COVID Vaccines In Pregnancy
There has been a lot of hype and hope regarding the COVID19 vaccines. Currently there are two COVID19 vaccines available for administration in the United States. They have been developed by Pfizer-BioNTech (BNT162b2) for age ≥16 years old and Moderna (mRNA-1273) for age ≥18 years old. Both are mRNA vaccines which utilize relatively new technology although based on old vaccine mechanisms. In fact, it is very similar to how the influenza vaccine works. Instead of introducing the piece of the virus for the immune system to react to, (as in the case of the influenza vaccine), these mRNA vaccines introduce the instructions for your body to make the piece of the virus for the immune system to react to. Importantly, mRNA vaccines do not contain live virus therefore can not cause actual infection.
Also, they do not interact or interfere with your own DNA as they do not enter the nucleus where the DNA is housed. Chances are really good you will not turn into a lizard monster or Wonder Woman no matter how cool the later may be!
There is limited data regarding the use of these vaccines in pregnancy and breast feeding. Currently pregnancy is considered a higher risk for severe disease thus vaccination may be an important consideration for the pregnant or soon to be pregnant woman. Vaccines that utilize this type of mechanism are not contraindicated in pregnancy and breast feeding. This is due to the fact that they do not use live or killed virus. However, the addition of using the mRNA step has not been widely studied in the pregnant population.
Both the CDC and the American College of Obstetricians and Gynecologists have released statements that stating that woman attempting to get pregnant, those who are pregnant, and those who are breast feeding should consider getting the vaccine unless there is an obvious contraindication to vaccination. This means that the average woman should get the vaccine. The rationale is that contracting the disease has potentially far worse outcomes than possible and/or theoretical adverse reactions from getting the vaccine.
In clinical trials, the vaccines had a very good adverse reaction profile. Below is a table reported by Massachusetts General from CDC data comparing the two currently available vaccines and lists the percentage of people reporting a reaction compared to placebo.
As with all medical intervention, discussion about your individual situation should be analyzed for benefit versus risk so that you can make the best informed decision for you, your family, and your newbie on the way.
About Dr. Drew Ambler
Drew Ambler, DO, FACOI, earned his Bachelor of Science degree in Biology from Ursinus College and his Doctor of Osteopathic Medicine degree from Lake Erie College of Osteopathic Medicine. Following his residency in Internal Medicine at Genesys Regional Medical Center, Dr. Ambler completed a fellowship in Infectious Disease at Botsford General Hospital in Michigan. From there, Dr. Ambler went on to work in various private practices including Colorado Infectious Disease Associates and has set up numerous Antibiotic Stewardship Programs for a wide array of facilities ranging from academic centers to small rural hospitals.