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Jennifer Gaines became pregnant with her second child early in the pandemic when vaccines were first becoming available. Jennifer is a Certified Nurse Midwife and shares how she made the decision to get vaccinated against COVID-19.
Becoming a parent is beautiful journey, but one that can also be full of uncertainty and stress. Add to that navigating a pandemic through pregnancy, birth and your little one’s first years, and the anxiety can be overwhelming. After all, it’s not just your health you have to be concerned about anymore.
That’s why Dr. Veronica Pimentel – a practicing OB-GYN, pandemic mom, and fierce vaccine proponent – is here to discuss the facts about COVID, vaccines, and motherhood. In Labor of Love, Dr. Pimentel works to alleviate the concerns of new parents who have questions about how COVID and the vaccines may impact pregnancy. In each episode, she’ll talk with real moms who share their stories about experiencing motherhood in the time of COVID, and follow up with maternal health experts who share accurate information so listeners are equipped to make the best choices for themselves and their families.
This podcast (“Resource”) is designed for patients and is for informational purposes only; it does not provide medical advice and it is not intended to replace the advice or counsel of a physician or health care professional. While ACOG makes every effort to present accurate and reliable information, this Resource is provided “as is” without any warranty of accuracy, reliability, or otherwise, either express or implied. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this Resource or reliance on the information presented. Please visit acog.org/laboroflove for more information, including the full disclaimer.
This Resource was supported by the American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as a part of a financial assistance award totaling $300,000 with 100 percent funded by ACOG and CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.
Dr. Vero Pimentel (00:06):
The last two years have been a rollercoaster. From the start of the first COVID-19 infections to quarantines to distribution of life saving vaccines, we've seen our world rapidly change right before our eyes. All while the world changed with each day, there were women everywhere whose own roles were changing in a very personal way. They were left trying to navigate how to best protect themselves and their families and all the stress and anxiety of living through the pandemic. ACOG is launching this new podcast on behalf of all women as a space for mothers to hear the stories of fellow moms navigating the pandemic, the decisions to get vaccinated and sometimes battling COVID itself. This is a space to hear from medical experts in the field of maternal health, fertility and mental wellbeing who'll provide the expert thoughts and recommendations on how to navigate pregnancy and motherhood during COVID. This is Labor of Love.
When the vaccines became approved and accessible, many new moms and pregnant women were in a dilemma. They wanted to protect themselves and their baby, but they were unsure of how safe the vaccines were, especially if they were pregnant or breastfeeding. Not to mention there were articles, pundits, and friends and family spreading all kinds of claims, some claims that were misleading and downright untrue.
It made the decision for many that was that much more difficult. Jennifer Gaines is a new mom who became pregnant with her second child in August of 2020. Jennifer is a healthcare worker and was eligible to receive the vaccine in the first stage of its rollout. But she was pregnant and although she trusted the medical and scientific community, she struggled to make the decision of whether to get vaccinated immediately or wait.
I got the chance to sit down with Jennifer and hear her story. I am very excited to present our first guest today for this episode. Her name is Jennifer Gaines and she's a certified nurse midwife from Everett, Washington. Jennifer is joining us to share her story as a healthcare worker, as a new mom at the beginning of the pandemic, and then as a pregnant woman during COVID who faced many challenging decisions. Thank you so much, Jennifer, for being here today.
Jennifer (02:29):
Thank you so much for having me.
Dr. Vero Pimentel (02:31):
You are welcome. Please tell us a little bit about yourself.
Jennifer (02:35):
Yeah, I'm a certified nurse midwife and I work in Everett, Washington, which is just a little bit north of Seattle, Washington. And for those of you that don't know, most certified nurse midwives do practice in hospitals, but some do out of hospital births. I practice in a hospital based practice in a busy hospital, actually the hospital that had the first COVID case, known COVID case shall we say in the US.
