Episode 15: Pregnancy & Breastfeeding during a COVID-19 Surge feat. Dr. Rahul D'Mello

Episode 15,  Sep 03, 03:00 PM

ACOG COVID-19 in Pregnancy and Breastfeeding Patient Page: https://www.acog.org/womens-health/faqs/coronavirus-covid-19-pregnancy-and-breastfeeding

CDC Website on COVID-19 Vaccine in Pregnancy and Breastfeeding: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html

Q1: How do we know the COVID-19 vaccines are safe?

A1:  The COVID-19 vaccines have undergone rigorous safety testing. The vaccines were authorized for emergency use by the FDA after clinical trials from around the world revealed the vaccines to be safe and effective in preventing infections, hospitalizations, and deaths from COVID-19.

Q2: Is it safe to get vaccinated if you want to have children now or in the future?

A2: Yes, there is no evidence that indicates the vaccines cause infertility in men or women.

None of the three vaccines authorized for emergency use in the U.S. change people’s DNA or interact with the organs necessary for reproduction, like the brain and the reproductive system, so they will not cause infertility in anyone.

People who are thinking about having children can get the vaccine as an effective way to prevent infection and complications caused by COVID-19 during pregnancy. It is not necessary to avoid getting pregnant after getting vaccinated against COVID-19.

Q3: Is it true that the fetus can develop COVID-19 antibodies if you get vaccinated during your pregnancy?

A3: In general, mothers pass antibodies to their babies during pregnancy, which protect them against diseases in the early months of life when they have no antibodies of their own.

Recent reports from the CDC have shown that people who have received one of the mRNA vaccines during pregnancy (especially during the third trimester) similarly can transmit antibodies to their fetuses, which may help protect them after they are born.

Q4: How dangerous is it for a pregnant woman to contract COVID-19?

A4: People who are currently pregnant or who were recently pregnant are more likely to get severely ill with COVID-19 compared to non-pregnant people. Severe illness during pregnancy can be avoided by getting fully vaccinated. 

In recent weeks, infections among pregnant people have been increasing, and in combination with the low rates of vaccinations in pregnant people, the highly transmissible Delta variant, and complications from COVID-19 during pregnancy the call for pregnant people to protect themselves and their pregnancies could not be more urgent. 

Risks to pregnant people who become infected with COVID-19 can include hospitalization, intensive care, the use of respirators or special equipment for breathing, or in the worst cases, death. Furthermore, pregnant people who have COVID-19 also have a higher risk of preterm birth.

Q5: Is there any risk for breastfeeding women who would like to get the COVID-19 vaccine?

A5: No. Current data from the CDC demonstrate that breastfeeding people who have been vaccinated with an mRNA vaccine have antibodies in their breast milk, which can help to protect their babies. 

Although the information about the COVID-19 vaccine’s interaction in people who are breastfeeding is still limited, the COVID-19 vaccines are not considered a risk for people who are breastfeeding, nor for their nursing babies because the vaccines do not contain a live virus or alter people’s DNA.

Q6: If pregnant people or nursing mothers decide not to get the vaccine right now, what can they do to keep themselves and their babies safe?

A6: We recommend that pregnant people and nursing mothers talk with their doctor and clear any doubts or worries they might have about the vaccines. Every person is different and there are different considerations when making a decision. 

If you are pregnant and have decided not to receive or complete the COVID-19 vaccine series, we recommend that you continue abiding by preventive measures to prevent infection:

  • Wear a mask in public places. Consider double-masking in indoor public places.
  • Don’t gather in large groups.
  • Maintain physical distance from people you do not live with.
  • Wash your hands.
  • Use disinfectants.

Q7: In recent weeks, infections among pregnant people have been increasing. Why is this?

A7:  With the combination of low rates of vaccinations in pregnant people, the spread of the highly transmissible Delta variant and the higher risk of complications from COVID-19 during pregnancy — the call for pregnant people to protect themselves and their pregnancies is urgent.

Q8: What did the new data reveal?

A8: In a new analysis of the latest data from the V-safe pregnancy registry — which collects health information from people who received COVID-19 vaccination in the periconception period or during pregnancy — scientists did not find an increased risk for miscarriage among people who received an mRNA COVID-19 vaccine before 20 weeks of pregnancy.

  • Previously, preliminary safety data from three safety monitoring systems on vaccinations late in pregnancy were reassuring, but data from people  vaccinated during early pregnancy were lacking. These new findings, which showed no increased risk of miscarriage after receiving an mRNA vaccine before 20 weeks of pregnancy, helped to fill that gap in knowledge.

  • Growing evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy demonstrates that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks.

Q9: Is the rate of miscarriage concerning?

A9: No. The miscarriage rates after receiving an mRNA COVID-19 vaccine are within the range seen in previous studies of pregnant women who never received a COVID-19 vaccine (11–16%). The latest data do not suggest an increased risk of miscarriage after receiving an mRNA COVID-19 vaccine.

Q10: So, the vaccines are working as expected?

That's right! The most recent report we have from the CDC that followed people 65 and older hospitalized for COVID-19 in Oregon showed that:

  • The Pfizer and Moderna vaccines were 91-96% effective in reducing the risk of hospitalization.
  • And, the Johnson and Johnson vaccine was 84-85% effective in reducing the risk of hospitalization.
  • In other words, vaccines save lives.