Pregnant people in the US are in prioritized groups for vaccination in many states, and yet many aren’t sure they want to sign up.
On the one hand, we don’t yet have clinical trial data demonstrating the shots’ safety and efficacy in the pregnant population, and (scientifically inaccurate) theories have swirled linking the vaccine in pregnancy to ill effects like infertility.
Dr. Jessica Shepherd, an OB-GYN and minimally invasive surgeon serves as the chief medical officer of VeryWell Health
Dr. Jessica Madden, a pediatrician and neonatologist, serves as medical director of Aeroflow Breastpumps
They talked about why they highly recommend the vaccines in pregnant women, as well as those who are breastfeeding or trying to conceive; whether there’s an ideal time in pregnancy to get the shot; what potential long-term risks of the vaccine might be; whether one of the vaccines may be better for pregnant women than others; and more.
Pregnant people who get the COVID-19 vaccine seem to pass vaccine-generated antibodies to their babies in utero and through breastmilk, potentially offering the newborns protection from the virus when they’re most vulnerable.
The results, which come from several studies that have yet to be peer-reviewed, help tip the scale in favor of vaccines in pregnancy – something researchers are just beginning to assess in clinical trials.
The studies found antibodies in umbilical cord blood and breastmilk
In one preprint, researchers looked at 131 vaccinated women – 84 were pregnant and 31 were lactating. They tested their blood, umbilical cord blood, and breastmilk for COVID-19 antibodies after both vaccine doses, and again two to six weeks after the second one. (All women received either the Pfizer or Moderna vaccine.)
They found pregnant people had just as robust an immune response as their non-pregnant counterparts, and that umbilical cord blood and breastmilk samples contained vaccine-generated antibodies. They also found moms who got the vaccine were better protected against COVID-19 than those who developed antibodies after being infected with the virus.
When comparing the Moderna to the Pfizer vaccine, the study authors found Moderna’s gave moms a bigger boost of one type of antibody, and the bump from Pfizer’s vaccine was less robust. That could have to do with the differences in length of time between doses. More research is needed to understand if one vaccine is better than others in pregnancy.
In another study out of Israel, researchers looked at 20 moms and their babies who received both vaccine doses within about a month of delivery. They all had antibodies in their blood and umbilical cord blood. The more recently they’d gotten their vaccines, the stronger the immune response.
“Getting the vaccine later in pregnancy can better guarantee antibody protection to babies via both the placenta and mothers’ breast milk,” Dr. Jessica Madden, a pediatrician and neonatologist who serves as medical director of Aeroflow Breastpumps, previously told Insider.
Even getting a single dose of the vaccine before delivery can help, one case study showed. In it, doctors detailed how a baby born three weeks after her mom’s first dose of the Moderna vaccine had antibodies generated from the shot.
We don’t yet have rigorous data on the COVID-19 vaccine in pregnancy
The findings aren’t especially surprising, as other vaccines like for the flu are recommended in pregnancy to protect both mom and baby.
But there’s still a lot to learn about how strong and long-lasting vaccine-generated protection from COVID-19 is in babies, and clinical trials are evaluating the safety and efficacy of getting the shot while pregnant, though experts believe they’re safe.
“Based on how the [Pfizer and Moderna] COVID vaccine works, there should be very little risk to a developing baby,” Madden said.
Harvard experts say the Johnson and Johnson vaccine, which is not made from mRNA but rather a harmless form of the common cold virus called adenovirus, should be safe in pregnancy too, though clinical trials still need to be conducted.
NARAL Pro-Choice America president Ilyse Hogue said in a recent Daily Beast podcast interview the organization is working to protect women’s reproductive rights with a deeply conservative Supreme Court in place.
In a discussion with editor-at-large Molly Jong-Fast, Hogue discussed Roe v. Wade, the 1973 Supreme Court decision that legalized abortion in the US and afforded women a constitutional right to the procedure.
“A lot of our work over the last few years has been about making sure that we have what we call islands of access — blue states that are codifying the right to abortion, making sure that we have like practice in place where women can go,” Hogue said.
For decades, conservatives have sought to overturn the ruling, but lacked a lopsided majority on the Supreme Court, one that they now possess with the installation of Judges Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett to the court.
NARAL Pro-Choice America president Ilyse Hogue said in a recent Daily Beast podcast interview that the organization is working to protect women’s reproductive rights in the wake of a sharply conservative Supreme Court that came to fruition during President Donald Trump’s tenure.
During an episode of “The New Abnormal” featuring editor-at-large Molly Jong-Fast, the discussion about women’s healthcare landed on Roe v. Wade, the 1973 Supreme Court decision that legalized abortion in the US and afforded women a constitutional right to the procedure. For decades, conservatives have sought to overturn the ruling, but lacked a lopsided majority on the Supreme Court, one that they now possess with the installation of Judges Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett to the court.
Jong-Fast suggested the US could “really lose Roe,” which Hogue further expanded on.
“We absolutely could, and we’re certainly preparing with our partners in the movement for that,” Hogue said. “A lot of our work over the last few years has been about making sure that we have what we call islands of access – blue states that are codifying the right to abortion, making sure that we have like practice in place where women can go.”
She added: “And at the same time, we have to walk and chew gum.”
