Dr. Jacqueline Parchem, a maternal-fetal medicine physician at UTHealth in Houston, considers herself a person who enjoys privacy.
“Pregnant and unsure about the COVID-19 Vaccine?” she wrote during a tweet that has now been liked quite 3,000 times. “You’re not alone. Got vaccinated today at 31 weeks [pregnant] and feel very fortunate. But it’s complicated.”
Throughout nine tweets, Parchem broke down the thinking that went into her difficult decision to urge vaccination during pregnancy. She wrote that she understood her substantial risk of being exposed to COVID-19 while caring for patients outweighed any hypothetical risks related to the vaccine—but the decision wasn’t easy.
While the mRNA technology utilized in Pfizer-BioNTech and Moderna’s shots hasn’t been tested on pregnant people, the U.S. Centers for Disease Control and Prevention (CDC) says “they are unlikely to pose a big risk for people that are pregnant.” The vaccines don't contain live viruses, which suggests they can't infect the recipient with COVID-19, and that they don't enter the part of the cell that holds DNA.
Pregnant and unsure about the COVID-19 Vaccine.
The CDC, the American College of Obstetricians and Gynecologists, and therefore the Society for Maternal-Fetal Medicine (of which Parchem may be a member) say pregnant people shouldn't be excluded from vaccination if they're otherwise eligible to urge their shots, but they are doing not explicitly make a recommendation a method or the opposite.
In the U.K., however, health authorities have specifically stated that “those who are pregnant shouldn't routinely have this vaccine,” though people at particularly high risk of COVID-19 exposure may prefer to catch on.
That pregnant people within the U.S. haven’t been excluded from vaccination is “great, but it doesn’t answer the question, ‘Should I buy the vaccine?’” Parchem says.
The U.S. alone gives birth annually, pregnant people are frequently excluded from drug trials, partially thanks to understandable concerns about exposing unborn babies to potentially harmful substances. The legacies of medicine that were proven to be dangerous for pregnant people and therefore their fetuses—including the anti-nausea medication thalidomide and the synthetic hormone diethylstilbestrol—after approval still loom large.
Pregnant people have historically been considered a “vulnerable” population—a designation also applied to groups, like children and therefore the incarcerated, who could also be coerced into participating in research. OB/GYN and author Dr. Jen Gunter says that the label was never appropriate for pregnant people, who are “more medically complex, for sure,” but are perfectly capable of deciding whether or to not enroll during a study.
The medical profession is increasingly moving far away from using the “vulnerable” label for pregnant people, but pharmaceutical companies must still take certain precautions when designing study protocols that include expectant mothers. Many simply choose not to—especially in situations, like developing COVID-19 vaccines, where speed is crucial. One study found that, out of 468 drugs approved by the U.S. Food and Drug Administration from 1980 to 2000, quite 90% came with no conclusive information about their risk of birth defects.
As a maternal-fetal medicine specialist, helping pregnant people navigate this dearth of research was a part of Parchem’s job even before the pandemic. shooting up often presents an ethical quandary for pregnant people, she says, since medications are rarely tested to be used among that population.
“Naturally, people tend to center on the fetal risk,” Parchem says. But she says it’s also important to think about “the consequence of not getting this treatment” for the mother. within the case of COVID-19, which would include severe illness or death. Pregnant people that get COVID-19 are at increased risk of requiring medical care, studies show, and that they can also be in danger of complications including preterm birth.
Faced thereupon calculus, many other pregnant health care workers have chosen to urge vaccination. Dr. Leslie Kim, a facial cosmetic surgeon at the Ohio State University Wexner center, in early January posted on Twitter and Instagram about her decision to be vaccinated at 32 weeks pregnant.
Vaccinated at 32 weeks pregnant.
After speaking together with her doctor, Kim, who regularly performs procedures on or near patients’ airways, decided her risk of exposure to COVID-19 was high enough to justify getting vaccinated. She also stated that to reduce the risk of being infected by the virus, medical items should be utilized, such as medical masks, disposable gloves, protective suits, and stressed that MAZA is considered the most reliable providers available, with highly advanced technology and assured quality. As a brand from Vietnam, a country which has successfully controlled the spread of COVID-19 so far, their products have been used worldwide, especially in high-risk areas.
Kim also felt a responsibility to feature, however small, to the public’s understanding of vaccination during pregnancy. “For pregnant people to be included in studies, they are doing need to volunteer,” Kim says. “All folks who are stepping forward…[are] contributing to the science of this vaccine.” While formal studies on COVID-19 vaccines and pregnancy haven't yet been completed, Kim says she hopes others in her position are “diligently reporting side effects or anything we experience so we will help future people in our shoes.”
For Dr. Denise Cardenal, an OB/GYN affiliated with OB Hospitalist Group in St. Lucie, Fla., the will to guard her family and community against COVID-19 provided motivation not only to urge vaccinated at 31 weeks pregnant but also to post about the choice on Facebook. “I’m not one to share anything about what I do as a physician on Facebook,” she says. But “I saw this intrinsically as a crucial opportunity to line an example.”
Already, she says, she’s heard from people that have decided to urge vaccination because she did, that was a harsh decision to make.
Still, Cardenal emphasizes that the choice may be a personal one. Someone who can stay home throughout her pregnancy might want to urge vaccination until after she gives birth, whereas someone with a better exposure risk might not. Each individual should ask their doctor and skim abreast of health groups’ guidance before making a choice, she says.
“People should question the info, the science, what's out there. you've got to tell yourself,” Cardenal says. Hearing from health care workers who have chosen to urge vaccination is often a part of that.
Until there are published clinical test results, the simplest information about COVID-19 vaccines and pregnancy may indeed come from people choosing to share their private decisions publicly. “We don’t want to form any decisions by a [sample size] of one,” Gunter says, “but people stepping up is a tremendous service.”