Pregnant or breastfeeding? CDC says to get COVID-19 vaccine

Urgency due to increase in severe COVID-19 cases in unvaccinated expecting mothers

Closeup of a pregnant woman sitting on the bed at home holding her baby belly.

Pregnant and lactating women should get vaccinated against COVID-19, the U.S. Centers for Disease Control and Prevention urged in recently updated guidance.

The CDC’s recommendation echoes statements in strong support of vaccinations from Sanford Health providers as well as several of the nation’s leading obstetric organizations. It comes at a time when many regions of the country are experiencing a surge in COVID-19 cases, hospitalizations and deaths.

This rise is driven by the highly contagious delta variant and draws attention to the potential risks involved for pregnant women who contract the virus. Expectant women run a higher risk than women who are not pregnant of severe illness and pregnancy complications from COVID-19, including possible miscarriage and stillbirth.

In short, the benefits in getting the vaccine far outweigh the theoretical risks.

“This is not just part of a recommendation encouraging everyone to get the vaccine,” said Christine Keup, M.D., a specialist in obstetrics and gynecology at Sanford Southpointe Clinic in Fargo, North Dakota. “For pregnant women, there can be significant complications with COVID that make it even more important for them to receive the vaccine.”

CDC data reveals, as of July 31, that just 23% of pregnant women received at least one dose of a COVID-19 vaccine. The hope is that the updated and strengthened CDC guideline can help boost those rates.

“There is a lot of misinformation out there, especially regarding vaccines and fertility,” Dr. Keup said. “The vaccines do not affect fertility at all. That misinformation makes it very important to have a connection with a provider you trust.”

Because pregnant women were not initially part of the vaccine trials, the CDC and other national organizations advised people to consult their providers and make an informed decision regarding COVID-19 shots. Since then, the accumulated data shows that it is indeed safe for those who are pregnant, wanting to become pregnant or breastfeeding.

As a result, the messaging from the CDC and others has become more urgent.

“People’s initial anxiety about the safety of the vaccine in pregnancy was well-founded,” said Erica Schipper, M.D., a Sanford Health OB/GYN in Sioux Falls, South Dakota. “Since then we’ve had more than 139,000 pregnant women get the vaccine and we’ve collected data showing no increase in adverse outcomes, no increase in adverse fetal or neonatal outcomes and no increase in adverse maternal outcomes.”

The CDC and its federal partners continue to monitor vaccinated people for serious side effects. A CDC analysis of current data from the v-safe pregnancy registry did not find an increased risk of miscarriage among nearly 2,500 pregnant women who received an mRNA COVID-19 vaccine before 20 weeks of pregnancy.

Miscarriage typically occurs in about 11% to 16% of pregnancies, and this study found miscarriage rates after receiving a COVID-19 vaccine were around 13%, similar to the expected rate of miscarriage in the general population.

“When we think about the vaccine and how it works, there’s no reason it should be unsafe in pregnancy,” Dr. Schipper said. “There are some vaccines we don’t give in pregnancy because they’re a live virus vaccine or they pose a threat to the mom or baby. That’s just not the case with this vaccine.”

Fortunately, the updated CDC guideline gives providers another tool in the quest to present accurate information. Given that so many remain wary of a proven safe method to help avoid the virus, physicians will take any help they can get in encouraging vaccination.

“It’s a hard conversation to have when people are reluctant,” Dr. Schipper said. “My hope is that because they trust me to provide the best possible prenatal and intrapartum care, they will trust that I have their best interests at heart when I make a recommendation about the vaccine.”

Important to remember:

  • Sanford Health recommends all patients 5 years and older be vaccinated, including those who are pregnant, planning to become pregnant, or breastfeeding. Sanford has also mandated this vaccination to every one of its nearly 50,000 employees.
  • The CDC recommends COVID-19 vaccinations for all people 5 years and older, including women who are pregnant, breastfeeding or trying to get pregnant now or in the future.
  • The Society for Maternal-Fetal Medicine (SMFM), American Society for Reproductive Medicine (ASRM) and American College of Obstetricians and Gynecologists (ACOG) all recommend that those who are pregnant should be vaccinated against COVID-19.
  • Pregnant women with COVID-19 are three times more likely to need ICU care than women who are not pregnant and are two to three times more likely to need advanced life support and a breathing tube.

Information in this story was accurate when it was posted. As the COVID-19 pandemic changes, scientific understanding and guidelines may have changed since the original publication date.

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Posted In Coronavirus, Fargo, Immunizations, Pregnancy, Sioux Falls

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