While the Gorsuch and Kavanaugh nominations left a 5-4 conservative edge on the court, Associate Justice Ruth Bader Ginsburg’s death in September 2020 further reduced the liberal wing’s impact on the court. Trump quickly nominated Barrett to replace Ginsburg, a longtime feminist judicial icon, with the Senate confirming the nomination only days before the November election.
Trump has opposed women’s reproductive rights, from re-enacting the Mexico City policy, a global gag rule that blocks US funding for non-governmental organizations that perform abortions or give abortion referrals, to appointing legions of anti-choice judges to the federal bench.
With the election victory of President-elect Joe Biden and Vice President-elect Kamala Harris, NARAL will soon have allies in the White House once again, but Hogue stressed that a lot of work still has to be done, including Biden rescinding the Mexico City policy.
When Jong-Fast suggested Biden’s administration could include “women’s health czar,” Hogue said she’d support such a move.
“It would send such a clear message that that terrible era that Trump ushered in is over,” she said.
Hogue said the anti-choice pieces of legislation championed by Trump and Vice President Mike Pence were rooted in control.
“It has always been about targeting women and women of color,” she said. “And it’s always been about forcing women to adhere to a very narrow period view of where they think our role in society is.”
A now-blocked Facebook post that went viral claimed the coronavirus vaccine could cause infertility.
It suggested incorrectly that the vaccine teaches the body to attack a protein involved in placental development.
In reality, the protein the vaccine spurs the body to make and attack bears little resemblance to the one in the placenta.
Although data is still lacking as to how the coronavirus vaccine works in pregnant women, experts expect it to be safe and say that women who are pregnant or of childbearing age should be able to get it if they want.
A post that was circulating on social media falsely claimed that Pfizer’s new coronavirus vaccine could cause infertility in women. The vaccine is “female sterilization,” an image in the post said, incorrectly attributing the myth to the “head of Pfizer research.”
The post, which has since been blocked by Facebook as “false information,” promoted an incorrect idea that the vaccine spurs the immune system to attack both a protein in the coronavirus and also a protein involved in the formation of the placenta – the organ that delivers oxygen and nutrients to the fetus during pregnancy.
But experts say there’s no evidence the vaccine could lead to infertility.
“Based on the way it’s made, it should be safe,” Dr. Zaher Merhi, an OB-GYN, reproductive endocrinology and infertility specialist, and the founder of Rejuvenating Fertility Center, told Insider.
The protein the vaccine teaches the body to fend off is not the same as the one involved in placental formation
According to USA Today, the post, written by an unidentifiable author, said: “The vaccine contains a spike protein (see image) called syncytin-1, vital for the formation of the human placenta in women.”
“If the vaccine works so that we form an immune response AGAINST the spike protein, we are also training the female body to attack syncytin-1, which could lead to infertility for an unspecified duration.”
That’s not true. First, the vaccine does not contain syncytin-1, but rather mRNA: genetic instructions that spur the body to produce, and therefore recognize, the unique spike protein that the novel coronavirus uses to latch onto cells.
While it’s true that syncytin-1 and the coronavirus’s spike protein share a small amino acid sequence, they are not interchangeable.
“It has been incorrectly suggested that COVID-19 vaccines will cause infertility because of a shared amino acid sequence in the spike protein of SARS-CoV-2 and a placental protein,” Pfizer spokeswoman Jerica Pitts said in an email to the Associated Press. “The sequence, however, is too short to plausibly give rise to autoimmunity.”
The theory also suggests that syncytin-1 is the one and only protein important for placental development, but it’s more complicated than that. A sibling protein, syncytin-2, for instance, helps prevent the mother’s immune system from attacking the fetus.
Plus, the vaccine prompts the body to produce antibodies very similar to the natural ones produced in response to infection. If those antibodies attacked the placenta, we’d to see high rates of placental complications and miscarriages among the more than 44,000 pregnant women who’ve gotten the coronavirus, Dr. Mary Jane Minkin, clinical professor of obstetrics and gynecology at Yale School of Medicine, told USA TODAY.
Pregnant women and those who may become pregnant can get the vaccine if they want to
Pregnant women were excluded from clinical trials, so we don’t know the real-world effects of the vaccine in that population. But experts say it should be safe, since the vaccine, like the flu vaccine, does not contain live virus.
The mRNA is “not going to be able to enter the cell of the baby and cause any problem, mechanistically speaking,” Merhi told Business Insider.
The organization, along with the Centers for Disease Control and Prevention and the Food and Drug Administration, says pregnant women who want the vaccine should be able to get it.
People who are in prioritized vaccination groups and are actively trying to become pregnant or are contemplating pregnancy should also get vaccinated, ACOG says. There’s no need to delay pregnancy after getting the vaccine, according to the group.
Getting COVID-19 while pregnant puts people at a higher risk of being admitted to the intensive-care unit, needing ventilators or life support, and dying than patients who aren’t pregnant, according to a November CDC report. So Dr. Rahul Gupta, chief medical and health officer at March of Dimes, previously told Insider anyone who could get pregnant should be a top priority for vaccination.
“We’ve got to make sure we make an active effort … to ensure that childbearing-age women, especially minorities, are able to get the vaccine even before they get pregnant,” he said.