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’s not alone.
According to a recent survey of approximately 18,000 women, more than half of pregnant participants said they would receive the COVID-19 vaccine if given the chance, an option not currently available to pregnant women in all 50 states.
However, this San Diego woman has a unique vantage point when it comes to discussion surrounding the vaccination of pregnant women — she is Dr. Rebecca Adami, a board-certified OBGYN and maternal-fetal medicine doctor affiliated with Sharp Mary Birch Hospital for Women & Newborns. Dr. Adami, who specializes in the care of women with high-risk pregnancies, chose — and was eligible — 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 women about the vaccine.
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 women 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 women 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 women 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. Now, COVID-19 vaccine manufacturers have begun to include pregnant women in vaccine trials, which will provide increased understanding of the effects of the vaccine on pregnant women and their infants.
So far, more than 30,000 pregnant women have received the Pfizer and Moderna vaccines, and no “red flags” have been identified through the V-safe after vaccination health checker system. However, longitudinal follow-up is ongoing. Until further information is available, the American College of Obstetricians and Gynecologists has come out with recommendations for vaccinating pregnant women.
What would you tell other pregnant women about receiving the COVID-19 vaccine?
When counseling women 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 women who are contemplating pregnancy to receive the vaccine prior to becoming pregnant. Otherwise, I encourage pregnant women to receive the vaccine after a discussion with their doctor of the risks of COVID-19 infection during pregnancy and the available data regarding vaccination during pregnancy. In San Diego, pregnant women will be eligible to receive the COVID-19 vaccine later this month, according to the county vaccination plan.
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 hope that soon the vaccine will be made available to all those who want to receive it.