Getting COVID as one person is already a risky and life-threatening experience, but imagine obtaining COVID while carrying another human inside of you! Though there are risks of getting the vaccine shots while pregnant, there are far more risks for the baby to be born unhealthy if the mother is unvaccinated. Why risk your baby’s life when there is an easily preventable way of avoiding the possibility of losing your child?
The risks from developing COVID-19 when pregnant and unvaccinated were demonstrated in a recent study from Scotland. From December 2020 until the end of October 2021, a period when vaccines were available, there were 4,950 confirmed coronavirus infections among pregnant women. 77% percent occurred in those unvaccinated, along with 91 percent of the 823 hospital stays and all but two of the 104 intensive care admissions, researchers report January 13 in Nature Medicine.
Babies suffered too. The death rate for babies born within 28 days of their mother’s COVID-19 diagnosis was 22.6 deaths per 1,000 births, much higher than the rate for all newborns during the pandemic, 5.6 per 1,000. All of the babies who died over the course of the study were born to women who weren’t vaccinated when they got COVID-19, the researchers found. Scientists are still unraveling what’s happening behind the scenes during a SARS-CoV-2 infection in pregnancy, and why the delta variant was especially deadly for those expecting. The highest numbers of U.S. deaths for pregnant individuals, 40 in August and 35 in September, occurred during the delta surge. There aren’t details yet on how pregnant people fare after becoming ill with the now-dominant omicron variant. But experts don’t advise a wait-and-see approach. And the vaccines continue to offer protection against severe disease and death.
Pregnancy can be a risky time to get an infection in general. Influenza and malaria, for example, can be more severe in people who are pregnant than in those who aren’t. That risk is tied to changes in the immune system. “Pregnancy is a very complicated immune state,” says Andrea Edlow, a maternal-fetal medicine specialist at Massachusetts General Hospital and Harvard Medical School in Boston. The immune system needs to defend pregnant individuals and their fetuses against pathogens. If COVID is contracted by the mother while pregnant, then the baby in the womb will have to fight off COVID just as the mother has to. Learned in AP Biology, the mother has an advantage over the baby because the mother’s immune system has been exposed to more pathogens including bacteria, viruses, toxins, or other foreign substances that the baby hasn’t. In other words, the mother has adaptive immunity or acquired immunity, so after the first line of defense, known as innate immunity, is insufficient to control the infection, the adaptive response kicks into gear to try and fight off COVID. This puts the baby at severe risk of dying because its immune system is not fully developed yet, and hasn’t been exposed to any other pathogen before.
There have been 169,407 cases of COVID-19 among pregnant individuals in the United States since the pandemic’s start, with a spike in late December of 2021 due to omicron. The counts for January 2022 are not yet complete. When the delta variant took over in the summer and fall of 2021, the risk of stillbirth grew, the study found. From March 2020 to June 2021, before delta, the risk was 1.5 times higher for pregnant women with COVID-19. From July to September of 2021, when delta reigned, there were 3,559 deliveries among women with COVID-19, of which 96, or 2.7 percent, were stillbirths. Of the 169,330 deliveries among those without the disease, 1,075, or 0.6 percent, were stillbirths. That’s four times the risk.
The first inklings that COVID-19 was especially dangerous for pregnant people came in the first year of the pandemic. Year two brought vaccines and plenty of research found COVID-19 vaccination was safe during pregnancy. More than 194,000 pregnant people in the United States have gotten COVID-19 vaccines as of January 31, according to the CDC. There have been no reported safety concerns. A study of close to 2,500 participants in a CDC COVID-19 pregnancy registry found no increased risk of miscarriage after vaccination, researchers reported in October of 2021 in the New England Journal of Medicine. Nor is there a risk of the baby coming too soon or too small, researchers report January 7 in Morbidity and Mortality Weekly Report. The U.S. study of over 40,000 pregnant women found no link between COVID-19 vaccination and preterm birth.
Even with the reassuring data on COVID-19 vaccination during pregnancy, it’s been hard to stamp out the uncertainty some feel about the shots. Other vaccines are routinely recommended in pregnancy, such as the influenza shot. But the COVID-19 vaccines were new, and pregnant people, as is standard practice, were excluded from the clinical trials that assessed the shots’ safety and efficacy. Excluding pregnant women from the trials can make it seem like “something must be wrong, this must be dangerous,” Edlow says. There were no safety issues among individuals who became pregnant during the trials, nor were there safety concerns in animal studies. Medical organizations said that COVID-19 vaccines shouldn’t be withheld due to pregnancy, but a forceful recommendation for vaccination didn’t come until July 2021.
Though there has been hesitation from amounts of pregnant women about receiving the vaccine, at the end of the day they are just trying to protect their children from this very harmful and deadly virus, and the more knowledge they get from their doctors the more they understand that the best way for their child to be protected and healthy is if they get the vaccine.