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Baystate Health doctors create guide for COVID-19 vaccination during pregnancy


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  • Boxes containing the Moderna COVID-19 vaccine. AP PHOTO

Staff Writer
Published: 1/13/2021 3:46:34 PM

SPRINGFIELD — As health care facilities around the country begin vaccinating against COVID-19, many pregnant people — a group not studied in initial clinical trials — question whether they can safely receive the vaccine.

To help those who are pregnant decide whether the vaccine is right for them, doctors at Baystate Health have released a decision guide that has drawn national attention and distribution.

Health officials have stated that most people can safely receive the Moderna and Pfizer COVID-19 vaccines, which were both approved for emergency use in the United States in December. But clinical trials were not open to pregnant people, leaving an absence of information for expecting or breastfeeding parents.

This lack of data does not necessarily mean that pregnant people cannot safely receive the vaccine, said Elizabeth Schoenfeld, a Baystate emergency medicine physician and researcher.

“It’s not that we have evidence that it’s dangerous in pregnancy,” Schoenfeld said. “We just don’t have evidence that it’s safe in pregnancy.”

But Baystate physicians say various factors support that the vaccine is worth considering for pregnant people, and that those interested should talk with their doctors to decide if the vaccine is right for them.

While physicians can’t point to guidance from Pfizer or Moderna regarding the safety of vaccinating pregnant individuals, doctors know “that pregnant people are at a really increased risk for complications of COVID,” said Katie Barker, a physician at Baystate Wesson Women’s Group, and that “there are tons of pregnant people who are at the front line” who are among the first group of people offered the vaccine.

“There is a strong desire for people to understand what they can about the vaccine because there’s such a strong desire to end this pandemic,” Barker said. “When there’s an area where there’s a lack of hard data, people want guidance.”

Barker, Schoenfeld and their colleagues at Baystate, including doctors Lauren Westafer and Amanda Westlake, who also played major roles in developing the guide, hope that the decision aid can provide this counsel for expecting parents. The six-page document, available on the Baystate website, lays out benefits, risks and expert recommendations for pregnant people considering the COVID-19 vaccine.

Different vaccines prompt various guidance for pregnant individuals: some, such as vaccines for tetanus and diphtheria, can be safely administered to pregnant people, Schoenfeld said, but others, such as the chickenpox vaccine, are not safe for this population.

Schoenfeld described the COVID-19 vaccine, which uses mRNA technology, as working “sort of like a recipe card.” The vaccine — which does not contain the live COVID-19 virus and cannot cause a person to become infected with the illness — prompts the body to recognize spike proteins, a tiny piece of the virus, and develop antibodies. This “recipe card” quickly degrades from the body, she said, and the vaccine mechanism does not indicate that it should cause problems in pregnancy.

The guide advises pregnant individuals who are at higher risk of exposure to COVID-19, or those who have risk factors for severe infection, to seriously consider vaccination. For those who are not at a higher risk, such as people who live in households where everyone is able to social distance throughout the person’s pregnancy, “it might make sense for you to wait for more information,” the guide states. This guidance is in development, Schoenfeld said, noting that the Centers for Disease Control and Prevention (CDC) is collecting data on pregnant people who receive the vaccine as it rolls out.

But until more data becomes available, pregnant people should feel that they have the choice and ability to make their own, informed decisions, the physicians said.

Baystate doctors originally had their colleagues in mind when creating the guide, but “quickly decided to share it with everyone we could,” Barker explained. “Once we did that we got such amazing feedback on it, and it took off from there.”

The guide has since been picked up by health care facilities around the country, including Boston Medical Center and Kaiser Southern California, and has been translated into languages such as Spanish and Russian.

“We really think that the decision about whether or not to get the COVID vaccine needs to be a decision that each person makes in conjunction with whoever is providing their care during their pregnancy or breastfeeding,” Barker said.

“We think the thing that’s important about this is to empower pregnant people and breastfeeding people to make the choice themselves,” she added. “It’s a choice they should be able to make with help from their health care providers.”

Jacquelyn Voghel can be reached at jvoghel@gazettenet.com.


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