Being Vaccinated Against COVID-19 and Flu in Pregnancy

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We have explained it here on The Pulse in different ways. Your obstetrician will say the same thing, as will your primary care physician, which means an MD or a DO who is trained in family practice, or internal medicine primary care, not a homeopath, a naturopath, nor a chiropractor. Pregnancy is not a reason to avoid getting vaccinated against SARS-CoV2 (the virus that causes COVID-19); in fact, for pregnant women it is even more important to get fully vaccinated compared with nonpregnant healthy people, and the same goes for your jab against seasonal flu. Not every medical treatment that you can get while pregnant puts a fetus or embryo at risk. Some treatments actually lower the risk to the fetus, vaccination being one of them when it comes to vaccination against certain diseases. So don’t let the anti-vaxxers fool you and scare you into putting yourself and your baby at elevated risk, by avoiding vaccination.

There are some vaccines that are avoided during pregnancy; these are the “live” attenuated vaccines, meaning vaccines consisting of viable replicating agents that do not cause the disease that they are designed to prevent, but that do replicate in cells of the host that they infect and spread to other cells. Even in this case, the reason is not really that there is evidence of specific risk from specific live vaccines. Rather, there is concern based on a hypothetical scenario that a live vaccine could spread to a fetus, due to a lack of data. Most of the vaccines today, however, are not live attenuated vaccines. This is the case for seasonal influenza vaccines and for the COVID-19 vaccines that are approved in the United States and most other countries. They are not live. They work through different mechanisms.

Now there are diseases for which you must be vaccinated prior to pregnancy, because the vaccine is a live attenuated vaccine and because the consequences of the mother getting the disease are profoundly horrible for the baby. Rubella is the prime example. Rubella vaccine, which can be by itself, or in combination with with vaccines for measles and mumps (MMR), or measles, mumps, and chickenpox (MMRV), is extremely important for women to receive prior to pregnancy, because of the prospect of congenital rubella syndrome.

As we have discussed in previous posts, pregnant women who become infected with SARS-CoV2 are more likely than their non-pregnant counterparts to suffer a severe case of COVID-19, more likely to be admitted to the ICU, and more likely to be put on invasive ventilation, meaning on a mechanical ventilator with a tube down the throat. Such patients are often sedated and their breathing muscles are paralyzed so that they will not fight the ventilator. Having COVID-19 also makes a woman three times more likely to give birth to a preterm infant compared with a woman who does not have COVID-19 and it increases the likelihood that the newborn will be admitted to the neonatal unit.

Also, in previous posts, we have, in detail, debunked misinformed claims that have been spreading that COVID-19 vaccines interfere with fertility and cause abruptio placentae on account of similarities between a protein involved in placental attachment and in fusion of the ovum and sperm. The vaccines do not cause either one of those things and the idea that they could cause those things is built on misunderstandings of immunology, biochemistry, and reproductive biology. We also have discussed how COVID-19 vaccination is better than natural immunity. To that discussion, I should add a point that, actually immunity acquired by getting infected with SARS-CoV2 and by getting vaccinated both are natural immunity. Vaccination is simply the safer and, in this case, the more effective route to becoming naturally immune. I suppose that the term un-natural immunity can apply only to passive immunity that you would get by receiving an antibody treatment, such as REGEN-COV.

What is really behind such unwarranted objections to safe therapies, such as vaccines being used during pregnancy? Really, it seems to be part of a belief system that anything that is human made and also has gone through rigorous scientific testing and is subject to guidelines and regulations must have some danger and therefore must be dangerous to a new being that is forming. Linked with this is a belief that other therapies that are not proven, that are not subject to regulations and guidelines because they are considered to be “natural” in the sense that they involve naturally-occurring substances, and often that have no plausible mechanism as to how they would be beneficial are not potentially harmful. Taken all together, this set of beliefs, this ideology, amounts to magical thinking. There is really no place for it in pregnancy care. So get your vaccination done, if you have not done so already.

David Warmflash
Dr. David Warmflash is a science communicator and physician with a research background in astrobiology and space medicine. He has completed research fellowships at NASA Johnson Space Center, the University of Pennsylvania, and Brandeis University. Since 2002, he has been collaborating with The Planetary Society on experiments helping us to understand the effects of deep space radiation on life forms, and since 2011 has worked nearly full time in medical writing and science journalism. His focus area includes the emergence of new biotechnologies and their impact on biomedicine, public health, and society.

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