Dr. Vero Pimentel (03:03):
That must have been a very exciting and nerve-wracking time for you. So before we go into that, tell us a little bit about how life was like for you before the pandemic hit.
Jennifer (03:16):
I had my first daughter in October of 2019. So I did maternity leave and was going back to work. I went back to work February of 2020, right before everything hit. And my big challenge postpartum is that my first daughter never took a bottle. She bottle refused like crazy, went 10 hours one day at like four months old not taking a bottle. So we had to be very creative and luckily my parents live close to the clinic I work at and they would drive her to me and I was nursing her between clients. And then my husband was sleeping at the hospital with her during my 24 hour call shifts, calling me to nurse and taking walks in the neighborhood. We were just thinking, okay, well, I think that was even at three months, we'll just wait till we get to four months, we'll start solids. We're going to figure this out little by little. Little did we know life would change drastically pretty soon.
Dr. Vero Pimentel (04:20):
That was commitment on your part I have to say, the strong commitment there. And then COVID came and just changed everything for you.
Jennifer (04:29):
Yeah. I knew I would not be able to have my husband and daughter sleeping at the hospital and napping in my call room. So I had some amazing colleagues who split my 24 hour shifts with me and I switched to only work night shifts and we slept trained my daughter early so that we could survive really. And we would all drive to the hospital, I would nurse her right before I went into my shift and then my husband would drive her to me so that I could give report really fast and run out and nurse right afterwards. And we didn't know a ton about COVID. Many people were going home and bathing before greeting their family. I couldn't do that. I just had to say, "I'm going to nurse my daughter who needs food."
Dr. Vero Pimentel (05:12):
I was one of those people, by the way so I understand. But you said you couldn't do that.
Jennifer (05:18):
Yeah, no, I couldn't. I had to nurse her and during my clinic days, I was nursing her in the car again between clients hoping that I wasn't giving her something that she couldn't get, but she needed nutrition. Because that was the only way she could get it was from me. But it was a day by day figuring out how to do my job and be a mom at the same time.
Dr. Vero Pimentel (05:43):
I can imagine. And in fact, in many ways I do know how stressful that is having gone through somewhat of a similar situation. However, I did not live in Everett where the first case of COVID-19 United States was reported to be. What was it like for you at that time having gone through all these forces of something that was very scary for the rest of us in the US?
Jennifer (06:06):
Yeah. It was very close to home because this is the hospital that I work at. Obviously it spread very quickly, lots of different places. So it wasn't just us being affected by it. Our hospital has a really unique situation in that our women and children's pavilion, where labor and delivery and the NICU are, are two miles away from the rest of the hospital. So we had this odd buffer that most people don't have and usually we don't like it because ICU is down the street, it's not right next door if we have an emergency. But it has been nice for COVID in that we're not getting the really sick COVID patients coming in our building.
We see lots of people with COVID, but generally they're there to have a baby, not because they're sick with COVID, although that has happened, but that's not usually why we're seeing them. So that felt like somewhat of a protection that we're not going through the same doors that everyone's going through that are going to the emergency room, but you're still in a hospital with lots of people and trying to figure out what it means to interact with everyone when everyone's on lockdown and so many people are working from home and I couldn't work from home.
Dr. Vero Pimentel (07:20):
Not only couldn't you work from home, but you're also trying to raise a small human. And then in August of 2020, you get pregnant with your second child. Tell me how you felt at that point in time. Were you more at peace? Were you more scared, more nervous? Did anything change at that point in time for you?
Jennifer (07:41):
Yeah. Pandemics just make you do crazy things. And I think we just thought "Let's have another kid." Which was great, but a little close together which makes life exciting. And I think we just thought that maybe this thing would end sooner than it did like many people and summer always makes you feel like there's some glimmer of hope because things tend to look a little bit better in the summer when people are outside more. I think often there's no perfect time to have a baby if you're going to have one. And you just never know when it's going to happen for sure. So we went for baby number two and then had to continue figuring out how to be pregnant and be raising a small human and work in a pandemic.
