COVID-19 Vaccine and Pregnancy: Our Recommendations
A lot of people are asking us for information regarding the COVID-19 vaccine. Here are our recommendations for pregnant and non-pregnant women.
I hope that you and your family are doing well and staying safe during these difficult times. I wanted to give you this update regarding COVID vaccine and my recommendations to my patients.
The FDA has approved the 1st COVID vaccine for emergency use
A few days ago, on Friday December 11th, the FDA gave emergency use authorization to the Pfizer COVID vaccine.
However, due to unprecedented political interference from the White House, many physicians opted to wait for confirmation from independent organizations before making any recommendations to our patients.
We now have independent confirmation of safety and effectiveness
As of yesterday (December 14th) ,we now have that confirmation: the western states scientific safety review work group has now completed their review and has confirmed that the Pfizer COVID-19 vaccine is safe and highly effective for adults aged 16 and over.
I now feel confident in recommending vaccination to my non-pregnant patients.
Pregnant women are at greater risk from COVID
I do want to address in a little more detail whether pregnant women should take this vaccine. This is a very important point since pregnant women who contract COVID, are more likely to have severe illness, hospitalization, ICU admission and death, compared to non-pregnant women.
Pregnant women have not been studied yet
Initially, I had two areas of concern regarding vaccination of pregnant women:
First, the vaccine trials in the United States specifically excluded pregnant women so we don't yet have safety data that is specific to pregnant women.
Animal development and reproductive toxicity studies are pending
Second, the FDA requires developmental and reproductive toxicity studies in animals to assess a vaccine's possible effect on a fetus. Normally, this would have been completed before large-scale human trials began. However, due to the urgency of getting these studies started, we do not yet have this data. We hope to have this data from Pfizer before the end of December 2020.
Pfizer and Moderna vaccines do not contain live virus
The Pfizer vaccine and the next vaccine most likely to be approved from Moderna do not contain any live virus. Live virus vaccines are the ones we usually worry about as causing potential issues with a developing fetus.
The new Covid vaccines are unlikely to cause problems during pregnancy
Based on how these new vaccines work and the ingredients they contain, we have no reason to suspect that either the Pfizer or Moderna vaccines would cause any problems for a pregnant woman or a developing fetus.
In fact, our two most authoritative academic physician organizations for women, the American College of Obstetrics and Gynecology, and the Society for Maternal-Fetal Medicine, have both released statements to say that this vaccine should not be withheld from pregnant women who otherwise meet the current criteria for vaccination, such as high-risk healthcare workers.
My COVID-19 vaccine recommendations
My recommendation to patients is based on weighing the risks versus the benefits. I recommend that for any men and non-pregnant women, get the vaccine as soon as you are able.
If you are currently pregnant and in a high-risk group, such as nursing home staff, urgent care or hospital worker, I feel that the benefits of COVID vaccination outweigh the theoretical risks. You should also be vaccinated as soon as possible.
If you are pregnant and not in a high-risk group, it is going to take some time for vaccines to be available for you anyway. By that time, we will have more information on which to make a decision.