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The COVID Vaccines Weren’t Tested in Pregnant Women. Here’s Why I Still Got the Shot

For myself, my baby and the rest of my family.

I was nervous to get my COVID vaccine at 24 weeks pregnant, but here’s why I’m glad I did.

I waited nervously for an hour in line–indoors–at the crowded convention center, praying that I wasn’t in the midst of a super-spreader event. How horribly ironic it would be to catch COVID-19 while getting my vaccine. As a pregnant woman, I knew that I was extra at-risk for any serious side effects of the disease.

That’s why, when my turn finally came around and the nurse jabbed my arm, I felt a tear prick my eyes. Not from pain, but profound relief. This quick shot (the first of two) was my ticket back to my cherished life with my husband and son, a life we all missed dearly. After a year of disruption, managing a 4-year-old’s pent-up energy while juggling Zoom calls and deadlines, my vaccine appointment shone like pure hope in the midst of a dark, empty social calendar.

But my decision to get the shot while pregnant wasn’t made overnight, especially since pregnant women were excluded from the clinical trials testing the vaccines, an unfortunate historical norm in drug development that remains the status quo.

These extremely effective and safe vaccines, which also appear to prevent the vast majority of viral transmission, are the result of decades of foundational scientific research and the diligence of some remarkable innovators, companies, and partnerships. By now, getting the shot, for most adults, should be a no-brainer.

For us pregnant women, however, the picture has been a bit murkier. Although a handful of women happened to get pregnant while participating in the trials, with no publicly reported concerns, the numbers were too small to be broadly reassuring or statistically significant. Yet, that day at the convention center, at 24 weeks pregnant, I got my first dose–the day after I saw my baby’s ultrasound. My decision came about after a great deal of research and consultations with several doctors.

First, there is no plausible biological mechanism by which the messenger RNA (mRNA) vaccines, those made by Moderna and Pfizer-BioNTech, could harm a fetus. mRNA is rapidly degraded in the body, like a Snapchat that briefly shows up to prompt an immune response and then disappears. According to Amesh Adalja, an infectious disease physician and pandemic policy researcher at Johns Hopkins, it is “extremely unlikely that it would be viable long enough to cross the placenta to even reach the fetus, let alone cause it harm, which it really is incapable of doing.”

Last December, when I was 11 weeks along, I turned to my seasoned OB-GYN who specializes in high-risk pregnancies. Normally a very cautious practitioner, shortly after the FDA authorization, he was at first on the fence about his patients receiving the vaccine. He had just received his first dose as a front-line health worker and there was too little data on pregnant women to make a strong recommendation. At the time, I didn’t have access anyway so had to wait. But by early March, he enthusiastically said he hoped all his patients would get it. So, what changed?

In fact, the last several months have yielded compelling evidence that the vaccine is indeed safe and effective for us. On March 1, the CDC released its latest analysis of the data on COVID vaccines in pregnant women. The report, which I devoured like the latest J.K. Rowling novel, was reassuring; more than 30,000 women had registered with V-Safe, a database established to track pregnant women who receive the vaccine. (Today, that number is over 87,000.)

The CDC had analyzed outcomes on 1,815 completed pregnancies, looking at complications from miscarriage and stillbirth to pre-eclampsia and preterm birth, comparing background rates of occurrences in the general population to the vaccinated women. Every single outcome was in line with the expected frequency of such incidences overall, indicating that the vaccine had not affected the outcome. In other words, side effects and any adverse events in these women indicated no safety problems related to the vaccine; no unexpected pregnancy or infant outcomes were observed.

Moreover, the largest study of its kind, recently published in the American Journal of Obstetrics and Gynecology, showed the mRNA vaccines are highly effective at producing antibodies in pregnant and lactating women. The vaccines confer protective immunity to newborns through breast milk and the placenta. According to the researchers, vaccine-generated antibodies were present in all the umbilical cord blood and breast milk samples, showing that the mothers transferred antibodies to their babies. (It is not yet known how long the infants’ antibodies will last.)

One more consideration went into my decision: Inaction is also a form of action. By not getting vaccinated, I’d leave myself vulnerable to getting COVID while pregnant. Available data shows that pregnant women who get infected are more likely to require hospitalization and mechanical ventilation, and more likely to die, compared with non-pregnant women. COVID might also increase the risk of preterm birth. For women who can totally isolate for the duration of their pregnancies, these concerns may not be a factor.

For me, I have one child about to return to preschool, and my state, New Jersey, is having one of the country’s worst spikes in new COVID cases. My choice was clear. I got the shot–for myself, my baby and the rest of my family. My only side effect was a sore arm for one day and some (possibly pregnancy-related) fatigue. It was a small price to pay for the science-given gift of protection from a deadly disease.


Kira Peikoff is a bioethicist and the editor-in-chief of Leaps.org, an award-winning science media platform that covers biomedical innovation and ethics. She is also the science editor for Goodinc.com and Upworthy.com.

Lifestyle

For myself, my baby and the rest of my family.

I was nervous to get my COVID vaccine at 24 weeks pregnant, but here’s why I’m glad I did.

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