeks.
COVID-19 infection can also bring an increased risk of premature birth, said Dr. Denise Jamieson, chief gynecologist and obstetrician for Emory Healthcare in Atlanta.
There are probably 10-15 cases reported in the scientific literature in which a baby born to a woman with COVID-19 gave positive results for the disease at birth, she said in an hour-long internet broadcast offered Wednesday by the American College of Medical Toxicology.
COVID-19 is unlikely to pass through breast milk, Jamieson said. “I think in terms of our messages, it’s safe to breastfeed … There are benefits of breastfeeding that probably outweigh any small risks of transmission.”
The government’s V-safe monitoring system, designed to track vaccine results, will specifically target pregnant women, Jamieson added, “so we should know sooner.”
Contact Karen Weintraub at [email protected]
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This article originally appeared in the USA TODAY: COVID vaccine, pregnancy: the benefits probably outweigh the risks for women