The third calendar year of the pandemic, and vaccination coverage among pregnant women remains incredibly low.
According to data from the United States Centers for Disease Control and Prevention, as of January 1, just over 40 percent of pregnant women in the United States ages 18-49 have been fully immunized before or during pregnancy, compared to 66% of the general population over age 5. For black pregnant women, the figure drops to around 25%. UK data is a bit less up-to-date, but only August 2021 22 percent of women who gave birth were fully vaccinated.
And with Omicron crawling is a problem. In late 2021, the UK vaccine watchdog, the Joint Committee on Vaccination and Immunization, announcement that pregnant women would become a priority group for vaccination, after oars of to research showed how vulnerable the group is to Covid.
But misinformation is rife within expectant parenting communities, where viral rumors have spread that vaccines cause infertility Where miscarriages, or that the spike protein in it damages a protein present in the placenta. A survey by the Washington Post found that app discussion forums for new parents are not only riddled with false claims, but include advice on how to convince doctors to delay or skip vaccines for pregnant adults and their children.
Expectant parents traditionally tend to display more vaccine hesitancythan non-pregnant peers. “You have to understand that initially pregnant women are terrified,” says Neel Shah, assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and chief medical officer of Maven Clinic, a telehealth company. for women’s health. “There are so many social messages around pregnancy that pregnant women feel like everything around them can be a threat.” Within these communities, any whisper of potential harm to a parent or baby will spread like wildfire.
To be clear: the data has resoundingly shown that vaccines are safe. A study published this month from the CDC of more than 46,000 pregnant women showed that vaccination did not increase the risk of delivering premature or smaller babies. Other recent studies have resoundingly show that vaccination does not affect fertility. There is no evidence of risk from vaccination during lactation; in fact, research at show that the protective antibodies a body produces against Covid end up in breast milk, potentially offering the baby some protection.
On the other hand, data has also shown that Covid can be deadly for pregnant women and their babies. A 2020 study in British medical journal found that if you are infected during your pregnancy, the risk of your baby being born prematurely doubles; the risk of stillbirth triples. Another study that year in the United States found that the risk of death for pregnant women with Covid was 22 times higher than their non-Covid counterparts. Pregnant women who are Covid positive at the time of delivery are more likely have preeclampsia or need an emergency caesarean section.
Clinicians have also started reporting a particular side effect of Covid during pregnancy, which they call covid placentitis. Placentitis is inflammation of the placenta, usually caused by an infectious agent, and is linked to stillbirths. And, more worryingly, cases are not appearing in patients with the most severe presentations of Covid – they appear in those who have mild to moderatecase.
Until July 2021, more than 99 percent of pregnant women admitted to UK hospitals with symptomatic Covid-19 were not vaccinated. But the low vaccination coverage cannot be blamed solely on the spread of false information. In fact, some of them may simply amount to garbled public health messages. Public health agencies in different parts of the world repeatedly changed tactics: First, vaccines were not offered to pregnant women. Then they could choose to get vaccinated, but it was not actively recommended to them. It took eight months after the vaccines became available for them to be recommended for pregnant women in the United States.
The inconsistency meant pregnant women no longer knew who to listen to or what the current advice was. (The term “pregnant people” includes trans and non-binary parents.) “What we weren’t very good at was making sure that every time the message changed, everyone got the memo,” explains Viki Male, an immunologist who studies pregnancy at Imperial College London. It doesn’t matter if a public health body updates its guidance — if news of the change doesn’t reach the intended audience, it won’t help.
A survey conducted by Shah’s company, Maven Clinic, asked 500 nationally representative pregnant women in the United States why they had not been vaccinated. Just over 60% I did not know that getting vaccinated was recommended during pregnancy. (Even today the web page for the UK Medicines and Health Products Regulatory Agency public evaluation of the vaccine Pfizer currently warns that “sufficient assurance of the safe use of the vaccine in pregnant women cannot be provided at this time” and that breastfeeding women should also not be vaccinated – both are false.)
A man points to Canada as a country that has handled the situation better: authorities have clearly communicated any changes in policy, she says, and as a result the percentage of fully immunized pregnant women is significantly higher than in the United States and in the UK. In the province of Ontario, for example, nearly 60 percent of people who were pregnant in September had received at least one dose.
While health authorities remained silent, pregnant women instead had to turn to trusted experts: their midwives, primary care providers and obstetricians. But the messages they received were mixed. In the Maven Clinic survey, a third of respondents said they had been advised against the vaccine by medical providers. Another survey of pregnant women in the UK conducted by Pregnant then fucked, a maternity campaign charity, discovered that more than 40 percent said they had been made to question the safety of the vaccine by medical professionals.
“A big part of why we were so confused with our messaging, especially for pregnant women, and so slow, is because historically we haven’t prioritized pregnant people,” Shah says. . Scientific research has a long history of forget women, and, more specifically, women carrying fetuses. The sordid legacy of thalidomide – a deadly drug distributed in the 1950s that killed thousands of babies and left many with deformed limbs – meant that medical researchers approached pregnant women with an overabundance of caution. This pandemic has been no different: To 2021 study in The Lancetfound that three-quarters of trials of treatments and vaccines for Covid-19 explicitly excluded pregnant women. “The default position for society as a whole – against which the health professions, including doctors, are not immune – is to be very, very hesitant to offer drugs to pregnant women” , says Shah.
This means that the lag in waiting for vaccine safety data has given people enough time to become skeptical or fearful. In the meantime, communication from health authorities has faltered, Male says, “and this is definitely a space where people who for whatever reason want to spread misinformation can go after this population.”
That we should prioritize pregnant women for vaccination should never have come as a surprise, Male says. “We should have thought, this will be a group that we probably want to vaccinate. And if that’s a group we want to vaccinate, we need to test a vaccine in that population,” she says. After the Zika virus outbreak, a group called To prevent was set up by academics to develop guidelines for the ethical inclusion of pregnant people in vaccine trials during a public health emergency. (The acronym stands for Task Force on Pregnancy Research Ethics for Vaccines, Epidemics, and New Technologies.) The guidelines included clear, contextualized communication of vaccine effectiveness to pregnant people, as well as evidence-based strategies to encourage confidence in the vaccine among this cohort.
But in this case, the guidelines weren’t enforced, Male says. “If we ever find ourselves in another situation like this, I think if we think pregnant women are going to need to be vaccinated, then we need to include them in the trials,” she says.
Shah believes that not prioritizing pregnant women, and the grim repercussions of that, is something we should have anticipated and prepared for. “In every humanitarian disaster, be it a pandemic, a war, a weather event, the well-being of pregnant women suffers disproportionately,” says Shah. “And I don’t know why we feel like we have to learn this lesson over and over again.”
This story originally appeared on wired.com.
