COVID vaccine during pregnancy – uptake lagging in the USA

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The CDC strongly recommends the COVID vaccine during pregnancy to protect the health of the mother and the developing fetus. The CDC stated that there are “no safety concerns” among women in their third trimester and for their newborn babies.

Despite the claims of COVID-19 deniers everywhere, the disease is dangerous and can cause both short- and long-term harm to anyone, and that means pregnant persons and their newborn babies. That’s why the COVID-19 vaccine is so important.

Unfortunately, recent data from the CDC shows that COVID-19 vaccine uptake during pregnancy has lagged badly. There are a lot of reasons for this, as you might guess.

Let’s take a look at what the CDC is reporting and why pregnant persons should get the COVID-19 vaccine.

COVID vaccine during pregnancy – lagging numbers

In a study published on 15 June 2021 in the CDC’s Morbidity and Mortality Weekly Report, researchers, using Vaccine Safety Datalink data which contains patient vaccination data from eight integrated healthcare systems in the USA, found that only a little over 10% of pregnant women were fully vaccinated against COVID-19 by early May 2021.

By 8 May 2021, 11.1% of pregnant individuals completed their COVID-19 vaccination series compared with 24.9% of non-pregnant individuals ages 18-49 during the same time period

The researchers also describe other results:

  • Vaccination rates were highest for women ages 35-49, with 22.7% receiving at least one dose of vaccine compared with only 5.5% of women ages 18-24, who had the lowest vaccination rates.
  • Vaccination was most common among non-Hispanic Asian women (24.7%) and non-Hispanic white women (19.7%)
  • Lower rates were observed in Hispanic women (11.9%) and non-Hispanic Black women (6.0%).

The researchers concluded:

Although low, COVID-19 vaccination coverage among pregnant women is expected to increase as vaccine availability and access improve, and as more safety data become available. Addressing barriers to access as well as augmenting the scientific evidence regarding safety and effectiveness of COVID-19 vaccines in pregnancy are critical. In addition, vaccine misinformation and hesitancy should be addressed. Strategies and approaches to expanding vaccination coverage in ways to ensure and prioritize equity also should be implemented.*** Finally, making accurate and timely information available to health care providers and pregnant women could increase confidence and thus acceptance of COVID-19 vaccines in this population.

COVID-19 vaccine and pregnancy – the research

The CDC recommendation was based on a study just published in the New England Journal of Medicine on 21 April 2021. The researchers used data compiled from 14 December 2020 through 28 February 2021 using data from the “v-safe after vaccination health checker” online surveillance system, the v-safe pregnancy registry, and the Vaccine Adverse Event Reporting System (VAERS) to study the initial safety of the COVID-19 mRNA vaccines from Pfizer and Moderna during pregnancy.

A total of 35,691 v-safe participants, age 16-54, were identified as pregnant. The researchers found that injection site pain was reported more frequently among pregnant individuals than nonpregnant persons. Headache, myalgia, chills, and fever were reported less frequently among pregnant women who received the vaccine.

Among the 3958 participants enrolled in the v-safe pregnancy registry:

  • 827 had a completed pregnancy.
  • 104 of those (12.6%) had a pregnancy loss The published incidence of spontaneous abortion, irrespective of vaccination status, is between 10-26%,
  • Among live-birth infants, 9.4% were preterm (compared to published 8-15% incidence), 3.2% were small size for gestational age (compared to published 3.5% incidence), and 2.2% had congenital anomalies (compared to a published 3% incidence).
COVID-19 vaccine pregnancy

The researchers also examined 221 VAERS reports that involved COVID-19 vaccines during pregnancy:

  • 155 (70.1%) involved non-pregnancy-specific adverse events.
  • 66 (29.9%) involved pregnant-or neonatal-specific adverse events.

I know that this is often lost on some people, but dumpster diving into the VAERS database can’t tell us much beyond very large safety signals. Also, these numbers do not represent every pregnancy where the COVID-19 vaccine was given, so the percentages don’t represent anything useful.

As it says on the VAERS website:

When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.

In other words, VAERS has only marginal usefulness to this analysis, and yet, it still doesn’t provide any safety signals for receiving the mRNA COVID-19 vaccine during pregnancy.

COVID-19 vaccine pregnancy
Photo by Spencer Davis on Unsplash

Conclusion

The dangers of COVID-19 during pregnancy indicate that getting the vaccine is one of the most important things that can be done to protect the pregnant person and their developing baby. Knowing that the vaccine is extremely safe during pregnancy should help anyone on the fence to feel comfortable that they are doing the right thing for themselves and their baby.

We have to continue to provide accurate information about the safety of this vaccine to counteract the various myths and tropes about the new COVID-19 vaccines. Furthermore, public health officials need to do a better job to reach out to communities of color to improve their vaccination rates.

Citations

  • Shimabukuro TT, Kim SY, Myers TR, Moro PL, Oduyebo T, Panagiotakopoulos L, Marquez PL, Olson CK, Liu R, Chang KT, Ellington SR, Burkel VK, Smoots AN, Green CJ, Licata C, Zhang BC, Alimchandani M, Mba-Jonas A, Martin SW, Gee JM, Meaney-Delman DM; CDC v-safe COVID-19 Pregnancy Registry Team. Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons. N Engl J Med. 2021 Apr 21. doi: 10.1056/NEJMoa2104983. Epub ahead of print. PMID: 33882218.


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The Original Skeptical Raptor
Chief Executive Officer at SkepticalRaptor
Lifetime lover of science, especially biomedical research. Spent years in academics, business development, research, and traveling the world shilling for Big Pharma. I love sports, mostly college basketball and football, hockey, and baseball. I enjoy great food and intelligent conversation. And a delicious morning coffee!