Dr. Vero Pimentel (08:28):
As if you are not facing enough challenges, correct? But also exciting as you talk about. When you were pregnant with your second child, at some point in time during that process the vaccine became available, but you experienced some hesitancy about taking the vaccine. Can you discuss where that anxiety came from and what concerns you had around the vaccine and who did you talk about those concerns?
Jennifer (08:56):
Yeah, so I assumed that I would not be offered the vaccine. As with many things in healthcare, we don't always have studies for pregnant women and things often with children and in pregnancy, things don't tend to get offered as quickly. And so I was actually really surprised when it was going to be an option. And so I hadn't even been contemplating it because I thought "I'm so glad this vaccine's coming out, but I'm not going to be able to get it till I'm postpartum." I'm 20 weeks pregnant. And then a week before my hospital offered it to me was when ACOG and other organizations came out saying that it should be offered. At that point, we didn't have specific data like we do now, but enough about how the vaccine works that these organizations said you should consider the risk benefit. And so in that week before I was offered it, I was really torn.
I was on a phone call with some family members crying, trying to figure out what to do, talking to some colleagues thinking, "What would I say to clients" and weighing all the risks and benefits. And for me, it didn't just come down to me and my baby, but there were so many other layers to it. So first I had to think about the safety of the vaccine and from what we knew, mRNA vaccines were safe in pregnancy, but we didn't have good data. So I had to trust what we know from the past. Then I had to think about my risk as a pregnant woman. And so I was reading about increased risk of being intubated if I were to get COVID, increased risk of death if I were to get COVID. It just, all the risks we already knew about COVID were to a higher degree if I were to get it pregnant.
And then that would also affect my child, my unborn child and my living child and my husband and just all these levels and layers that would ripple out. And I had to think about me being at risk for getting COVID and spreading it to my family because I had to work around people. Then how that effect now my parents were helping with childcare again and they're older, I had to think about them as being risk factors, about my husband, my daughter, all these and my clients. If I were to have gotten COVID, I could have spread it to them, especially asymptomatically. So it wasn't just about me and it wasn't just about my unborn child. It was all these different layers that felt difficult to know how to weigh them all.
Dr. Vero Pimentel (11:35):
I completely understand. On a personal note, when I was pregnant during the COVID-19 pandemic, I was having those similar thoughts. I was lucky enough to have someone help me take care of my child during the pandemic that allowed me to come to the hospital and take care of my patients. And one of my biggest fear is that I would bring COVID to her, given that she was older at a higher risk. So those are the layers that you're talking about. It's not just about us, but it's about those that help us do what we do and those that care for us. So completely understand that. Where were you getting the information from at that point in time and did you get anything, any information from social media or news that might have affected your thought process or your decision making process?
Jennifer (12:25):
I actually went to ACOG a lot and the Society for Maternal and Fetal Medicine and looked at what we knew about COVID and pregnancy and what we knew about mRNA vaccines. We didn't have all the data we have now about the safety of the COVID vaccine in pregnancy. And I went on what I knew with years and years of my beliefs, well, not just my beliefs about the science of vaccine safety and how I have seen how vaccines have saved lives. I've done a lot of international work as well and know that vaccines are so important for safety and for saving millions of lives. I had to just believe that and I do believe that people aren't just making these vaccines willy nilly, and yes, this was really fast, but that's the amazing thing of how science is working and how quickly it has worked in this pandemic.
Once I signed up to get the vaccine, I got the email and I also didn't know at that point, if I said no now, when would my next opportunity be? This is when the vaccines were so limited that I thought, "How do I know I will be able to get one later?" I don't know. But I just remember feeling a huge sense of relief once I signed up and I thought, "Okay, this is telling me something. This is the right thing to do, that all I can do is make the best decision that I can with the information that I have right now." And I don't know how the information will change, but what I can do is feel good that I've made the best decision for myself and for my family in this moment.
