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Pregnant or Breastfeeding? Here’s What You Need to Know About the COVID-19 Vaccine

Covid-19 vaccine pregnancy

The approval of the two coronavirus vaccines in the US was exciting and historic news. It seemed like the very answer we needed to the collective fear, worry, and anxiety that had taken over the country–and the world. The antidote was here! And the light at the end of this dark and lonely tunnel? We could finally see its glimmer!

But for those trying to conceive, pregnant, or breastfeeding, the arrival of the vaccine has further complicated matters. On the one hand, the vaccine could protect them from potentially life-threatening complications associated with contracting COVID-19 as well as help prevent the spread if they were asymptomatic carriers. On the other hand, what risk is the vaccine posing to a developing fetus or a breastfeeding baby?

Just like coronavirus has challenged families to make difficult decisions to protect their own safety and the safety of those around them (continue fertility treatments or not?, virtual school or in-person school?, childcare or no care?, go to the playground or stay away?), families now have to do another wishy-washy risk-benefit analysis when it comes to getting the vaccine if they are trying to conceive, pregnant, or breastfeeding.

To bring clarity to this issue, we tapped OB/GYN Shieva Ghofrany, MD partner at Coastal OBGYN and Cofounder of TRIBE CALLED V. An OB/GYN who has delivered tens of thousands of healthy babies and a mama herself, she offers incredible insight into the recommendations put forth by leading organizations to help families make the best decision for them.

Now that the COVID-19 vaccine is available, what are the American College of Obstetricians and Gynecologist’s (ACOG) recommendations for those who are pregnant?

ACOG, the Society for Maternal-Fetal Medicine (SMFM), and the American Society of Reproductive Medicine (ASRM) are very clear that while the vaccine has NOT been tested on those trying to conceive, pregnant, or lactating (because the guidelines seem to historically preclude “vulnerable populations” from these studies), they still support women in these categories in getting vaccinated if they choose to, especially if they are in higher risk situations (for example, health care workers).

But they also make it clear that these women should NOT be forced to be vaccinated if they choose not to.

Patients should always consult their individual healthcare provider, but what factors should women be considering as they think about getting the COVID vaccine during pregnancy?

Interestingly, the CDC and ACOG clearly state that while patients may consult their individual healthcare provider, if this will delay possible vaccination in a patient who desires vaccination then she does not need her individual healthcare provider’s approval. In other words, if she has access to the vaccine and wants it, she should be able to get it without consulting her doctor.

In general, I am hopeful that women will continue to look at objective scientific data rather than speculative social media comments to inform their decision. For example, it is important to understand the science behind the COVID-19 vaccine and how the mRNA in the vaccine degrades, leaving only the antibodies to persist (which then cross the placenta and breast milk to give immunity). It’s also important to understand that we know that the COVID virus itself can certainly cause more significant illness in pregnant women (albeit the vast majority of pregnant women will be ok!).

While the decision is ultimately yours to make, your healthcare provider can certainly help you weigh your own potential risks to virus exposure versus the benefits of getting the vaccine. They can also keep you informed of the latest scientific data.

For example, based on current data, I would support my patients who feel that they are ready to vaccinate especially, if they are in higher risk positions like healthcare workers or those who come into frequent contact with other people. Likewise, I would support my patients who evaluate that their risk to contracting the virus to be very low and choose not to vaccinate during pregnancy (but plan to continue taking all necessary precautions like wearing a mask and frequent hand-washing).

This decision to vaccinate or not adds emotional complexity to an already overwhelming process that is pregnancy and new motherhood. What advice do you have for those trying to do what’s best for their family?

I think women on BOTH sides (yay or nay for vaccine) should feel comfortable being clear that their decision is theirs to make without judgment from others.

My advice generally for women is this: each of us knows our own intuition and what will increase our OWN anxiety—i.e. if the concern for the virus outweighs the concern for the vaccine, then vaccinate! And vice versa. The problem is that we are systematically taught to NOT trust our own intuition and then we are easily led to different opposing views now that social media and the internet allow all opinions to be “published.”

I also encourage women to make the decision, and then move ahead and NOT second guess themselves constantly (though clearly if new data arises, they may pivot of course.

Now about breastfeeding. What are the COVID-19 vaccine guidelines and recommendations for those breastfeeding mothers?

They are the same as for pregnant women! But as far as I am concerned, the decision is even easier because we know that even the “live virus” vaccines like rubella are safe with breastfeeding. Given this is not a live virus, it is likely that only the antibodies cross to the milk which will be ultimately be protective to the baby!

Anything else you are telling your patients?

I think it is appropriate and natural that we are reticent about new things. I also think, however, that we should remember that this particular vaccine strategy by the government has been committed to ensuring everyone’s safety from day one. By having recipients log into Vaccine Adverse Event Reporting System (VAERS) and receive daily emails, they are attempting to gather as much data about the vaccine effects in the general population. This should very much encourage a sense of trust, which is not something our disjointed and non-centralized system has always done well!

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Category Pregnancy
Tags covid-19

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