As a maternal-fetal medicine physician at UTHealth in Houston, Dr. Jackie Parchem has seen the toll coronavirus infections can take on her pregnant patients. While routine testing has revealed many are asymptomatic, she said others have become critically ill and even died.
She signed up for the COVID-19 vaccine as soon as it became available to her as a frontline worker. But she admits it wasn’t an easy choice because — like her patients — she’s pregnant.
“I had friends and family members say, ‘You're not getting that, are you?’” Parchem told News4. “And even though I'm the specialist and the scientist, those types of comments do make you think for a moment.”
Research shows pregnant women are at higher risk of severe illness from the coronavirus. But, as is common in early drug trials, they were excluded from the initial COVID-19 vaccine clinical trials in order to avoid any potential risk to the fetus. As a result, doctors and pregnant women are left to make agonizing decisions with little data.
“If we want to have data on vaccine safety and pregnancy, pregnant people have to get vaccinated,” Parchem said.
She’s among a growing number of pregnant doctors who have shared their vaccination decision on social media in recent weeks. Parchem told News4 there were several reasons she chose to get the vaccine, including that she’s at an elevated risk of contracting COVID-19 at work and because the clinical trials have shown a high efficacy rate against severe coronavirus infection.
The decision, she explained, came down to a simple question: “If I don’t get the vaccine now and I get sick while I’m pregnant … will I regret the decision?”
The Centers for Disease Control and Prevention has stopped short of recommending all pregnant women — or women seeking to be pregnant — get vaccinated, but has said “people who are pregnant and part of a group recommended to receive the COVID-19 vaccine may choose to be vaccinated.”
The American College of Obstetricians and Gynecologists and The Society for Maternal-Fetal Medicine struck similar stances, with ACOG advising, “COVID-19 vaccines should not be withheld from pregnant individuals who meet criteria for vaccination.”
Dr. Tamika Auguste, the interim chair of Women's and Infants' Services at MedStar Washington Hospital Center and who serves on the ACOG board, said it’s hard to make a full-throated recommendation for pregnant women to receive the vaccine without an in-depth study.
Still, she said there’s nothing about the science behind the Pfizer and Moderna vaccines that gives her pause.
“Physiologically, scientifically, the vaccine should have no impact on pregnancy and lactation based on how the vaccine works,” Auguste said.
Women are routinely given vaccinations during pregnancy to prevent illnesses such as the flu or whooping cough. Unlike the flu vaccine, which uses particles of dead influenza virus, both the Pfizer and Moderna vaccines rely on messenger RNA technology. The vaccines don’t contain the live virus and therefore can’t give the recipient COVID-19 and work by causing cells to produce antibodies that fight the coronavirus.
“Vaccine administration during pregnancy is not something that's novel or new,” said Auguste, who called for pregnant and lactating women to be included in future drug trials from the start. “I think the COVID vaccine will be one of the routine vaccines that we administer during pregnancy moving forward.”
In this age of misinformation, both doctors have heard some of the myths on social media, including a debunked claim that the vaccine can cause infertility. That dubious theory is based on the notion that, due to similarities between the spike protein that causes COVID-19 and the protein that helps form the placenta, the antibodies produced by the vaccine could attack the latter.
“There are a few problems with that logic, and it's not really based on any scientific rationale,” Parchem said.
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She said there are minimal similarities between the proteins and added, “Our immune system is too smart to let that kind of thing happen.”
The lack of clinical trials on pregnant women and fertility means there’s no clear data on when or if there’s an ideal time to get vaccinated. Still, Auguste said she’d advise women planning to get pregnant to “get vaccinated now and move forward with your fertility afterwards.”
Parchem added that, given how common early miscarriage is in a typical pregnancy, some women who are already pregnant might want to wait until after the first trimester to get vaccinated for peace of mind.
“What we don't want is for people to have guilt; to associate something that they did with [a potential] miscarriage,” she said.
The doctors had even less concern about giving the vaccine to women who are lactating, with Parchem stating it could only be of benefit to the baby if antibodies are passed through breast milk.
Both said women should discuss their particular circumstance with their health care provider to determine if and when the vaccine is right for them, especially those who are immunocompromised or have a history of anaphylaxis. And they said women shouldn’t feel badly regardless of their choice.
“It’s really a very personal decision,” Parchem said.
A handful of women who participated in the initial COVID-19 vaccine trials reportedly became pregnant and, so far, none who received the vaccine has experienced adverse outcomes.
Meanwhile, clinical trials involving pregnant women are expected to begin this year.
Reported and produced by Katie Leslie, and edited by Steve Jones.