For pregnant people, the deployment of the COVID-19 vaccine raises painful questions about whether vaccination is safer and at risk of infection.in spite of New evidence Vaccines are generally safe and effective, but even if the risk of complications from the disease is high, there is virtually no data on whether it applies to the person you expect.
Regulators around the world may give inconsistent advice on pregnancy and the COVID-19 vaccine. Centers for Disease Control and Prevention (CDC) Said The vaccine should be made available to pregnant people, but ultimately it is up to the pregnant parent and his doctor to make the decision. World Health Organization (WHO) Recommended Against it, unless the pregnant person is at high risk.
So how does someone make an evidence-based decision as to whether vaccination is safe in the absence of safety data? “It all turns on the characteristics of your life,” says Ruth Faden, Founder of the Johns Hopkins Berman Institute for Bioethics, Maryland.What each person needs to balance is Vaccines are known for being known about their own risk of getting infected.
Experts suggest discussing Let’s take a look at these decisions with healthcare providers, the facts available here, what is still organized, and why there is reason to be optimistic.
What we know about past vaccines
Scientists generally know quite a lot about vaccines and pregnancy, but historically it took longer to get evidence than general safety data. Pregnant people are usually required to obtain drug or vaccine approval due to the ethical complexity of pregnancy (parents and their foetation face interrelated risks) and the risk of liability. Excluded from randomized clinical trials.
In the past, it has taken years since the vaccine was approved for general use, it took years to collect enough data to show how it works during pregnancy. Many of these follow-up studies are observational and have a small number of participants. As a result, pregnant women may hesitate to vaccinate and doctors may postpone their recommendations.
“What happened was decades that were inherently unfair to pregnant women,” he said. Pregnancy Research Ethics (PREVENT) Project for Vaccines, Epidemics, and New Technologies.. While it may make sense not to include pregnant parents in early trials, she states that she “has protected pregnant women to death.”
However, scientists have accumulated indisputable evidence that certain vaccines are safe, effective, and in some cases urgently needed. CDC today I strongly recommend it Pregnant people get flu shot Causes serious complications in pregnant women.. Medical professionals also recommend vaccination against whooping cough (or whooping cough), which can be fatal to newborns. Pregnant women can also be vaccinated against several other illnesses, such as hepatitis and meningitis.
The lessons from these vaccines show that there is no reason to worry about the types of shots that use inactivated viruses to elicit an immune response. Because they cannot infect parents or babies. Jita Swami, Associate Professor of Obstetrics and Gynecology, Duke University School of Medicine, North Carolina, and a leader in maternal vaccination.
On the other hand, vaccines using small amounts of live viruses such as measles, mumps, rubella, and chickenpox can cause mild infections that some scientists fear may harm the foetation. There is. But Swami says it is “still based on theoretical risk concerns” rather than evidence that it has happened.
What is the difference between COVID-19 vaccines
Moderna and Pfizer-BioNTech vaccines for COVID-19 pose new challenges. Until now, the messenger RNA platforms they use have not been licensed for human use. As such, the only pregnancy-related data available are from preclinical studies in laboratory animals and from a small number of clinical trial participants who later discovered that they were pregnant. (((This is the latest information on the COVID-19 vaccine..)
But we know a fair amount How mRNA technology works.. Instead of using inactivated or live viruses, these vaccines contain fragments of the genetic code that are wrapped in lipids or fat globules to prevent code degradation. Upon infusion, the mRNA directs the cell to produce the SARS-CoV-2 peplomer. This causes the body’s immune response.
Theoretically, like past vaccines, all of this is promising because no live virus is involved. “Everything that is understood to be biologically applicable to mRNA vaccines is incredibly reassuring,” says Faden. “It should not affect pregnancy or the outcome of pregnancy.”
Anthony Fauci, Chief Medical Advisor of the White House Said again “There is no danger signal so far” in the data of pregnant people.
Still, scientists are questioning how mRNA vaccines actually work. The biggest concern is whether mRNA can cross the placenta and produce spike proteins in the foetation. If so, it is not necessarily harmful and will not cause birth defects, but the concern is that the foetation may experience side effects, including pain, swelling, and fever. Swami says animal studies have shown no signs of physical side effects, but they have not yet been tested in humans.
Mother’s side effects can also be a problem. Christina ChambersPerinatal epidemiologists at the University of California, San Diego are studying pregnant women vaccinated with COVID-19. She states that if a pregnant woman has a high fever, it can harm her baby. “If it’s a side effect, you’ll want to pay attention to it and talk to your provider about taking something to reduce your fever,” she says.
There are clinical trials in the pipeline to investigate the effectiveness of the vaccine in pregnant women. Fadden hopes that these trials will begin as soon as the vaccine is approved by the FDA, but she points out that the process is proceeding faster than before.
“We used to hit the drums in this vast silence and felt like one or two lonely drums,” she says. “Now, like the entire percussion section, we want to include pregnant women in more data and vaccine deployments, and that’s really good.”
Risk of infection
On the contrary, we are well aware of the risks COVID-19 poses to pregnant parents. “There is no doubt that pregnant women are destined worse than non-pregnant women,” says Swami.
the study Shows Pregnant people with COVID-19 are at increased risk of hospitalization, ICU admission, and mechanical ventilation. In January, research Published in the journal JAMA Internal Medicine COVID-19 was not very likely to be stillborn, but was found to be associated with blood pressure problems and a high probability of preterm birth.And the October study discovered it 1 in 4 pregnant COVID-19 may be a “long haul carrier” and its symptoms can last for weeks or even months.
However, the risk of severe illness is lower than in other high-risk groups, such as the elderly and those with heart disease. Therefore, look at individual factors that increase an individual’s risk, such as the number of daily contacts, access to tests and high-quality PPE, and comorbidities such as asthma and obesity, and see if there is anything that can be done to reduce them. Is important.
Timing also needs to be considered. Swami says there is no evidence that the vaccine can cause developmental problems or miscarriage in the first semester. However, women at low risk of infection may choose not to be vaccinated during that period. This is essential for the development of fetal organs and is the time when miscarriage usually occurs. (The flu vaccine is safe at any time during pregnancy.)
For pregnant women who are at high risk of exposure and do not have the option to mitigate that risk, it may make sense to consider vaccination as soon as they qualify. But to be sure, Chambers says, “The emergency is to get data about people who are vaccinated.”
What we are still trying to find
There is reason to expect scientists to quickly understand how the COVID-19 vaccine works during pregnancy. In the short term, scientists are looking forward to data from pregnant health care workers who started vaccination in December. Faden states that the data needs to be robust. Over 15,000 Pregnancy of vaccinated person was reported To CDC As of January 20th.
Besides the mRNA vaccine, there are several new options.Johnson & Johnson It has been submitted Vaccines for FDA approval by AstraZeneca and Novavax on February 4 Recently released Important Phase 3 study data. All three vaccines rely on techniques previously studied in pregnant women, and Swami states that it could provide additional relief. (((Do people need to get multiple types of COVID-19 vaccines?)
Recent studies have also suggested that vaccination during pregnancy may have additional benefits. One study Published in the journal JAMA Pediatrics Women infected with COVID-19 have been shown to efficiently infect babies with protective antibodies, especially if infected early in pregnancy.The study does not suggest that this transfer occurs after vaccination, the co-authors say. Karen Puopolo, Go to a neonatologist at Pennsylvania Hospital. However, Swami says the good news is that the antibody is a natural infection that crosses the placenta on a regular basis and expects a similar response to vaccination.
“Vaccinated women have shown that they can have such a 2: 1 price,” she says. “Vaccination of women can provide some benefits in early childhood.”
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