Covid vaccine during pregnancy

[Eleano]

I couldn't find a recent thread so I'm posting a new one.

I'm 11 weeks pregnant and have had no encouragement from my midwife to get the Covid vaccine. I've booked it for tomorrow and wanted to get some opinions.

I got vaccinated for Covid a few times when everyone was being called for vaccination and have no issue with being vaccinated but I'm nervous now that I'm pregnant since it seems that most pregnant women don't get vaccinated due to fear and a lack of guidance.

I heard a few womens' midwives told them to avoid it since pregnant women weren't in the clinical trials and since the current variant isn't severe.

However, my husband's a teacher and brings Covid home about twice a year and I catch it every time and it makes me ill for about a week.

I'm the only pregnant woman I know in my social circle getting the vaccine. Am I doing the right thing?

Yes you are.

From here https://www.nature.com/articles/s41467-023-40965-9

"In summary, our national, population-based study provides high-quality evidence that SARS-CoV-2 infection in pregnancy is associated with increased risk of serious neonatal and maternal adverse outcomes, including preterm birth, very preterm birth, maternal critical care admission or death, and maternal venous thromboembolism. We expand on previous studies to show that the increased risk of preterm birth reflects the increased risk of both spontaneous and provider-initiated preterm birth, whereas the increased risk of very preterm birth reflects the increased risk of provider-initiated very preterm birth only. We also show that the increased risks are associated with infections in later, but not earlier, pregnancy. We do not find any evidence of an increased risk of hypertensive disorders of pregnancy or pregnancy-related bleeding following infection at any stage of pregnancy. Together, these findings can help to inform the clinical care of women with SARS-CoV-2 infection in pregnancy, for example, they suggest a need for vigilance for venous thromboembolism but no clear need for enhanced ongoing pregnancy monitoring due to infection in early pregnancy. We found no evidence that COVID-19 vaccination just before or during pregnancy was associated with any adverse neonatal or maternal outcomes, supporting current recommendations that COVID-19 vaccination remains the safest and most effective way for pregnant women to protect themselves and their babies from the risks associated with SARS-CoV-2 infection."

Yes you are doing the right thing. Flu vaccine is safe and recommended too.

I find it very interesting that despite all the messaging of the past few years you're the only person in your social circle getting it. The tide seems to be turning.

Personally I would not be getting it, but no doubt someone will pop along shortly to say that I shouldn't be saying this on a parenting forum. I'd want a personalised risk benefit analysis for my age, health, weight etc and careful combing through of data in pregnant women etc.

Considering pregnant women aren't allowed soft cheese and aspirin I think careful scrutiny of this vaccine is warranted. It does not use the same underlying mechanism as the flu jab or other conventional vaccines.

They'll also say that following the accepted scientific position is what is generally best, and they're probably right, but there have been many times when doing that has gone wrong for some.

You'll probably be fine either way, it's just choosing which risks are more tolerable to you.

In any event, good for you for asking the question, you're going to be a great mum! Xx

. ...I'd want a personalised risk benefit analysis for my age, health, weight etc

The SARS-COV-2 vaccine is recommended for pregnant women, because it is safer for them and their babies to be vaccinated than unvaccinated, even in young, healthy, normal BMI women.* *Pregnancy itself is a risk factor.

...and careful combing through of data in pregnant women etc.

Yup, this is what has informed recommendations for vaccines in pregnancy.

@Eleano Your best bet for unbiased up to date info is RCOG - they have a decision making tool which includes the most up to date info on coronavirus & vaccines in pregnancy to help you make an informed choice on this

https://www.rcog.org.uk/guidance/coronavirus-covid-19-pregnancy-and-women-s-health/vaccination/covid-19-vaccines-pregnancy-and-breastfeeding-faqs/.

"COVID-19 vaccines are strongly recommended in pregnancy. Vaccination is the best way to protect against the known risks of COVID-19 in pregnancy for both women and babies, including admission of the woman to intensive care and premature birth of the baby."

I second henlees message.

Considering pregnant women aren't allowed soft cheese and aspirin I think careful scrutiny of this vaccine is warranted.

I think this is a little disengenuous - these things are known to cause adverse effects (both with a strong biological rational i.e., soft cheese contains live bacteria, and empirical evidence).

For the SARS-COV-2 vaccine there was no hypothesised mechanism by which they would be harmful to pregnant women or babies in utero, which is why very high risk pregnant women were offered them when the rollout began. This assumption was made from our understanding of how vaccines work, and how these particular vaccines work.

These assumptions of safety were bourne out - robust examination of outcomes form women who were vaccinated allowed safety and efficacy to be established. this group. This is what led to the decision to offer to all pregnant women, especially when balanced against the risks of COVID for this group.