Dr. Vero Pimentel (13:58):
That is exactly how I felt myself. And I think that's exactly how many women feel after getting the vaccine. I wonder how you feel now that a lot more information has come up and that we have very good data about the safety and how it protects pregnant people and new moms and their babies.
Jennifer (14:18):
Wow, huge relief. I don't think I doubted it, but it gives you the extra feeling of peace and knowing that you did make the right decision. And it gives me more motivation to encourage other people to get the vaccine because now I can just tell them, "Well, I think this is a good idea." And I did tell people that, and that I did get the vaccine, but I can say, "This is what we know and this is what the data shows."
And I had both my original vaccines while pregnant and I was actually still nursing my first daughter and then in nursing when I got my booster. So here we're at a stage now that we don't have vaccines for children under five and I have a lot of friends in that stage with children under five. And hopefully we'll get a vaccine soon that is effective. But I love knowing that hopefully they got something from me and we don't have the perfect data about how much is transferred in utero or how much is transferred through breast milk, but it's better than zero and not getting vaccinated.
Dr. Vero Pimentel (15:26):
Something is better than nothing at the end. Well, you already talked a little bit about this, but I wanted you to discuss a little bit more about what you would want women to know about getting vaccinated. Like specifically when you talk to your patients, what do you want them to know now with the data that we have today?
Jennifer (15:45):
That now, especially we are seeing risk associated with getting COVID in pregnancy that include really scary things like stillbirth and preeclampsia and preterm birth. And these are not things that you want to mess around with for you or your baby. And I think everyone thinks, "Oh, that won't be me," but we're just seeing a lot more complications anecdotally from people getting COVID in pregnancy and we don't know exactly how that's affecting their babies. And yes, you can still get it, but if you get the vaccine, it's less likely to be as symptomatic and as bad of an infection and therefore less risk of these other things for your baby. And so that's so exciting. And I think people think, "Well, you still get it with a vaccine," but the vaccine really is protective against all these risks that why wouldn't you want to get it for your baby?
And you get to vaccinate your baby without giving them a needle. You get to take the needle for them. And there's so many things as parents that we wish we could take for our kids so that they wouldn't have to have the pain in some way. And I also know that everyone's experience with COVID vaccines are different. I kind of thought that being pregnant with a weakened immune system I might have a worse reaction, but I really didn't react to any of the vaccines. I didn't really have side effects. That is not everyone's experience, but it was great not to have any side effects.
Dr. Vero Pimentel (17:17):
How having gone through a pandemic, being a patient yourself and delivering a baby and being a new mom affected how you relate to your patients, how you counsel them and the level of connection that you have with them now compared to before, for example, before the pandemic?
Jennifer (17:35):
Learning to be a parent in a pandemic is a unique experience. And being able to talk to parents about what that feels like and how it can feel isolating and talking about ways to help prevent postpartum depression and making sure they have some sort of community, even if that community can feel different than it might have been before. And just the importance of some things that we had taken for granted when we weren't as worried about the pandemic and that it's kind of been a moving target.
I feel like month to month and based on where you live and what's going on, you might change your guidelines and how you feel about masking or unmasking or where you go or what you do as a parent with a small baby. And that's okay. And that's part of parenthood is you're constantly re-figuring out where your comfort level is. And just because you make one decision one day doesn't mean it has to be the same the next day. So you might feel one day about vaccines and you can change your mind, just like you might feel one day about sleep training and you might change your mind or one day about nursing and you can change your mind. That parenthood is this journey of giving up control.
Dr. Vero Pimentel (18:47):
I want to thank you for taking the time to share your story with us. You are in the trenches. I can only imagine how it might have felt. Thank you for the work that you do. And thank you for being here with us today.
Jennifer (19:01):
Thank you so much for letting me share.
