Vaccination protects pregnant people and their babies from serious COVID

As a perinatal specialist, Jacqueline Parchem, an assistant professor at McGavan Medical College at the University of Texas Houston Health Science Center (UTHealth), cares for many people with high-risk pregnancies. However, before the COVID-19 pandemic, she has rarely seen the types of illnesses that have since become a devastating part of her practice. (ECMO) Machine. Temporarily replaces heart and lung function.

“I was training when the H1N1 pandemic happened, and that was the most similar time I can remember,” says Parchem. “This is an order of magnitude worse.”

Approximately 19 months after the COVID pandemic, there is increasing evidence that pregnant people are more vulnerable to more serious illnesses than the general population. Infection with COVID during pregnancy significantly increases the risk of death and some pregnancy-related complications.However, despite the increasing number of studies demonstrating COVID Vaccine is safe About during pregnancy 32 percent of pregnant people Ages 18-49 in the United States were fully vaccinated as of September 25. This figure suggests that “some data may be due to the delta mutation,” especially now. More serious illness As the CDC points out, more than previous variants of unvaccinated people. On September 29, the CDC issued a health recommendation that strongly recommends COVID-19 vaccination “pre-pregnancy or during pregnancy”, and the benefits of vaccination are potential risks for both pregnant people and their foets. I quoted evidence that it exceeds.

How COVID Affects Pregnant People

The medical community was closely watching this group early in the COVID pandemic, as previous outbreaks caused by other coronaviruses were particularly dangerous for pregnant individuals, said Fetal Medicine at the Oxford Maternal-Fetal Medicine Institute. Professor and Principal Investigator Aris Papageorghiou says at Oxford University.

However, tests were not widely available at the time, and it took scientists time to properly investigate the question. NS First small study In China, it has been suggested that pregnant people are not at increased risk of COVID, but larger studies have since begun to show that they are not.Analysis of women of reproductive age diagnosed with this disease shows that pregnant women are significantly More likely Be admitted to the intensive care unit (ICU) and receive more invasive ventilation than those who do not.

However, comparing pregnant and non-pregnant women does not give a complete picture of the effects of the virus on pregnancy. “Non-pregnant women do not have preterm birth or pre-eclampsia,” says Papageorghiou.To overcome that limitation, he and his colleagues in 18 countries conducted a cohort study to compare the results of pregnant people. With or without COVID.. They registered 706 pregnant women with COVID. For each of these subjects, about two other pregnant individuals without COVID were immediately recruited at the same medical center to form a comparative group with similar characteristics.

Pregnant women with COVID in this study had a 76% higher risk of developing pre-eclampsia (a pregnancy complication characterized by hypertension) and a 59% higher risk of preterm birth. They were five times more likely to be hospitalized in the ICU and 22 times more likely to die than those without COVID. Papageorghiou believes that these results helped to upset the balance between risk and benefit in favor of vaccination of pregnant individuals. “At the same time, there is evidence that vaccines are not dangerous and COVID during pregnancy is a significant burden,” he says.

Studies have also determined which risk factors make pregnant individuals More susceptible For severe COVID. Pregnant women over the age of 25 are at increased risk of being employed as health care workers or having underlying illnesses such as obesity, chronic lung disease, chronic hypertension, and diabetes, according to a study by the US Centers for Disease Control and Prevention. understood. ..

“Interestingly, we also found that the risk of serious COVID-19 increases with the number of underlying conditions, which information indicates the individual risk of pregnant people becoming infected with severe COVID-19. It can be helpful to understand, “said Romeo Galang, CDC’s obstetrician and gynecologist and lead author of the study.

The impact of COVID on pregnant people also varies from country to country, and inequality is widening. In Mexico Maternal mortality rate has increased According to a study coordinated by Genny Carrillo, an associate professor of public health at the University of Texas A & M, more than 60% of pandemics occurred during the year. Prior to that, maternal mortality was declining in this country. “Everyone was surprised at the number of pregnant women affected,” she says. In addition to deaths directly related to COVID, Carrillo says the disruption to medical services also contributed to the increase.

Delta Variant: “Alarm bell is actually ringing”

The currently predominant SARS-CoV-2 strain, the delta variant, appears to be particularly bad for pregnant people, said Linda Eckert, a professor of obstetrics and gynecology at the University of Washington. Preliminary data presented by the CDC during the Advisory Committee on Immunization and Implementation (ACIP) meeting on September 22 according to preliminary data. This year I was hospitalized in the ICU or died of COVID..

“Pregnant women’s mortality is the highest ever and is on the rise during a pandemic, so I think our alarm is really ringing about how dangerous COVID is for pregnant people. “Masu,” says Eckert, ACIP’s liaison for the American College of Obstetrics and Gynecology (ACOG).

By September 27, a total of 161 pregnant women had died from COVID, 22 of whom occurred in August alone, according to the CDC. “It represents the maximum number of deaths [in pregnant individuals] In a month of a pandemic, “says Galan.

How scientists know that vaccines are safe

Initially, there were few safety data for this group, as pregnant people were not included in the Phase 3 clinical trial of the COVID vaccine. ACOG’s first recommendation was that eligible pregnant individuals should make informed decisions with physicians who weigh the risks and benefits.

This scenario has changed. Preliminary real-world data RNA vaccines have been suggested to be safe for both pregnant people and the fetus. Data from more than 3,900 pregnant women who received these vaccines show no increased incidence of miscarriage, birth defects, or preterm birth. Another analysis did not show an increased risk for pregnant women who were vaccinated with more than 2,000 people.latest ACOG practice recommendations We currently recommend that all eligible people, including pregnant and lactating individuals, receive the COVID vaccine.

“Previously more cautious groups, such as the ACOG and the Maternal-Fetal Medicine Society, now believe that the information provided about safety actually alters calculus,” said department professor Sonya Rasmussen. increase. He holds a PhD in Pediatrics and Epidemiology from the University of Florida. father, Evidence suggests COVID antibodies in vaccinated people infect babies during pregnancy.

Low vaccination rate

Experts agree that the vaccination rate of 32% of pregnant people in the United States is incredibly low in the high-risk group (for comparison, 83.6% of people over the age of 65). Was completely vaccinated As of October 4th).

It is important to recognize that UTHealth’s Parchem can complicate decision making during pregnancy. “People are thinking about two people, so they are generally risk averse,” she says.

Parchem was pregnant with a third child last year. She was happy and relieved when the vaccine became available as a front-line healthcare provider. She says her confidence in her science and experience of seeing pregnant people getting sick of COVID made the decision to simplify the vaccine. But she remembers having to deal with strong reactions from people who thought the vaccine was dangerous.

“When people you know have this reaction to what you’re doing, it inserts doubts in your mind,” she says. “I had to take a step back and say,’Wait a minute, this is actually my exact area.’ [of expertise].. I was initially a scientist, a high-risk pregnancy expert, and have been in school for a very long time to help others make these decisions. I can make this decision myself. “

Parchem tries not to focus too much on the data whenever he talks to a patient at risk about vaccination. Instead, she admits that pregnancy is difficult to make decisions and focuses on how pregnant people not only protect themselves with vaccines, but also protect their babies. “No one is pregnant who prioritizes not protecting their baby, so I’m trying to focus on that message,” she says.

For Parchem, seeing a severely ill pregnant woman with COVID is even worse than in the early days of the pandemic because the disease is preventable. “I have a lot of regrets about not doing everything I can to protect myself and my baby and loved ones,” she says. “It’s devastating.”