@Eleano I second getting your information from RCOG, who give a list of recommended vaccines in pregnancy and the evidence behind these recommendations. FWIW, I would go ahead if pregnant.

I got it, as did most of my mumsnet “due in the same month” group

I got it around 2 years ago when I was around 7 months pregnant. I drove myself mad deciding if it was the right thing to do.

I was emotional, hormonal and didn't know which way to turn.

I was scared of getting covid whilst pregnant and I was also scared incase the vaccine harmed my baby, unborn or later down the line. This was when omicron was doing the rounds.

It's a personal choice that only you can decide on. I went for it but I did wait until I was well over the 6 month mark.

For the SARS-COV-2 vaccine there was no hypothesised mechanism by which they would be harmful to pregnant women or babies in utero

Well, I'm not sure about this. We know now that the LNPs (and therefore mRNA) get into a very wide range of tissues, which then express the spike protein. The idea that it stays in the deltoid (which is what we were initially told) has turned out not to be true. And when a tissue expresses a foreign protein, it CAN set an unpredictable set of immune responses in motion. Clearly most people are fine, and I'm not for or against, but there's still quite a lot of uncertainty, OP. I'm sure you'll be fine either way, but don't feel pressured in any direction. All the best.

I've been struggling with the same decision OP. I'm 17 weeks pregnant and have had the flu jab and will get the whooping cough plus any others offered. But wasn't sure about the Covid jab. Anyway, the decision has been taken out of my hands in a way as I currently have bloody Covid for the fourth time. Was hoping I'd get away with a lighter dose but I've been well and truly floored with it and only just feeling better. The midwives also have me on Clexane injections for ten days to reduce the risk of blood clots.

I'm thinking that having Covid will give me the same sort of immunity (for a while) that the jab would? So I'll probably not get it now but just hope this current bout of it hasn't harmed the baby in any way!

I couldn't find a recent thread so I'm posting a new one

Looks like you inadvertently started two - here's the other:

Covid vaccine during pregnancy | Mumsnet

And for those who don't want to click through to it, following is what I posted there:

I wonder if there really are that many midwives who don't understand the issue and misrepresent both the safety of the jab and the additional risks that covid causes to pregnant women? (I hope it's just your pregnant so-called friends who are repeating stories that become more inaccurate with each telling).

The jabs have been give to literally tens of millions of pregnant women worldwide, with no observable increase in rates of miscarriage, stillbirth/neonatal death or congenital issues in the new born. The data from the ongoing surveys of actual use is now much more extensive than that from the early trials, and midwives as HCPs should know that.

Also, covid is not benign, and pregnant women are more at risk of the disease being moderate or severe (mildness in the general population is not the relevant standard here). There are higher rates of miscarriage amongst women who have covid in pregnancy. Also, covid isn't just a cold, it causes cardiovascular issues, which can include placental function. There's also a link to higher rates of diabetes, but I'm not sure if relationship with GD is adequately examined yet.

Feel you're deliberately taking my statement out of context, here it is in full:

For the SARS-COV-2 vaccine there was no hypothesised mechanism by which they would be harmful to pregnant women or babies in utero, which is why very high risk pregnant women were offered them when the rollout began.

I was making the point that, unlike soft cheese or aspirin, as mentioned by a PP, there was not a reason to think these vaccines would be harmful in pregnancy, which is why they were offered to high risk women (i.e., for those for whom potential unknown risks of a new vaccine were vastly outweighed by how risky COVID was for them) @vinegarasacleaner

As I said, this data could then be used to provide robust evidence for safety and efficacy in this group, which led to the later recommendation for it to be rolled out to all pregnant women.

This in turn led to more data, replicated and worldwide, which has been incredibly reassuring in informing vaccine guidelines. HTH.

@leafyygreens

For the SARS-COV-2 vaccine there was no hypothesised mechanism by which they would be harmful to pregnant women or babies in utero, which is why very high risk pregnant women were offered them when the rollout began.

From https://www.sciencemuseum.org.uk/objects-and-stories/medicine/thalidomide#:~:text=It%20took%20five%20years%20for,and%20reporting%20of%20side%2Deffects.

"It took five years for the connection between thalidomide taken by pregnant people and the impact on their children to be made."

Just because we don't know about problems doesn't mean there aren't any that won't take some time to discover - as @vinegarasacleaner notes above some issues are already coming to light.

I take your point about all the evidence etc., but as I've said before there are huge interests at play here. What do the studies actually say? Who is paying for them? For an example of the strange things that go on have a look at https://www.igor-chudov.com/p/how-to-make-covid-vaccines-appear. Also see Pain Hustlers film on Netflix for lots of fun and and an interesting note at the end about the research facilitating the debacle.