Dr. Vero Pimentel (19:08):
Jennifer eventually made the decision to receive the vaccine, but it didn't change the fact that she initially hesitated like so many pregnant women out there. We wanted to explore these hesitations so I sat down with a couple of maternal health providers to gain insight on key information to the many questions pregnant women may have. For today's episode, we have two more guests, Dr. Meaney-Delman and Dr. J. Martin Tucker. Dr. Meaney-Delman is the lead for maternal COVID-19 immunization efforts at the CDC. Dr. Tucker is the current ACOG President and Chair of Obstetrics and Gynecology at University of Mississippi Medical Center. Dr. Meaney-Delman and Dr. Tucker are here today as our health experts to provide evidence-based information around COVID-19 vaccination and safety. What an honor to have both of you here today. Welcome.
Dr. J. Martin Tucker (20:03):
Thank you so very much.
Dr. Meaney-Delman (20:03):
Thank you so much.
Dr. Vero Pimentel (20:05):
My first question is for Dr. Meaney-Delman. Can you briefly tell us about v-safe and what important data has come from it?
Dr. Meaney-Delman (20:14):
So v-safe is a text messaging system that is voluntary. It was developed specifically for COVID-19 vaccines. When individuals are vaccinated, they can sign up for v-safe and it will text message at various points to ask if individuals are having symptoms. From the v-safe text messaging system, we then developed the v-safe pregnancy registry. When women are identified as pregnant, when they sign up for v-safe, we then contact them and ask if they are willing to participate in the v-safe pregnancy registry, which allows us to contact them throughout their pregnancy, as well as after their child is born to examine the outcomes that occur both to the mother and to the infant. In terms of information that's come from this registry, it was rapid information. And I think the most important information was how many pregnant women were actually getting vaccinated.
And we saw many pregnant women who were choosing to be vaccinated early in the pandemic and throughout the pandemic. In terms of safety information, we did identify through v-safe that pregnant women were similar to the rest of the population in terms of the side effects they were experiencing. They had no higher risk of side effects than people who were not pregnant. In addition, we've been able to establish through v-safe that the vaccine is safe, it does not have an increased risk of miscarriage, it does not have an increased risk of other pregnancy outcomes. So overall v-safe has been one of the safety monitoring systems that has helped us determine that the COVID-19 vaccination during pregnancy is safe.
Dr. Vero Pimentel (22:04):
Well, as a physician who counsels patients and as someone who actually got the vaccine as well, I want to thank you for that work because this has helped us tremendously. So thank you again.
Now, our first guest Jen was really torn about receiving the vaccine given how quickly she felt that it was produced. A lot of women, a lot of people likely have similar hesitancy. What would you tell women who are pregnant or thinking about getting pregnant about the speed of development of the COVID-19 vaccine?
Dr. J. Martin Tucker (22:36):
The first COVID vaccine that was approved under Emergency Use Authorization was a messenger mRNA vaccine. And despite that relatively quick way that the vaccine came on the market, the platform for that vaccine had actually been developed many, many years before. In layman's terms was kind of sitting on a shelf as a way or a reason to use this platform. So in some ways, the research and the speed had already been taken care of, and the vaccine itself was developed over a relatively short period of time working with an existing platform. So I think that all the scientists involved in that development, all the physicians who ultimately ordered this vaccine, all the patients who took the vaccine, especially early on, feel very good as far as ensuring that this vaccine was and is safe and was developed with good, sound scientific knowledge before it was released to the public. I don't know if Dr. Meaney-Delman has anything to add to that, but those are some of the things that I would talk to patients about early on in the pandemic.
Dr. Meaney-Delman (23:51):
I completely agree Dr. Tucker. I think the other point that I would make is what was expedited was the approvals and the reviews. It was still in a scientifically rigorous process, but we just expedited the scheduling of the various reviews. So typically it would take a pretty significant amount of time to get on the books to have meetings both with FDA and CDC, they'd be much more spaced out. However, in this situation we knew we were in a pandemic and we knew we needed everyone working around the clock to review all the data carefully, but to meet and prioritize meeting and establishing the Emergency Use Authorizations for these vaccines.
