Q&A: Vaccination ‘absolute best way’ to protect pregnant women against COVID-19 risks

In an urgent Health Advisory on Sept. 29, the CDC strongly recommended that women who are pregnant, who were recently pregnant, who are trying to conceive or who may become pregnant in the future get vaccinated against COVID-19.

Healio spoke with Nora Colburn, MD, an infectious disease specialist at The Ohio State University Wexner Medical Center and assistant professor at The Ohio State University College of Medicine, to find out more about the CDC’s recommendation and how physicians treating these women can encourage them to get vaccinated.

Healio: What prompted the CDC to make these recommendations?

Nora Colburn

Colburn: As of Sept. 27, more than 125,000 laboratory-confirmed COVID-19 cases have been reported in pregnant people, including more than 22,000 hospitalized cases and 161 deaths. The highest number of COVID-19-related deaths in pregnant people (n = 22) in a single month of the pandemic was reported in August. Data from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) for 2021 indicate that approximately 97% of pregnant people hospitalized (either for illness or for labor and delivery) with confirmed SARS-CoV-2 infection were unvaccinated. As of Sept. 18, only 31% of pregnant women were fully vaccinated.

Healio: Why are these recommendations necessary?

Colburn: Pregnant women are at high risk for severe disease from COVID-19, which puts them at risk for admission to the ICU, being put on a ventilator and death. Vaccination is the absolute best way to avoid serious illness, hospitalization and death.

Healio: What are the risks that COVID-19 specifically presents to pregnant and postpartum women?

Colburn: In addition to the risks for severe illness and death, there is an increased risk for serious adverse pregnancy and neonatal outcomes. These include preterm birth and admission of the baby to a NICU. When a baby is born early, they can have serious, long-lasting health consequences from prematurity. Other adverse pregnancy outcomes, such as stillbirth, have been reported.

Healio: Have you seen vaccine hesitancy among your own patients who are pregnant or who plan on becoming pregnant? If so, why have they said they are hesitant?

Colburn: I have seen vaccine hesitancy in many patients, including pregnant and postpartum women. During pregnancy, women must avoid certain medications and foods to avoid serious infections in themselves or the fetus. It is understandable to pause to make sure a medication or vaccination is safe. Many patients do not know all the data that have been published regarding the safety and efficacy details of the vaccines. There is also a tremendous amount of false information on social media and the internet about the seriousness of COVID-19 and the vaccines.

Healio: What common myths have you seen related to the vaccine and pregnancy?

Colburn: One common myth circulating on the internet is about infertility. This is an incredibly cruel rumor that taps into the natural fear that many people have of not being able to conceive in the future. There is absolutely no evidence that any vaccine, including the COVID-19 vaccines, cause infertility.

Healio: How do you respond to these concerns?

Colburn: First, I listen carefully to my patient’s concerns and questions with empathy and without judgment. After I have identified their questions and concerns, I answer them truthfully and reference the high-quality data that have been published in a way that is easily understandable. The vaccine protects not only the mother’s health, but also the baby’s health. Women can pass protective antibodies to their babies through the placenta and breastmilk when they are vaccinated.

I also try to make the conversation very personal. When speaking to pregnant women, I often share that I was pregnant during the pandemic and understand their concerns about wanting to protect their baby, especially during such a frightening and tumultuous time. The vaccine was not yet available when I was pregnant, but I wish I could have been vaccinated then so I could have passed on protective antibodies to my baby. I also share that I am fully vaccinated, my family is fully vaccinated, and when my infant son is old enough, he will be vaccinated.

Healio: Now that these recommendations have been released, what can doctors do to encourage more women to get vaccinated?

Colburn: Doctors should talk to their patients at every visit and urge them to get vaccinated. We must be trusted sources of information for our patients and combat the huge amount of misinformation on the internet. The CDC has several resources on its website to help doctors address vaccine myths and encourage their patients to get vaccinated. The CDC and many professional societies such as the Infectious Diseases Society of America have resources on their websites about how to talk to patients about the COVID-19 vaccine.