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For pregnant and nursing women, risks of COVID-19 probably outweigh risk of vaccine, experts say



Although there’s very little data on how pregnant and nursing mothers will respond to a COVID-19 vaccine, professional organizations and individual doctors say the benefits are very likely to outweigh the risks.

Pregnant women appear to have the same chance of catching COVID-19 as everyone else. But they might fare worse if they do.

According to a November study by the U.S. Centers for Disease Control and Prevention, pregnant women are significantly more likely to be admitted to an intensive care unit, to end up on a ventilator, and to die from COVID-19 than women of the same age and health status who aren’t pregnant.

So far, none of the large clinical trials of vaccines have included pregnant or nursing mothers, which is “incredibly disappointing,” said Dr. Geeta Krishna Swamy, an obstetrician/gynecologist at Duke Medical Center, who helped write the vaccine guidelines for the American College of Obstetricians and Gynecologists.

Pfizer and BioNTech, which make the first vaccine authorized for emergency use in the U.S., say they are completing tests on animals to ensure its safety before beginning trials in pregnant women early in 2021. Moderna — whose vaccine granted emergency use authorization in December — completed toxicology studies in rats, and a Food and Drug Administration review concluded it did not harm reproduction or fetal development.

Swamy, who was vaccinated in December, said data from both vaccines reassured her that unless a woman is able to isolate at home during her pregnancy, the known risks of catching COVID-19 likely outweigh the theoretical risk of vaccination. The vaccine has been shown to be safe, she said, and “is likely one of the most effective vaccines we’ve ever had.”

The risk, Swamy said, “can never be zero without data” but so far there’s nothing to suggest that pregnant women and their unborn children won’t be safe.

Dr. Jason Melillo, medical director of women’s health at OhioHealth, said he would have no qualms recommending the vaccine to a pregnant woman.

“Pregnant women can’t get COVID-19 from this vaccine,” he said. “That’s impossible.”

Most people won’t have access to the vaccine for months, to allow for more production, so likely there will be more data by the time they have access to a shot.

“For a lot of patients, if they are further along in the pregnancy and they don’t really have risk factors … you will be delivered before it’s your turn in line to get the vaccine, so it will become a nonissue for you,” said Dr. Amol Arora, medical director for Women’s Health at Mount Carmel Health System.

But a large percentage of frontline health care workers are women of childbearing age and are confronting this decision now, as the first people to receive the vaccine.