The American College of Obstetricians and Gynecologists (ACOG), a professional membership organization for OB-GYNs, issued a practice advisory Sunday to say that both pregnant and breastfeeding people who are in the priority groups for the vaccine should receive doses as well.
“ACOG recommends that COVID-19 vaccines should not be withheld from pregnant individuals who meet criteria for vaccination based on [Advisory Committee on Immunization Practices]-recommended priority groups,” the statement read. “COVID-19 vaccines should be offered to lactating individuals similar to non-lactating individuals when they meet criteria for receipt of the vaccine based on prioritization groups outlined by the ACIP.”
What should pregnant people do?
The question of whether an expecting parent should receive a COVID-19 vaccine will eventually come down to a number of factors, including everything from the trimester, risk factors for COVID-19, ability to remain socially distanced in their lifestyle and occupation, guidance from federal and state officials and recommendations from a person’s own physicians, according to both Faden and Rao.
Overall, people should feel comfortable that a COVID-19 vaccine is safe, but parents-to-be might need to wait a bit before receiving one, according to Dr. Rashmi Rao, a maternal-fetal medicine specialist at UCLA Medical Center in Los Angeles.
“The message right now is that once it gets cleared from the FDA and vaccinations become available, if it’s safe to do so for the public, then I would recommend that you get your vaccination when you’re eligible,” she said. “However, if you’re pregnant, you will likely have to wait until you’re no longer pregnant or until we gather more data regarding safety and pregnancy.”
Similar to the flu vaccine, which was not tested on pregnant people in clinical trials, health experts will need to rely on continuously incoming data to make decisions around how safe the COVID-19 vaccines are during pregnancy. Officials are doing the same for the general population, considering the speed at which the COVID-19 vaccines were developed, according to Faden, who noted that people who are pregnant should not be “unnecessarily alarmed.”
“Vaccines are coming, and they’re coming before we have all of the information that we would like to have to make recommendations for pregnant people,” she said. “But this is the context in which decisions are being made and recommendations are being made for the general population, without all of the evidence we would like to have, which is why the studies will continue.”
The Society for Maternal-Fetal Medicine (SMFM) released a statement earlier this month encouraging expecting parents to “engage in shared decision-making” about the vaccine with their doctors.
“In general, SMFM strongly recommends that pregnant women have access to COVID-19 vaccines in all phases of future vaccine campaigns, and that she and her health care professional engage in shared decision-making regarding her receipt of the vaccine. … mRNA vaccines, which are likely to be the first vaccines available, do not contain a live virus but rather induce humoral and cellular immune response through the use of viral mRNA,” the society said in its statement. “Health care professionals should also counsel their patients that the theoretical risk of fetal harm from mRNA vaccines is very low.”
Even now, nearly one year into the coronavirus pandemic in the U.S., many questions remain about how pregnant people are impacted by COVID-19.
The CDC has shared data showing that people who are pregnant have a significantly greater risk for severe illness from COVID-19 when compared to nonpregnant people, but they are not at a greater risk for death.
“What I tell my patients is the one thing I know for sure is that pregnant women can get COVID,” Rao said. “We’re not seeing huge rates of any adverse fetal outcomes yet, but, again, that’s still to be determined, because we have a long way to go with collecting information.”
Rao said everyone, including pregnant people, needs to remain on guard when it comes to COVID-19 by continuing to follow safety protocols, including face mask wearing, social distancing and hand washing.
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