Women’s health professionals recommend COVID vaccination for potential mothers

By CALLAN PUGH

Public Health Educator

Wyandot Public Health

COVID-19 vaccination is recommended for people who are pregnant, breastfeeding, trying to get pregnant now, and for those who may become pregnant in the future. 

Megan Bair a certified nurse practitioner and certified nurse-midwife, as well as certified nurse-midwife Susan Hotelling, both working in Women’s Health at Wyandot Memorial Hospital, explained that the recommendations follow the American College of Obstetrics and Gynecology and the American College of Nurse Midwives. 

“Both colleges are recommending vaccination regardless of gestation, regardless of post-partum for all ages that are eligible for the vaccines,” Bair explained. “If you’re trying to get pregnant, if you’re done being pregnant, it does not matter. They recommend vaccination regardless. We’re trying to educate people about that when they come to the office. The Centers for Disease Control and Prevention also is recommending vaccination for those who are pregnant, breastfeeding, and who are considering pregnancy in the future.” 

Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing, according to Bair. The data suggest that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy. Bair explained that there have been no studies that show adverse outcomes in pregnancy due to COVID vaccination at this time. 

Adverse effects of contracting COVID-19 while pregnant 

While there is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in people, there is evidence of the negative effects of contracting COVID-19 when pregnant. 

“The pregnancy effects from the vaccine are different than someone who gets COVID and then has adverse outcomes,” Bair said. “In Wyandot County, we’ve seen pregnant moms get sick, and pregnancy is considered a high-risk population.” 

Contracting COVID-19 when pregnant increased likelihood of pre-term births and increased risk of still births related to COVID. Bair explained that in an analysis of 8,000 stillbirths among 1.2 million delivery hospitalizations in the United States during the pandemic, pregnant COVID-19 patients had a higher stillbirth rate than those without COVID-19. The difference was a rate of 1.2% for deliveries among those patients with COVID-19 verses 0.64% for deliveries among those patients without COVID-19. 

“So, when you hear only 1% of deliveries, your instinct is to say, ‘Oh that’s not that bad,’ but when you compare it, the typical percentage is .64%, it’s double what we would expect to see,” Bair said. “Data from September 2021 specifically states that vaccination for COVID vaccination does not increase risk for miscarriage, but we do know that being sick with COVID-19 increases the risk for miscarriage and loss.” 

Bair explained that as a high-risk population for COVID, some pregnant people in Wyandot County who contracted COVID-19 have seen pre-term births related to their illness across the labor and delivery department providers. 

In addition to pre-term births and still births, Hotelling explained that Wyandot County providers are seeing additional adverse outcomes among those pregnant people with COVID. 

“It’s harder to rebound when you’re pregnant and you have COVID, and you must be careful any time you have a fever when you’re pregnant,” Hotelling said. “COVID also puts you at a higher risk for blood clots and when you’re pregnant, you’re already at a higher risk for blood clotting.” 

In addition to vaccination, the providers are continuing to encourage pregnant people to remember the basics. 

“Good hand washing, wear your mask, stay 6-feet away from people, avoid gatherings of people,” Hotelling listed. “Then when you bring your baby home, in discharge instructions we educate people on screening visitors – Good handwashing of visitors when they come into the home to see the baby. I always tell people on discharge, when they go home, let your family members be the ones who go to the grocery store. Because we don’t want mom to get sick.” 

Passing antibodies to baby 

Hotelling and Bair explained that mothers can pass antibodies on to their babies both during pregnancy and through breastfeeding. 

“If mom vaccinates when pregnant, the baby is getting immunity if mom is vaccinated at least two weeks before delivery – that’s what we know with the Tdap vaccine,” Hotelling explained.  

Antibodies for COVID similarly may pass to the baby through breast milk, Bair said.  

“In the setting of COVID-19 infection the infant may receive passive antibody protection against the virus from mom,” Bair explained. 

She noted that the benefits of breast feeding outweigh the concerns of droplet transmission when a mother is breast feeding the baby while sick with COVID. 

“There’s more benefits than there is potential risk,” Bair said. “There is a consensus that breast feeding should be encouraged because of the many maternal and infant benefits. The American Academy of Pediatrics supports breastfeeding in mothers with COVID-19 – wash your hands before, wear a well-fitting mask during breast feeding. It’s a low likelihood of passing maternal infection to the newborn when the proper precautions are taken.” 

Deciding on vaccination 

Since the release of COVID-19 vaccines, there has been a concentrated focus on collection of data from mothers who are vaccinated for COVID and the outcomes. This is a resource others may use as they make decisions about COVID-19 vaccination. Bair said she understands why potential mothers are concerned about getting vaccinated against COVID-19, but said she hopes their decision is to get vaccinated. 

“It’s so conflicting, because fertility is something that people hold so close to themselves, and we’re all sick of hearing it’s unprecedented, but it is,” Bair said. “Every time there’s a new vaccine, we get a little leery because it’s something that we put in and we can’t necessarily take it back out. So, it’s a decision that we don’t take lightly. But from what we’re seeing and what women are experiencing there’s no reason to believe that it’s going to affect future fertility. We’ve had lots of moms here locally who were vaccinated before they were pregnant, they got pregnant and now they’re having healthy babies.” 

“I think it’s important to have the conversation with your family, but we encourage vaccination and encourage you, if you are vaccinated and get pregnant to enroll in a registry. Because that’s the only way we’re going to know more, by collecting more data.” 

The Centers for Disease Control and Prevention is currently enrolling eligible participants and analyzing data to better understand how COVID-19 vaccines affect pregnant people and their babies. As of April 25, 2022, the registry has enrolled 23,711 pregnant people in the United States. To learn more about the v-safe registry, visit cdc.gov/coronavirus/2019-ncov/vaccines/safety/vsafepregnancyregistry.html. 

Wyandot County Public Health currently offers walk-in clinics for COVID vaccinations from 9 a.m. to 4 p.m. Wednesdays at the health department, 127 S. Sandusky Ave # A, Upper Sandusky, OH 43351. Moderna and Johnson and Johnson initial doses and boosters currently are available.