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Why pregnant people should get vaccinated for COVID-19 a maternal care expert explains | MorungExpress


New York, March 20 (The Conversation/PTI) I put on a gown, gloves and mask to enter the hospital room of a young mother with COVID-19.

She lies in bed, exhausted between coughing fits; her one-day-old baby is comfortably resting across the room. She contracted COVID-19 a week before giving birth and was hospitalized when she went into labor.

Given the illness of the mother and her inability to care for the newborn, we plan for the baby to go home with his father on the second day of life. But his mother will need to stay in the hospital to recover from COVID-19 and after giving birth.

The couple’s other two children are also in need of care. The road to recovery for this family will be a long one, but fortunately, the mother’s illness does not require intensive care or mechanical ventilation.

This is not what the family imagined when they made the decision not to vaccinate her against COVID-19 during pregnancy.

Unfortunately, scenarios like this have become all too common for me and other healthcare professionals during the COVID-19 pandemic. During the latest omicron surge, it was not unusual for four or five patients with active COVID-19 infection to be in the maternity ward at the same time.

Pregnancy is often a time of sweet anticipation. But the constant pressure to make the right decisions for the health and well-being of both the pregnant woman and the unborn child softens that excitement.

And, no doubt, making the decision to get vaccinated against COVID-19 adds another layer of stress.

The relative newness of COVID-19 in our lives, the fear of the unknown, and the abundance of misinformation often complicate these decisions. Advice during pregnancy comes from many quarters, including well-meaning friends and family, and sometimes even strangers.

It is worth noting that the decisions a person makes during pregnancy stem from a desire to avoid activities that could cause complications during pregnancy or harm the fetus.

At the same time, it is also important that the parent does everything possible to protect the well-being of the couple.

As a family physician specializing in maternity care, I often hear about the difficulties and embarrassment that pregnant women experience when making such important decisions.

My role is to respect the autonomy of pregnant women and provide evidence-based information that can help them make a decision.

When deciding whether to vaccinate against COVID-19, pregnant women should consider the potential risks of the vaccine, as well as any potential harm from exposure to SARS-CoV-2, the virus that causes COVID-19. These two sides of the same coin are important in the discussion and final decision that the patient makes.

Simply avoiding action is not the answer. Every pregnant woman should weigh her decision carefully and not passively accept doing nothing as a safer option, as choosing to do nothing is likely to mean accepting the risk of preventable harm.

COVID-19 has caused serious illness requiring hospitalization in more than 30,000 pregnant women in the United States, with 292 deaths as of mid-March 2022. The risk of severe illness is higher in pregnancies complicated by advanced age, high body mass index, hypertension, and diabetes.

Pregnant women infected with COVID-19 are three times more likely to require intensive care than non-pregnant women. Pregnant death is rare, but COVID-19 greatly increases this risk.

During the pandemic, disparities in health status have become more apparent. Black and Hispanic populations were disproportionately affected by COVID-19 infection, serious illness, and death.

This disparity persists among pregnant women, with infection rates among Hispanic pregnant women almost twice those of whites.

Leading health organizations, including the Centers for Disease Control and Prevention, the American Academy of Family Physicians, and others, recommend vaccinations to protect against serious COVID-19 illnesses for all pregnant women or those who plan to become pregnant.

The mRNA vaccines developed by Pfizer and Moderna are recommended for pregnant women in an initial two-dose series followed by a booster immunization five months later. Developed immunity has been shown to reduce disease severity, pregnancy complications, stillbirth and maternal mortality.

In mid-February, 68% of pregnant women over 18 were fully vaccinated compared to 75% of the general adult population. Vaccine complications are rare and mild, as are complications in non-pregnant patients. There is no increased risk of miscarriage, infertility or pregnancy complications associated with the vaccine.

In addition, vaccination during pregnancy provides important protection for newborns. Vaccinated pregnant women pass blood antibodies through the umbilical cord to the fetus, and this has been shown to protect the newborn from serious COVID-19 disease for up to six months.

A study of newborns in 20 children’s hospitals in 17 states found that 84% of hospitalized infants under 6 months of age were born to unvaccinated people.

And babies born to people vaccinated with two doses of the mRNA vaccine were 61% less likely to be hospitalized with COVID-19. As neonatal vaccination is unlikely to be available in the foreseeable future, the best option is to protect this vulnerable population through vaccination during pregnancy.

It is natural for pregnant women to have some uncertainty about the decision to get the COVID-19 vaccine.

They are likely to be insecure and have conflicting feelings about it, and they may receive conflicting advice from family and friends. I believe it is important to be empathetic and respectful of this duality when sharing information about vaccine safety and the risks of COVID-19.

Pregnant women should receive up-to-date, evidence-based information to help them make decisions about vaccination. If they choose to get vaccinated, family members or others may benefit from removing any access barriers that may stand in the way.

On the other hand, a pregnant woman who chooses not to be vaccinated should be provided with other additional advice, such as advice on wearing masks and avoiding high-risk contacts, to reduce the risk of illness.

The ripple effects of COVID-19 go far beyond the person with the infection, especially during pregnancy. It is clear that the vaccine can help prevent serious illness in pregnant women and that this is one way to prevent newborns from returning home without their mothers, either temporarily or permanently.



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