Earlier this month, New Yorkers with qualifying conditions including pregnancy became eligible for the COVID vaccine. Increased eligibility is unequivocally good news — yet many pregnant women and people trying to conceive have concerns about getting vaccinated. Being or trying to get pregnant can already be anxiety-provoking; the uncertainty of the vaccine’s effects can understandably exacerbate those feelings. To explore these issues and learn more, Lauren A. Tetenbaum, LMSW, JD spoke with Dr. Arielle Bayer, an OBGYN and Reproductive Endocrinology and Infertility fellow in New York and a recent second-time mother herself.
Lauren: Congratulations on your new family of four! This is a happy occasion, though we both know that caring for a newborn baby can feel lonely at times. And it goes without saying that the pandemic has been very isolating. How has COVID affected welcoming your baby and the postpartum period, compared to when you had your first child back in 2017?
Arielle: Thank you! I am missing the support from visiting friends and family that I had the first time. On the other hand, one thing I didn’t have the chance to do with my firstborn but am so glad to have had this time, is the opportunity to participate in a parent support group. Connecting with other new moms who have just gone through this shared experience has been really meaningful, even though it’s virtual! While it’s been sad to not yet introduce my baby son to friends and family, the arrival of the vaccine and subsequent declining infection rates are giving me tremendous hope that there’s light at the end of this tunnel. And I am so grateful that I myself am now fully vaccinated so I can best do my job as a physician.
Lauren: I’m so glad to hear that. Can you share a bit more about your decision to get vaccinated while pregnant?
Arielle: I was fortunate to have been offered the vaccine at the end of 2020 at the hospital where I work, when I was already 39 weeks pregnant. Because pregnant and breastfeeding women were excluded from all of the clinical trials, I did not make the decision lightly. Ultimately I did not want to pass up this tremendous opportunity as supplies have been extremely limited. I wanted to protect not only my own health and pregnancy given my exposure risk as a healthcare worker, but also that of the patients with whom I work. They are either planning to become pregnant or are in the very early stages of pregnancy; it’s such a vulnerable and stressful time to begin with! My vaccination helps protect loved ones in my household as well. I am so grateful for modern medicine and all the scientists, researchers, trial participants, and healthcare systems who made the opportunity possible.
Lauren: So did you find that the potential benefits outweighed the risks and unknowns?
Arielle: Absolutely. The American College of Obstetricians and Gynecologists (ACOG) recommends that, despite their having been excluded from the clinicals trials, the COVID-19 vaccine should not be withheld from pregnant women. This is especially true for those in a high-risk group like healthcare workers like myself. Over the last year, data has come out that pregnant women who get COVID are at higher risk of more severe illness than if they had not been pregnant. For pregnant women, we saw higher rates of hospitalization and ICU stays, the need for mechanical ventilation and respiratory support, and even death. COVID infection was also associated with preterm delivery, and higher C-section rates were seen as a result. Having a co-morbidity such as diabetes or obesity may also put you at higher risk of severe illness while pregnant. And devastatingly, as we’ve seen over and over again, Black and Hispanic women who are pregnant have disproportionately higher rates of COVID and death. Pregnancy itself is now considered a “high risk” condition by the CDC, so I was very pleased to see that New York State included pregnancy on its list of qualifying conditions for vaccine eligibility. All that said, each individual has different medical needs — it is imperative to discuss the risks and benefits of your own situation with your healthcare provider.
Lauren: I have been hearing from a lot of people who are trying to conceive or already pregnant who are worried about the unknown potential effects of the vaccine on the fetus.
Arielle: As of now we don’t have any reason to believe there will be detrimental effects on the fetus. The vaccines are not made with a live virus, but instead with mRNA (or “messenger RNA”) which is a synthetic genetic material that causes the body to “write” the code for a protein on the outside of the virus. When this protein is made, our bodies recognize it as “foreign” and will make antibodies to it. Similar to other vaccines that are recommended to be given in pregnancy (ie. influenza, TDap, etc.), our bodies do not see or encounter a live virus, but merely a blueprint to create the protection. In fact, there is some early evidence showing that antibodies made from the COVID vaccine have been found in fetal cord blood, which is very much what we were hoping for. The potential for the newborn to be protected is tremendous, especially since there are currently no approved vaccines for babies or children (and likely won’t be for some time).
Lauren: That’s great news. How about being postpartum and getting the vaccine while breastfeeding?
Arielle: There are several ongoing studies to examine the amount and effect of antibodies in the milk, but we believe they may offer some protection to the baby as well. There is definitely no need to stop breastfeeding in order to get the vaccine.
Lauren: Thank you so much for this information and for sharing your story as a doctor, a mom, and a pioneer in this area!
Arielle: Absolutely. And again, this is still a very personal decision; while I believe the vaccine should be offered to every woman trying to become pregnant, already pregnant, or recently pregnant, it is also completely understandable and perfectly okay if someone wants to wait until the vaccine has been out longer and more evidence has been established. Whenever something like this is new, the individual risks and benefits must be carefully weighed. I’d be happy to provide information on any further questions!
Dr. Arielle Bayer can be reached via Instagram: @ArielleBayerMD.