Dr. Vero Pimentel (24:33):
So if I'm understanding you correctly, there were no safety steps that were not taken. It was just expedited. Is that a correct summary?
Dr. Meaney-Delman (24:43):
In fact, quite the opposite. I would say there was so much more attention to safety and so many more eyes on the data about the vaccine trials that I would say yes, it was expedited, but it had an even more rigorous process because we were in a pandemic and there were so many eyes on all the materials and all that data.
Dr. Vero Pimentel (25:03):
Thank you for saying that because I think that's a concern that many patients have had and many women, particularly pregnant women have had. How has the guidance surrounding COVID vaccine change from the beginning to now? Some patients were concerned that in the beginning the vaccine wasn't necessarily recommended and then that recommendation came about. Can we briefly talk about why there was a change in the strength of that recommendation?
Dr. J. Martin Tucker (25:28):
Yeah, and that's a great question. And to kind of take you through the timeline with that, these vaccines were not studied particularly in pregnant patients. However, there was a fairly large cohort of patients that during the studies who were inadvertently pregnant and there were really no safety signals that occurred within those patients during that time. So starting in December, 2020 moving into the early 2021, there was uptake of the vaccine amongst pregnant patients. Once again, no safety signals. So organizations such as ACOG continued to monitor this throughout the winter and spring of 2021. And as more data was accumulated, we went from the suggestion or the guidance that these vaccines should be offered to pregnant patients, to the strong recommendation that you pointed out, that came out I think in late July or early August of 2021 that says we recommend that all pregnant patients be vaccinated against COVID. And that was huge.
Dr. Vero Pimentel (26:39):
That change in the strength of recommendation was based on having more safety data to show that the vaccine was in fact safe. Correct?
Dr. J. Martin Tucker (26:48):
Absolutely. Absolutely. We went from just having, like I said, a smaller group of patients that had been inadvertently vaccinated to a much larger cohort of patients over a period of six to eight months that were intentionally vaccinated and the safety remained the same. No safety signals and it appeared to be a very safe vaccination, particularly for pregnant patients.
Dr. Meaney-Delman (27:13):
And if I can just add to that, I totally agree with everything that was stated. I think the other piece to remember here is pregnant women were intentionally excluded from the initial clinical trials. So we had very little information. And that being said, we made the recommendation to offer the vaccine to pregnant individuals, even without having that data because we know from other vaccines that they're generally safe in pregnancy unless they're a live vaccine.
So we went ahead and offered it. And I think that's an important piece that pregnant women were never, it was never a contraindicated for pregnant women from the start of the vaccine. And in fact, healthcare workers who were among the first groups that were vaccinated, pregnant healthcare workers signed up, got vaccinated, and in fact, enrolled in v-safe and that allowed us to produce the initial data to strengthen the recommendation to say, yes, in fact, we now have data to recommend this vaccine. Whereas before that, it had been primarily based on what we know about the vaccines, what we know about other vaccines and what we know about pregnancy. I think the important point is we follow the evidence with recommendations and we were able to strengthen that recommendation so quickly because all of these individuals signed up to provide the information about their experience. We're incredibly grateful to that first cohort of pregnant women who did in fact get vaccinated with very little information.
Dr. Vero Pimentel (28:43):
Dr. Meaney-Delman, you make an excellent point that vaccines were never contraindicated in pregnancy. And I think that's something that's worth restating. Many women still have some reluctancy to taking the vaccine because there's no long term safety data. What would you say to them?
Dr. Meaney-Delman (29:03):
First I would say we are continuing to monitor pregnant women who've been vaccinated through v-safe, through many other monitoring systems, but there's no reason for us to expect that there'll be any long term sequelae or consequences of these vaccines. We know a lot about vaccines. Yes, these are mRNA vaccines, but we know a lot about vaccinating in pregnancy. And we know that the benefits far, far, far outweigh any theoretical risks and there really is no reason to think that there'll be adverse long term effects on the children.
