As COVID-19 vaccines became available in the U.S., one local pregnant woman says she was more concerned that she would be denied COVID-19 vaccination than she was about any potential risk in receiving the vaccine. And she wasn’t alone.
When the COVID-19 vaccines were first offered to the general public, pregnant individuals were not eligible to receive the vaccine in all 50 U.S. states. And some care providers were unsure about whether to recommend the vaccine to their pregnant patients, as data were limited at that time.
That all changed recently, however, when the Centers for Disease Control and Prevention (CDC) released new data on the safety of the COVID-19 vaccines in pregnant people, and announced its urgent recommendation that all people age 12 and older get vaccinated against COVID-19, including all pregnant people, people who are trying to or may become pregnant, and those who are breastfeeding.
A unique vantage point
This San Diego woman is not surprised by these findings. As a board-certified OBGYN and maternal-fetal medicine doctor affiliated with Sharp Mary Birch Hospital for Women & Newborns, Dr. Rebecca Adami has a unique vantage point when it comes to the discussion surrounding the vaccination of pregnant people.
She is well aware of the severe risks of COVID-19 during pregnancy, especially as the highly contagious delta variant continues to spread across the country. And Dr. Adami, who specializes in the care of people with high-risk pregnancies, recognizes that the benefits of receiving a COVID-19 vaccine for pregnant people outweigh any known or potential risks, which is why she chose to receive the COVID-19 vaccine in the first trimester of her pregnancy.
Dr. Adami answers a few questions about her decision to get the COVID-19 vaccine, and how she counsels other pregnant individuals about their choice to be vaccinated.
Did you have concerns about receiving the COVID-19 vaccine while pregnant?
Like anyone else, I wanted to make an informed decision regarding getting the vaccine. After seeing the data from the FDA advisory committee meetings for the vaccines, I really had no concerns about getting vaccinated.
However, I have pregnant friends who worried about the vaccine’s side effects, especially the possibility of having a fever after receiving the vaccine, given the increased risk of birth defects due to fever in the first trimester of pregnancy. While the risk of a fever above 100.4° F is approximately 1% to 15% after vaccination, acetaminophen is thought to be safe in pregnancy and can reduce or eliminate a fever, should one develop. To me, the risk of COVID-19 infection during pregnancy outweighed the potential for mild fever due to the vaccine, especially seeing that the fever can be treated with over-the-counter medication.
Other reported vaccine side effects — mild nausea, headache and fatigue — are some of the same symptoms you might expect from being pregnant. These probably increased slightly when I received the vaccine but didn’t prevent me from working.
How did your knowledge and experience as an OBGYN inform your decision to be vaccinated?
We know that most pregnant people with COVID-19 will have relatively mild symptoms or may even be asymptomatic (without symptoms); however, about 5% will become severely ill. Studies have shown that pregnant people who become infected with COVID-19 are more likely to require hospitalization, intubation, heart and lung support, and are more likely to die than non-pregnant people of the same age.
Additionally, we are still learning about the effects of COVID-19 infection during pregnancy on the fetus, especially if the infection occurs in the first and second trimesters. We know there is a significant association between COVID-19 and preterm delivery and NICU admission, as well as a possible increased risk of stillbirth.
Seeing the effects of the virus firsthand and the toll it can take has given me a great appreciation for the hard work that went into making the vaccine in such an expedited fashion.
What would you tell other pregnant people about receiving the COVID-19 vaccine?
When counseling patients about the COVID-19 vaccines, I start by explaining how they work. COVID-19 vaccines help our bodies develop immunity to the coronavirus that causes COVID-19 without the possibility of infection because no live virus is involved.
The COVID-19 vaccines currently available — the two mRNA vaccines manufactured by Pfizer and Moderna, and the adenovirus viral vector vaccine produced by Johnson & Johnson — work in different ways to offer protection, but with all three, the body is left with a supply of “memory cells” that will remember how to fight the live virus if it is encountered in the future.
If they have the opportunity, I encourage people who are contemplating pregnancy to receive the vaccine prior to becoming pregnant. Otherwise, I encourage pregnant people to discuss with their doctor the risks of COVID-19 infection during pregnancy and the available data regarding vaccination during pregnancy .
I feel so incredibly fortunate that vaccination was offered to me when, as a health care provider, I became eligible late last year. I am extremely grateful to have had the opportunity to be vaccinated, and I join the CDC in encouraging everyone, including those who are pregnant, to get the COVID-19 vaccine.