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Whether it’s the variants of SARS-CoV2 (the virus that causes COVID-19), vaccination and how the COVID-19 vaccines work, how the virus gets into the body cells and causes disease, or how the virus and treatments relate to fertility or the placenta, there is an enormous amount of information floating around, and with it plenty of misunderstandings and myths. With that in mind, in this post, let’s take a brief trip through a handful of claims about COVID-19 and pregnancy, being clear about which ideas are myths, which are factual, and which are somewhere in between.
Claim 1: COVID-19 is just another kind of flu. This is a MYTH promoted by conspiracy believers that we dissected here on the The Pulse back in February of the current year. COVID-19 is caused by SARS-CoV2, a subtype of virus within the coronavirus family. Not only is the structure of coronaviruses different from that of influenza viruses, but the disease COVID-19 is very different from the flu, for many different reasons. All of these reasons result from how the SARS-CoV2 virus enters, not only cells of the respiratory system, but also cells that line the insides of blood vessels, and many other cell types throughout the body by attaching to a protein on cell surfaces called ACE-2. The virus attaches by way of its spike protein, the same protein that gives the virus a corona (crownlike) appearance in electron microscopy and that the vaccines teach the immune system to utilize for target practice.
Claim 2: COVID-19 is dangerous, mostly for elderly people and those with certain health conditions, so pregnant women are not at any particular risk. This is a HALF-TRUTH, so let’s unpack it just a bit. Older age certainly is one of the main risk factors for developing a severe case of COVID-19 for those who become infected with SARS-CoV2, while male gender also entails an elevated risk, although plenty of women also have succumbed to this horrible disease. Additionally, the presence of other health conditions increases one’s risk of requiring hospitalization, admission to the ICU, and of dying from a SARS-CoV2 infection. Health conditions increasing one’s risk most dramatically are obesity (your body mass index [BMI] is 30 or higher], type 2 diabetes, heart failure, and hypertension (high blood pressure), plus there are numerous other conditions increasing risk, including chronic kidney disease, cancer, severe asthma and various other lung conditions, various blood conditions, liver disease, heart disease, cystic fibrosis, certain neurological conditions, an immunocompromised state, blood vessel problems, and yes, to a certain extent, pregnancy. As we discussed in late February, compared with your non-pregnant, female friends of similar age, if you develop COVID-19, pregnancy makes you more likely to suffer a severe case. Along with this, you are 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, although such treatment is becoming increasingly less common as treatments given to people with mild and moderate COVID-19 are becoming more effective. As for risk to the fetus, COVID-19 in the mother makes preterm birth three times more likely, thus increasing the likelihood that the newborn will suffer medical problems. So while being a young to middle age woman with no major health conditions makes you very unlikely to die from COVID-19, pregnancy is considered a COVID-19 risk factor, making it all the more important for you to get vaccinated, as soon as vaccination is available to you.
Claim 3: COVID-19 vaccines may reduce your fertility and harm the placenta for those who do become pregnant. This is a MYTH that we dissected in detail back in January, 2021.
Claim 4: Keeping six feet, or two meters away from other people in public is a scientifically justified way to keep from spreading the virus. This is sort of a HALF-TRUTH. While there are plenty of data supporting the policy of social distancing, the idea that people should spread out, the particular distance of two meters (six feet in the US) is just a guess. This distance has not been verified and, probably, given the rise of the variant B.1.1.7 (UK variant), which is much more contagious than the original, wild type variant that first spread through the world, there is plenty of reason to think that two meters may not be enough. Safe distance furthermore can be expected to chance, depending on factors such as temperature and humidity of the air, the amount of ventilation and ventilation patterns in a room, and very significantly, whether it is an outdoor or an indoor setting. Certainly, if there a solid scientific foundation for a social distance so precise as two meters (six feet), then by now the recommendation from health authorities would have been modified to a greater distance, thereby requiring stores to change those little circles on which we stand while waiting to pay for our groceries. Just stay as far apart as you can from other people.
Claim 5: COVID-19 vaccines will change the DNA in your cells. This is a MYTH. As we have discussed on The Pulse in various posts dealing with the Pfizer-BioNTech, AstraZeneca-Oxford, Moderna, Johnson and Johnson-Janssen, and Novavax vaccines, the vaccines that are authorized and soon-to-be authorized do not work by modifying the DNA of the recipient’s cells, but there are a handful of different mechanisms. All of the vaccines work by causing spike protein to be presented to the recipient’s immune system to use as target practice. In the case of Novavax, the business end of the vaccine is the spike protein itself, which is taken in by a very tiny number of body cells that present it on their surfaces. In the cases of Pfizer-BioNTech and Moderna, the business end of the vaccine is a strip of mRNA, which is taken into a very tiny number of body cells. Remaining in the cytoplasm, the part of the cell outside the nucleus, the mRNA strips are translated numerous times into spike protein, and are degraded in a matter of hours. In the cases of Janssen and AstraZeneca, a strip of DNA is delivered into a very tiny number of body cells. Although this DNA from the Janssen and AstraZeneca vaccines enters the nucleus of each cell that receives it, the DNA does not incorporate into the cell’s chromosomes. Instead, it exists as a circular entity called an episome, which is transcribed over and over into strips of mRNA that encode the spike protein and move from the nucleus into the cytoplasm, where they are translated into spike protein, until the cell is destroyed.