I said OP should get a personalised risk benefit analysis. This has to be different for an obese 40 year old than for a healthy 20 year old. Nobody got this during the initial role out and I do wonder how many would have made different decisions if they had. It will be interesting to see how the AZ litigation goes, and how long it will take for Pfizer to face the same.

As @vinegarasacleaner says, we are arguing about the margins, the vast, vast majority will be fine either way. But in a way we are arguing about something far more fundamental - the possibility of "The Science" getting it wrong, and taking some time to realise that it did so. The possibility that "The Science" is at least ever so slightly biased towards making profits for big pharma, and happy to take a few fines on the chin along the way. (https://en.wikipedia.org/wiki/List_of_largest_pharmaceutical_settlements)

I said OP should get a personalised risk benefit analysis. This has to be different for an obese 40 year old than for a healthy 20 year old. @AreYouVeryAnti

As I said, the SARS-COV-2 vaccine is recommended for pregnant women, because it is safer for them and their babies to be vaccinated than unvaccinated, even in young, healthy, normal BMI women. Pregnancy itself is a risk factor.

I think you should discuss with your midwife or GP, not ask randoms online. For what it's worth, why wouldn't you get it. Protect yourself and baby.

But in a way we are arguing about something far more fundamental - the possibility of "The Science" getting it wrong, and taking some time to realise that it did so. The possibility that "The Science" is at least ever so slightly biased towards making profits for big pharma, and happy to take a few fines on the chin along the way. @AreYouVeryAnti

This kind of stuff is endless on MN. There is no "The Science", and it's silly to try and imply this public health recommendation is just based on data from Pfizer (or whatever).

The current recommendations of vaccination in pregnancy is made by synthesising all the evidence we have. This is a complex process, done by 10s-100s of people and involves identifying all existing studies, robustly assessing them, and conducting quality assessment.

This has been done independently, by multiple public health bodies worldwide, each for their own country. The evidence itself is made up of multiple independent studies, all conducted by individual entities (e.g., universities, research bodies, other institutes).

You are implying a conspiracy that would involving thousands of experts - clinicians and scientists, to throw all their morals out the window, or just be incompetent, to push a vacccine where the benefits do not outweight the risks.

HTH and sorry @Eleano ! Sadly these kinds of threads only ever go one way.

I'm a teacher so couldn't avoid germs. I was on steroids for the first trimester so was offered the vaccine then and took it. Also had it in the third trimester. I now have a three week old baby.

Noted, but I still think a personalised risk benefit is important for informed decision making. For example, hypothetically, say chances of serious vaccine injury are 1 in 250k. Someone who has a risk of death from covid of 1 in 200k may take a different view to someone with a risk of 1 in 1k. Both will in theory be told risks outweighed by benefits.

But I'm not sure how many more times it can be said - even for the "lowest risk" pregnant woman, the risks due to pregnancy itself mean that vaccination against coronavirus is recommended, due to it being safer for both mum and baby.

At various points and in a number of places, the jabs have been "recommended" for healthy children aged 5-12 (at various points despite the JCVI disagreeing). The benefits did not outweigh the risks in these age groups. Same for university-aged students. And yet, it was "recommended" (sometimes on grounds which were quickly shown to be spurious - like prevention of transmission). The point is that, sadly, the recommendations do not always reflect what's likely to be best for an individual, so it's not surprising that people are no longer trusting them without question. Now, you might argue that it's best for pregnant women to get jabbed - but don't do so on the basis that it's "recommended".

One of my DDs is currently 37 weeks pregnant, and had the Covid vaccine in her second trimester.

@Eleano she has a first class Masters in the control of infectious diseases (basically she's a cross between an epidemiologist and a vaccinologist) so is pretty well qualified to make a risk assessment.

I had 3 covid vaccines whilst pregnant, one in each trimester and now have a healthy nearly 2 year old. I was happy to get the vaccine at the time with the information available.

Now, you might argue that it's best for pregnant women to get jabbed - but don't do so on the basis that it's "recommended".

This statement doesn't make sense @vinegarasacleaner

As described in my PP, these vaccines are recommended for this particular group (pregnant woman) because the benefits have been shown to outweigh the risks - it is safer for both mum and baby to be vaccinated than unvaccinated.

This is a recommendation based on research aggregated from many independent sources, and is a decision that has been come to by independent countries public health bodies, after they have evaluated the evidence themselves.

You are free to access all the studies which fed into these recommendations, and they are readily available. However as described, it takes the work of many experts to syntheises and appraise such huge amount of of info, which is why at some point you do have to take guidance from other people regarding health decisions.

@henlee I suppose what I'm saying is that, personally, I now want to see and appraise evidence myself, rather than trusting that what's currently recommended is what best for me. Until COVID, I was quite happy to go with "official recommendations", trusting thst they reflect best evidence. Turns out that they often don't.

Anyway, with any luck, the OP feels she can do what she feels best after looking into it.