We live in a society that has been called the “Instant Culture;” everyone wants instant gratification. But it’s ironic that when we are provided with the solution to the COVID-19 pandemic, the majority are very slow to embrace it or not adapt it at all. The simple answer for the majority of us is it to get vaccinated.
The answer to a pregnant patient is not so simple. The obstetrics world is a unique one in the medical field. Most studies on new medications/vaccinations will exclude pregnant patients due to the possible risks to the baby. The American College of Obstetrics and Gynecology (ACOG) aggressively lobbied from the beginning to have pregnant patients included in the studies, but this didn’t occur. ACOG highly encouraged its members to recommend the vaccine to pregnant patients since the biological mechanism of the available vaccines have no plausible way to directly affect pregnancy while the risks of contracting the disease can be severe.
Recently, many more organizations including Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics, Society for Maternal Fetal Medicine (SMFM) and American Society for Reproductive Medicine (ASRM) have recommended the COVID-19 vaccine for women who are pregnant, recently pregnant, planning a pregnancy, or may become pregnant in the near future.
Most pregnant patients are young and the absolute risk of COVID-19 to them is low, but pregnancy itself is associated with an increased risk for maternal severe illness, ICU admission, mechanical ventilation, and death. The risks also increase in pregnant patients with known underlying health conditions (diabetes, obesity, increasing age and cardiovascular disease). To date, there have been a total of 21,823 hospitalized pregnant patients due to COVID-19, an increasing number of pregnant patients requiring ICU admission and a total of 159 deaths in pregnant patients.
Now we have enough body of evidence that showed: No evidence of adverse maternal or fetal effects from vaccinating pregnant patients. None of the COVID-19 vaccines available for use cause infertility. There is no increased risk of miscarriage with vaccine use. No evidence for pregnancy complications such as preterm birth (before 37 weeks), babies born smaller than expected, stillbirth or neonatal death. No evidence that the vaccine enters the breastmilk; even if it did, the vaccine components will be destroyed in the baby’s stomach. Therefore, vaccination is safe during breastfeeding.
Personally, I received the vaccine in the early days of COVID-19 vaccine rollout, my wife and my daughter received the vaccine when it became available to them. I will be getting my booster shot in the next few days. I highly recommend and encourage my patients to receive the vaccine. Will my patients have side effects from the vaccine? Most likely they will. These side effects are a sign that the immune system is reacting to the vaccine and developing antibodies to protect against COVID-19 illness. Pain at the injection site, fever, muscle pain, joint pain, headaches, and fatigue are common side effects. ACOG recommends that acetaminophen is used for pregnant women who experience fever or other side effects. Further, I also encourage pregnant patients who get vaccinated to sign up for the CDC’s v-safe safety monitoring program.
Please get vaccinated! It’s the right thing to do for your own benefit, your baby’s safety, your children, your family, and your community at large.
Dr. Bassel Eid, MD, FACOG, is Director of Obstetric Services at Eastern Iowa Health Center in Cedar Rapids. An OB/GYN, he speaks fluent English and Arabic and specializes in minimally invasive surgery and high-risk pregnancy.