After an astonishingly fast effort to develop a safe and effective vaccine against COVID-19, the United States is on the precipice of having multiple options. Public health experts believe we’re weeks (or less) away from the first doses being available, which will be rolled out to health care workers, nursing home residents and then other high-priority groups, like older Americans and essential workers.
But what about pregnant women? Should they get vaccinated against the coronavirus — and should they be prioritized?
Here’s what we know, and don’t know, so far:
There’s no official guidance on pregnancy and COVID-19 vaccination … yet.
Because none of these vaccines are actually available yet, and all of the research we have on them is still very new, organizations like the U.S. Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists haven’t made any formal recommendations at this point.
As Dr. Christopher Zahn, ACOG’s vice president of practice activities, told HuffPost: “There isn’t a simple answer to questions about whether pregnant people, or those considering pregnancy, should take the COVID-19 vaccine, especially since no vaccine is currently approved.”
Pregnant women have NOT been included in trials.
“When the vaccines do become widely available, unfortunately, we have no data on the safety of the vaccine in pregnant and lactating individuals because they were excluded from Phase 2 and Phase 3 clinical trials for all of the COVID-19 vaccines in development,” Zahn said.
So we won’t know anything specific right off the bat about how a coronavirus vaccine might affect pregnant women, breastfeeding moms or their babies.
Despite a decadeslong push to include expectant mothers as subjects in clinical research, it’s actually not uncommon to exclude pregnant women from the early stages of vaccine development, when researchers are really testing for safety. For example, pregnant women weren’t included in initial trials for the H1N1 vaccine. So while they were identified as a high-risk population, there wasn’t readily available data about what kind of dosing they should receive.
“Certainly the lack of safety and efficacy data will need to be part of the conversation that patients who are pregnant or considering pregnancy will need to have with their obstetrician-gynecologist or other health care professional,” Zahn said about receiving a COVID-19 vaccine.
One critical note: The lack of information so far on how the vaccine might impact pregnant women does not necessarily indicate that researchers and doctors are particularly concerned that it would be harmful to them. Women get vaccinated for other illnesses during pregnancy all the time, including whooping cough and the flu. And some of the antibodies they develop pass through the placenta (or breast milk, for breastfeeding moms), which offers their baby some protection.
“There is no suspicion that the vaccine should be bad for pregnant women,” Dr. Jane Minkin, clinical professor of obstetrics, gynecology and reproductive sciences at Yale University School of Medicine, told HuffPost. “But we just do not have the information.”
Pregnant women do seem to face higher risks with COVID-19.
Unlike with the H1N1 virus, which posed a grave risk to pregnant women, the impact of the coronavirus has been less clear. But based on data collected over the past few months, the CDC and ACOG say that pregnant women are at slightly higher risk of becoming seriously ill with COVID-19. They also have a higher risk of dying from the virus than their non-pregnant counterparts.
Scientists aren’t sure yet whether the virus can cross the placenta, though one preliminary study of 31 women did find evidence of it in women’s umbilical cord blood, placenta and breast milk. However, the good news is that the CDC says it’s “uncommon” for newborns whose mothers have COVID-19 to have the virus themselves, and among those who do, it’s not clear whether they contracted the virus before, during or after delivery.
The old public health standbys remain particularly important for moms-to-be.
Because pregnant women appear to be at higher risk of severe illness, and because it may be some time before we get clear answers about COVID-19 vaccine safety for them, experts say it’s especially crucial that those women be diligent about the preventive measures we know protect against the virus.
“What do I advise pregnant women? To practice what we all should be doing: mask-wearing, hand-washing, social distancing. And please get flu shots if you haven’t had them yet ― that’s one thing we can easily do,” Minkin said. “Be careful and stay tuned.”
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.