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COVID-19 vaccine safety and pregnancy

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Now that COVID-19 vaccines are rolling out, expectant mothers have many questions about the benefits and possible risks involved in receiving the vaccine. When federal regulators approved the first two COVID-19 vaccines, they gave pregnant women the option to decide whether to get immunized.

If you’re pregnant, the best thing is to get more information so you can evaluate the risks and benefits of getting or not getting the COVID-19 vaccine. Some women are worried because there is not a lot of data about pregnant women and the type of vaccine being used for the COVID-19 vaccine.

However, national organizations such as the American College of Obstetrics and Gynecology, the U.S. Centers for Disease Control (CDC) and the Society for Maternal Fetal Medicine recommend that each person consider their own potential risk factors and discuss them with their OB provider. They agree that in most cases there is no reason for pregnant women to not receive the vaccine.

What factors might influence a pregnant woman’s decision to get the COVID-19 vaccine?
You’ll want to evaluate your own risk of contracting COVID-19. Talking with your OB provider can help you further evaluate your risk. You are at higher risk if you have lots of contact with people outside your home. For example, if you are a teacher or healthcare worker. You are also at more risk of getting COVID-19 if you are pregnant and over age 35 or are overweight, or have other medical conditions, or smoke or belong to a minority groups. Generally, the vaccine makes sense for women in those groups.

You’ll also want to look at the rate of COVID-19 in your local community. Utah’s positivity rates are fairly high right now. Most pregnant women in Utah communities should opt to have the vaccine when it’s available.

When people who are pregnant get COVID-19 they have a slightly higher risk of ending up in the ICU and having a severe case COVID-19. It makes sense to protect yourself. The COVID-19 vaccine is a critical part of how we end this pandemic. Intermountain Healthcare is committed to vaccinating as many people as possible.

If you’ve had a severe reaction to another vaccine you’ll want to talk about the risks and benefits of the vaccine with your OB provider.

Sean Esplin, MD, senior medical director of women’s health at Intermountain Healthcare says his patients who are pregnant have a wide spectrum of feelings about the vaccine. “Some are biased by misinformation they’ve heard about vaccines,” said Dr. Esplin. “For years, we’ve encouraged pregnant women to take other vaccines, such as for the flu, Tdap, etc.”

Were pregnant women included in the U.S. COVID-19 vaccine trials?
About 30 pregnant women were included in the U.S. trials for COVID-19 either because they didn’t know they were pregnant or they became pregnant after getting the first dose of the vaccine. Typically, pregnant women are not included in trials because it adds another variable and that can make it more difficult to separate out the results. The pregnant women in the trials didn’t have any unexpected side effects or problems. The vaccine seemed to work as effectively as in non-pregnant women.

Does it matter what trimester of your pregnancy you are in when you get the vaccine?
There is no evidence that women in their first or second trimester are at higher risk if they get the vaccine. It is OK to get pregnant after getting vaccine.

What type of vaccine is the COVID-19 vaccine? And how does it work?
This is an mRNA vaccine. Some other types of vaccines are made with a virus that has been killed. The COVID-19 vaccine contains pieces of mRNA, which is basically a recipe for making a protein. It is a very effective way to do a vaccine. It should be safe in pregnancy. It won’t cross the placenta or change MRNA code. It should protect both mom and baby.

Will pregnant women who get the vaccine be studied?
Future studies of the COVID-19 vaccine will include pregnant women. National registries are keeping track of data on pregnant women. We recommend pregnant women now be included in these trials and they continue to collect data.

What about the side effects of the COVID-19 vaccine?
If you get the vaccine, there could be side effects. “That’s normal and expected and it’s a sign the vaccine is working,” said Dr. Esplin. Side effects include a sore arm, body aches, fever, fatigue, headache. The vaccines currently available are 95 percent effective if you get both doses. “The efficacy is much more pronounced after the second dose. Be sure to get the second dose,” said Dr. Esplin.

If you get the vaccine do you still need to wear a mask and practice social distancing and good hand hygiene?
Yes. Getting the vaccine means you have a lower chance of getting the virus, but you can still get the virus. Getting the vaccine also means if you get the virus, your case is likely to be milder than if you didn’t get the vaccine. So wearing masks and practicing social distancing and good hand hygiene will further reduce your risk of getting COVID-19 and other viruses such as the flu or colds as well.

Where can women go for more information?
Talk with your OB provider. You can also visit intermountainhealthcare.org and websites for the CDC, American College of Obstetrics and Gynecology and the Society for Maternal Fetal Medicine.