Experts say COVID-19 vaccine should be offered to pregnant women
The American College of Obstetricians and Gynecologists says pregnant patients who meet Advisory Committee on Immunization Practices recommendations should be offered a COVID-19 vaccine.
The recommendation only applies to the current vaccines that have received an emergency use authorization (EUA) by the FDA, the organization said in a recent practice advisory.
Recent studies have shown symptomatic, pregnant patients with COVID-19 are at increased risk for more severe disease, ICU admission, mechanical ventilation and death than nonpregnant patients, according to William Hartman, MD, PhD, a principal investigator for AstraZeneca’s COVID-19 vaccine trial at the University of Wisconsin’s Madison campus and an assistant professor of anesthesiology.
He told Healio Primary Care that the lack of “established safety or effectiveness data on pregnant individuals” among the currently authorized vaccines should not deter health care professionals from offering them.
“Various vaccines have been safely administered to pregnant women without issues for decades,” Hartman said. “Further, the COVID-19 vaccines have proven to be safe and effective in nonpregnant individuals and the mRNA does not enter cell nuclei, so altering the individual’s genome does not occur.”
Kurt R. Wharton MD, FACOG, vice chair of obstetric operations and medical director of the Family Birth Center at Beaumont Hospitals – Royal Oak in Michigan and a professor at Oakland University’s William Beaumont School of Medicine, also said that COVID-19 vaccines can be safely administered in pregnant women.
“It is absolutely safe for the majority of women to receive a vaccine if they are pregnant, breastfeeding, or considering becoming pregnant in the immediate future as the majority of these women meet the criteria established by the Advisory Committee on Immunization Practices,” he told Healio Primary Care.
The advisory encourages, but does not require, pregnant patients and their health care teams to have discussions regarding the vaccine that cover “important” topics like:
- the level of activity of the virus in the community;
- the potential efficacy and safety of the vaccine; and
- the risk for and potential severity of maternal disease, including the adverse events that COVID-19 could have on the fetus and newborn.
Mary Jane Minkin, MD, clinical professor of obstetrics and gynecology at the Yale School of Medicine, acknowledged these conversations will be “difficult.”
“A physician would feel awful if a person got really sick from COVID,” Minkin said in an interview. “Pregnant women who refuse the vaccine should be supported in their decision, as there isn't a right or a wrong answer since there is really not a lot of literature on the topic available.”
According to the advisory, breastfeeding and nonbreastfeeding women alike should be offered the vaccine. Like Minkin, ACOG stated that pregnant patients who refuse the vaccine should be supported in their decision.