Pregnant women are worried about whether to get a coronavirus vaccine

The same challenge faces millions of women across the country. Among them are many healthcare professionals, such as Rivas, who have been provided with untested vaccines for pregnant or lactating women.

Jane Frederick, a fertility specialist in Newport Beach, California, said, “There is a lot of confusion. There are questions from those who are pregnant and those who are expecting to become pregnant.” Doctor, what should I do? Is it? “”

With the exception of the smallpox vaccine, which can cause rare but serious fetal infections, the vaccine is safe and very beneficial to pregnant women and their babies. Experts say that the safety of a new mRNA vaccine that does not contain a live virus is probably the same for pregnant and non-pregnant people. In addition, pregnant women face the potential for serious illness due to covid-19, which can increase the risk of preterm birth and other serious consequences for both mothers and babies. Experts also warn against bringing together two different biological stages of pregnancy and lactation.

The· Centers for Disease Control and Prevention Concluded “People who are pregnant and are part of a group recommended to receive the coronavirus vaccine, such as healthcare professionals, can opt for vaccination.” The CDC also said, “The mRNA vaccine is breastfeeding.” It is not considered a risk to the infant inside. “

The· American College of Obstetricians and Gynecologists Similarly, “[coronavirus] Vaccines should not be withheld from pregnant individuals who meet vaccination criteria. We also recommend providing vaccines to lactating women. However, ACOG adds that due to the lack of data, “the potential risks to pregnant individuals and the foetation are unknown.”

All of this leaves the process of weighing the strengths and weaknesses to the individual in consultation with the doctor.

Daryl Stoner, an obstetrician at Einstein Physicians Women’s Associates for Health Care on the outskirts of Philadelphia, said: “The medical community did a good job saying,’I don’t know.’ “It makes people crazy. They want to be told it’s safe.”

Questions arose in online pregnancy forums such as: What to expect“I’m definitely getting it” from a woman who says “I’m not at risk of putting my baby at risk” and from a woman who counseles others to wait for more data or a pandemic. There are various views, even medical professionals who declare that. Concerns are rising in some Facebook groups as vaccine opponents have expressed false concerns about many vaccines. Many are related to British policy Advice against Immunize pregnant women until more information about mRNA vaccines.

The various messages relate to many American vaccine professionals, such as Ruscalon, director of the Immunization Research Center at the Johns Hopkins Bloomberg School of Public Health. Ruscalon praised the way US regulators and groups of experts handled the situation and emphasized the need for more. the study.

From the beginning, “we and many others were drumming to think about pregnant women,” promoting the inclusion of pregnant women’s interest in developing vaccines against new pathogens such as Zika. Karon, the leader of the PREVENT project, said. , Ebola, and now covid-19.

Karron would have hoped that a toxicological study known as DART study focused on developmental and reproductive risk had previously been completed. The resulting information, along with initial safety data from non-pregnant individuals in clinical trials, can be reviewed by experts to determine how and when to formally evaluate the vaccine in pregnant women. I can do it.

Currently, there are a few data from a small number of women who became pregnant during clinical trials.Observation data will also be revealed when vaccinated pregnant women register V safeA CDC app that uses text and web research to check in to recipients of coronavirus vaccines.

Clinical trials in pregnant women and toddlers may begin earlier this year. Stephanie Go, an assistant professor of maternal-fetal medicine at the University of California, San Francisco Medical Center, who is studying the effects of covid-19 on pregnancy, says her team will begin research on vaccines during pregnancy and lactation. Said. Women in the coming weeks.

“There is a great deal of interest from healthcare professionals,” says Gaw. “‘Do you want my breast milk? Blood? How to evaluate my immune response?” “

Mary Praal, an assistant professor of pediatric infectious diseases at the University of California, San Francisco, who works with Go, said she would like to see parallel clinical trials of vaccines for pregnant women.

Praal, who is 14 weeks pregnant and will be vaccinated soon, said he was relieved to know that the vaccine was available because he had been studying covid-19 most of the year.

“I have no hesitation in myself,” Prahl said, admitting that if she advised the patient, she would experience potential risks and benefits.

“Everyone brings something different to the table,” she said.

The establishment of biomedicine has long excluded pregnant women from research. National Institute of Health Laboratory on women’s health Until 1990, the onset of gynecological symptoms of AIDS helped confirm the need to focus on women.

According to Ruth Faden, founder of the Johns Hopkins Berman Institute for Bioethics and a colleague of Karon on the PREVENT project, the combination of ethical concerns and liability continues to impede progress in clinical trials.

“It’s a serious fraud for pregnant women and their offspring to be late for the table and receive benefits,” Fadden said.

According to David Jaspan, chairman of the Department of Obstetrics and Gynecology at the Einstein Healthcare Network in Pennsylvania, he has come to the conclusion that obstetricians must rely on observational data for many treatments. New shot.

“I can’t comment on the safety of the vaccine. I can comment on the effects of Covid on pregnancy,” said Jaspan, who recently went with a pregnant healthcare professional who didn’t want to be the first recipient. I explained the conversation.

Such shared decisions are further complicated by large fluctuations in the situation of pregnant women. Women who work from home are at a lower risk of being exposed to the virus than, for example, workers in the food service industry in hospitals or those whose partners travel by public transport daily. Some pregnant women suffer from symptoms such as obesity and high blood pressure, and are more likely to have complications if infected with covid-19.

And pregnancy is a dynamic state, not only from the perspective of fetal development, but also because it has a beginning and an end. Women in the weeks leading up to childbirth may decide to delay vaccination and instead avoid exposure to the virus until the baby is born. birth.

In addition, women have a limited number of years of childbirth, and some feel that they are under pressure to become pregnant.

Frederick, a fertility specialist, The vaccine adds to the anxiety that many of her patients already feel.

“It’s a state of sensitivity to the time they have,” she said. “They need to continue treatment without delay, hoping that the pandemic will disappear.”

Frederick advised patients to close the clinic early in the pandemic and postpone treatment until more information about the coronavirus was known. But now she sees vaccines as a positive step and generally advises them that the benefits outweigh the risks.

“I think it’s a good protection,” Frederick said.

Healthcare providers and their patients should expect the evolution of knowledge and their own situation, Jaspan said.

“If they decide no today, they can decide yes tomorrow,” he said. “And that’s okay.”