Amidst an environment filled with conflicting information, expectant mothers have a crucial choice to make regarding their health. You may hear conflicting narratives; one from Robert F. Kennedy Jr., the Secretary of Health and Human Services without a scientific or medical background, suggesting that the COVID-19 vaccine isn’t necessary for you, while the experts from the Centers for Disease Control and Prevention insist on the importance of boosters for this high-risk group. The consensus in the scientific world appears to lean towards vaccination. Pregnant women who contracted COVID-19 faced a higher likelihood of severe illness and hospitalization compared to their non-pregnant counterparts with similar health and demographic backgrounds, particularly during the early days of the pandemic.
A comprehensive analysis of 435 separate studies drew a harrowing picture. Pregnant and recently pregnant women infected with the virus were more likely to require intensive care, invasive ventilation, and faced a higher mortality risk than women of similar health profiles who weren’t expecting. These studies predate the availability of COVID-19 vaccines. As new variants emerged and vaccinations rolled out, the risks associated with serious manifestations of COVID-19 showed fluctuations.
Science triumphs over politics when lives are at stake, particularly the lives of expectant mothers who face an objectively higher risk of complications. An attempt at seeking comments regarding the scientific literature supporting COVID-19 vaccination for pregnant women on record yielded a non-responsive unsigned email from the HHS’ public office. Unfortunately, no further responses were received when support for an on-record statement was solicited.
In a surprising turn of events, Kennedy announced on May 27 that COVID vaccines would be omitted from the immunization schedule recommended for healthy pregnant women and children. This decision, bypassing the scientific processes that are the norm for CDC decision-making, came as a shock to officials at the agency.
Admittedly, much about COVID’s impact on pregnancy continues to remain shrouded in mystery. The physiological interplay between COVID-19 infections and mothers and fetuses at varying stages of gestation is a complex maze to navigate. Notably, pregnancy-induced changes to the immune system contribute to the increased risk facing expectant mothers.
“Naturally, during pregnancy, the maternal immune system experiences a certain level of suppression to prevent an attack on the developing fetus. While the maternal immune system is still at work, it’s not operating at its peak, making pregnant individuals more susceptible to illness and potentially struggling to effectively combat infections.”
Beyond the immune system, pregnancy quintuples women’s likelihood of blood clot formation, a risk further amplified if a COVID-19 infection enters the equation. The virus interacts with the vascular endothelium, a specialised cell layer lining blood vessels and orchestrating blood flow. Under normal circumstances, these cells contribute to clot prevention by regulating the vascular system through chemical production.
However, in the case of a COVID infection, this delicate balance is disrupted as the virus interferes with these cells’ ability to produce these vital chemicals, as demonstrated in scientific research. This disruption can lead to clot formation or other blood disorders, presenting notable dangers for both expectant mothers and their unborn children. Inflammation and clot presence in the placenta could increase the likelihood of stillbirths, particularly with certain COVID variants. This is according to studies published in renowned medical journals and findings from the CDC itself.
An inflamed placenta poses a significant challenge to the transportation of blood carrying essential oxygen and nutrients to the growing fetus. Disruptions in these operations, whether due to inflammation, clotting or disruptions in blood flow, will impact the functionality of the placenta and hinder the fetus’ growth and development. The placenta, a highly specialized conglomeration of blood vessels, appears to be a prime target for the virus due to its nature.
The placenta’s blood vessels are smaller and thus more prone to clotting compared to the larger vessels in a mother’s circulatory system. Recent findings indicate that even with prior immunity from vaccination or an earlier infection, pregnant women with a COVID infection retain a heightened risk of pregnancy-related issues like pre-eclampsia, premature birth, and miscarriage. Women can still face severe complications requiring hospitalization.
The link between COVID and stillbirth is also shifting due to widespread immunity procured from vaccines or past infections. Despite this, the field is ripe for further exploration. Both mRNA and non-mRNA vaccines have already shown to be safe for use in pregnancies. Later studies support these initial findings, revealing that vaccine boosters administered during pregnancies result in reduced newborn hospitalizations within the first few months following birth.
As more data becomes available, the benefits of a COVID-19 booster shot for expectant mothers should become increasingly clear. Owing to its capacity to bolster a pregnant woman’s immune system through an influx of neutralizing antibodies, vaccination reduces the chance of severe illness and hospitalization if the mother contracts COVID. “This vaccine will provide protection from more grave disease manifestations for the pregnant individuals,”
In addition to safeguarding the mother, vaccines given during pregnancy also offer protection to newborns who aren’t eligible for their own shots until they reach six months. Almost nine out of ten babies who required hospitalization due to a COVID infection were born to mothers who did not receive the vaccine during their pregnancies. Research as recently as April 2024 found that apart from the group aged 75 and above, unvaccinated infants experienced the highest rates of hospitalization due to COVID.
Scrapping the vaccine from the list of recommended shots for pregnant women has financial implications – insurance companies may choose not to cover the cost of the vaccine. Wanting the vaccine might mean pregnant women are forced to pay hundreds of dollars from their own pocket. “Newborns will be entirely unexposed to COVID, vaccinating pregnant women continues to be a valid strategy to safeguard newborns.”