mRNA COVID-19 Vaccinations During Pregnancy: Deadly Hesitancy Remains
COVID-19 Vaccines are Recommended During Pregnancy, But Potentially Deadly Hesitancy Remains
The CDC as well as professional medical organizations, including the American College of Obstetricians and others recommend COVID-19 vaccination any time during pregnancy.
Pregnancy can be physically difficult and risky. One potential risk are worse outcomes from COVID-19 infection. A multicenter study published in 2023 “Impact of COVID-19 on Pregnancy Outcomes across Trimesters in the United States” Virk, S. et al. found that pregnant people had a greater risk of death and complications if infected with COVID-19:
“Our findings suggest that COVID-19 during pregnancy is associated with increased risk of maternal mortality and complications, particularly in the third trimester.”
These results are bolstered by a host of other studies showing that pregnancy increases risk of complications from COVID-19 infection that can also lead to fetal mortality. In general, COVID-19 infection increases the risk of losing the fetus.
COVID-19 vaccination reduces chances of being infected and developing severe disease, and death. But many pregnant women are still opting out of vaccination. A recently published study from Lancet shows in a large cohort that vaccine boosters further reduce incidence of stillbirth. Their findings are summarized here:
“COVID-19 vaccination protects against adverse maternal–fetal outcomes, with booster doses conferring additional protection. Pregnant people should be high priority for vaccination and stay up to date with their COVID-19 vaccination schedule.”
Despite this there is an overall low rate of vaccination before or during pregnancy with the CDC finding “Among 102,275 persons with a live birth occurring during May 1, 2021–October 31, 2022, COVID-19 vaccination coverage before or during pregnancy was 41.6% overall.”
The same study shows significant ethnic and racial disparities in vaccine uptake among pregnant people before or during pregnancy with Asian people being the highest at 55% and Hispanic people being the lowest at 26.7%.
Given the amount of disinformation about the vaccine I encounter on a daily basis, I can only conclude that it must be significant part of the equation as to why so few pregnant people are getting vaccinated for COVID-19.
To help combat scaremongering below I provide a list of linked peer reviewed studies demonstrating safety of COVID-19 vaccination for pregnant people and the positive outcomes for infants.
I review the first three studies in the most recent mini episode of “From Bench to Bedside” which can be found on Spotify and YouTube.
Evaluation of Acute Adverse Events after Covid-19 Vaccination during Pregnancy DeSilva, M. et al. New England Journal of Medicine, 2022
Newborn and Early Infant Outcomes Following Maternal COVID-19 Vaccination During Pregnancy Jorgensen, S.C.J. et al. JAMA Pediatrics, 2023
Neonatal Outcomes After COVID-19 Vaccination in Pregnancy Norman, M. JAMA, 2024
Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy Prasad, S. et al. Nature Communications, 2022
mRNA Covid-19 Vaccines in Pregnant Women Riley, L.E. New England Journal of Medicine, 2021
Maternal mRNA covid-19 vaccination during pregnancy and delta or omicron infection or hospital admission in infants: test negative design study Jorgensen, S.C.J. et al, BMJ 2022
COVID-19 mRNA vaccine in pregnancy: Results of the Swiss COVI-PREG registry, an observational prospective cohort study Favre, G. et al. Lancet, 2022
Safety of COVID-19 vaccines in pregnancy: a Canadian National Vaccine Safety (CANVAS) network cohort study Sadarangani, M. Lancet Infectious Diseases, 2022
Efficient maternal to neonatal transfer of antibodies against SARS-CoV-2 and BNT162b2 mRNA COVID-19 vaccine Beharier, O. Journal of Clinical Investigation, 2021
COVID‐19 vaccine and pregnancy outcomes: A systematic review and meta‐analysis Carbone, L. et al. Int. J. Gynaecol Obstet. 2022
I loved the podcast on this as well. Bravo!