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University Health Q&A: COVID-19 vaccines and pregnancy

The latest recommendation is that pregnant women should get the vaccine.

SAN ANTONIO – Recommendations for pregnant women on the COVID-19 vaccine have been confusing, but Dr. Patrick Ramsey, medical director for inpatient OB services at University Health, explains the science behind it, how the vaccine is made, and why pregnant women should get the shot.

Q: The WHO recently reversed their recommendation that pregnant women not get the Moderna vaccine and took a similar position on the Pfizer vaccine. Why is that?

A: The World Health Organization did release a statement last week that they (had formerly) recommended pregnant women not receive the Moderna vaccine, and they reversed that mainly because they had a lot of pressure from other organizations -- the American College of Obstetricians and Gynecologists, the Society of Maternal Fetal Medicine -- basically kind of supporting that pregnant women are at risk for the COVID-19 infection and have higher risk for adverse outcomes. So, they basically changed their statement that we don’t believe the vaccine has any potential for harm -- although there is no data -- (and said) that pregnant women should be eligible to receive the vaccine. Basically, we just don’t have a lot of information about the safety, specifically, for pregnant women. The studies that were done in over 30,000 individuals worldwide for the Pfizer and Moderna vaccines didn’t include pregnant women for the most part, so we really don’t know safety in that specific population. We are planning a study here at University Hospital and UT Health to look at the Pfizer vaccine, so we’re excited to see what those results show.

Q: Even without a formal study, are there women who were pregnant and got the vaccine? Did they have adverse reactions?

A: There were a small number of women in the Pfizer study that were pregnant or became pregnant, and we haven’t seen any adverse outcomes in those women, and as you mentioned, there have been a lot of women who have received the vaccine who are pregnant or lactating and we have not seen any adverse outcomes for their pregnancy related to the vaccination.

Q: Should pregnant women get the COVID-19 vaccine anyway?

A: We are recommending that pregnant women do receive the COVID-19 vaccine, either Moderna or the Pfizer vaccine, or the other vaccines that are potentially coming out. And the reason for that is we know that pregnant women have a higher risk for complications in pregnancy, higher risk of getting more sick, higher risk of being in the intensive care unit, needing to be on a ventilator, and we really want to avoid those. So, the vaccine should be safe. We have no reason to believe this vaccine would cause any problems about the risk of having COVID-19 in pregnancy are substantial.

Q: Is the Pfizer or Moderna vaccine a live virus vaccine?

A: Neither the Pfizer nor the Moderna vaccine contain are a live virus vaccine. Basically, they are what’s called MRNA. It’s like giving your body a recipe to make a protein that is part of the virus that your body will respond to and make an immune response to give you protection, so, it’s not a live virus at all.

Q: Are pregnant women more likely to get COVID-19?

A: The good news is we’ve had almost a year of experience with COVID-19 to date worldwide, and we have learned that pregnant women have not appeared to be at higher risk to develop COVID-19 if they’re pregnant. So, that’s good news for women who are pregnant today.

Q: What are the risks to mother and baby from COVID-19?

A: We know from the mother’s standpoint there’s an increased risk chance of disease severity. Moms are more likely to have to go to the intensive care unit, have worse respiratory disease, potentially need to be intubated to support their life. But from the baby’s standpoint, we haven’t seen any clear evidence that there’s a higher risk of early delivery, adverse outcomes from the baby, itself, either while inside or after delivery. So, kind of a mixed blessing related to the effects of mom and baby.

Q: If a woman comes into University Hospital in labor and is COVID-positive, can a support person be with her?

A: If a woman is proven to be COVID-19 by testing when she comes in or comes in symptomatic of COVID-19, we allow for a support person to come into the Labor and Delivery Unit with her. That person, however, needs to stay in the room with her for the entire course of her hospitalization, and is not able to leave the hospital during her stay.

Q: If women give birth while they are COVID-positive, do they have to stay away from their babies?

A: We are able to keep mom with her baby if mom is COVID-19 positive. We make sure she uses the right precautions. She’s using a mask, uses hand sanitization to prevent any potential exposure to the baby. We know it’s very important to keep mom with baby in that post-partum period. So, we do everything we can to make that happen, even if she’s COVID-19 positive.

Q: Can COVID-positive mothers breastfeed?

A: Yes, it’s really important for mothers to consider breastfeeding. There’s lots of amazing benefits to breastfeeding. Giving babies immune protection against other diseases, including COVID-19. So, if mom is COVID-19 positive, we strongly encourage breastfeeding. But, again, mom will wear a mask, do hand sanitization before and after she breastfeeds, to make sure she minimizes the risk of her baby.

Q: What effect does the vaccine have on a woman’s fertility?

A: We have no evidence that the vaccine causes any problems for women to be able to get pregnant. Certainly, we will learn more about the vaccine as we have more experience over time. But today there is no suggestion that of any problems of patients be able to get pregnant after the vaccine.

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