Dr. J. Martin Tucker (29:33):
Yeah. The safety of the vaccine continues to be reaffirmed day by day, week by week, month by month. And we still know that pregnant patients, if they get COVID while they're pregnant, they're more at risk of severe disease, they're more at risk of being admitted to the ICU, they're more at risk being placed on the respirator or mechanical ventilator, and they're more at risk of dying. And so Dr. Meaney-Delman pointed out once again, it is proven to be safe and we absolutely know the benefits of the vaccine and those benefits have been proven over the last, going on a year and a half now.
Dr. Vero Pimentel (30:12):
Dr. Meaney-Delman, I counsel my patients to get vaccinated at any point during pregnancy. In fact, I tell them the sooner the better. Based on data that you're getting from v-safe, is there a point in time where you think is best to get vaccinated in pregnancy?
Dr. Meaney-Delman (30:28):
I completely agree with you. I give my patients the exact same advice, which is to get vaccinated as soon as you seek prenatal care, as soon as it's available to you. What we have seen is that vaccinating pregnant women does create antibodies and those antibodies do pass to the fetus. And we are accumulating more data that is demonstrating that when women are vaccinated, there's actually protection of the fetus or the infant against hospitalization from COVID.
So right now, in the situation we're in now, if a woman were to come in early in her prenatal care, she would get her first dose, her second dose about a month apart, and then six months later, five to six months later, she'd get a booster. So depending on when she shows up, she will create a fair number of antibodies that can cross to the infant and ultimately can protect the baby. I tell them as soon as possible because you might even be able to fit in the two doses plus the booster, which probably will provide the highest amount of protection to the infant, although the data still yet to be seen on that. Dr. Tucker, would you agree?
Dr. J. Martin Tucker (31:35):
I do agree. And I think you stated it perfectly and as you pointed out, these antibodies certainly not only crossing the placenta, but also in the breast milk are suggestive of protection. I think intuitively most physicians would agree that there likely is a level of protection for the fetus, for the infant. To what degree as you pointed out, we really don't know, but certainly we will learn that as time goes on.
Dr. Vero Pimentel (32:01):
And many of us will say that something is probably better than nothing. So we'll work on that principle until we have data about that. Dr. Tucker, where is the best place for women to get the most accurate information about COVID-19 and the vaccines from ACOG?
Dr. J. Martin Tucker (32:17):
So ACOG has done a tremendous amount of work with vaccinations in general, dating back well over a decade now and they've been a leader in information regarding COVID vaccination during pregnancy. For patients, they can go to acog.org and go to the patient facing website there. There are many FAQs, frequently asked questions, that are posted on that website. There's traditional information regarding vaccinations in pregnancy, especially the COVID vaccination and particularly related to when it should be given, the safety, the efficacy, some of the protective aspects of it that we talked about earlier. Certainly that's where I would encourage patients to go initially. But there are many other great sources of information. For instance, the CDC or Center for Disease Control website is another great place to go. And not only a great place to go, but for reliable information because there's lots of information, lots of misinformation out there that patients need to be aware of and try to stay away from. And these are two places that you can go for reliable, reproducible information that you can count on.
Dr. Vero Pimentel (33:33):
Thank you. Dr. Meaney-Delman, can you expand more on the resources that the CDC has to guide women through the pandemic and through the vaccine decision making process?
Dr. Meaney-Delman (33:45):
Probably the easiest way is to Google CDC pregnancy vaccines, because there are so many pages out there and that will take you to the section of our website that really focuses on COVID and vaccines during pregnancy. We do produce reports on the number of pregnant women with COVID. We also produce reports on the number of pregnant women with severe COVID, which as Dr. Tucker pointed out, is a real concern when women contract COVID-19 during pregnancy. And in addition, we have a variety of websites that are targeted to the specific patient population. So for example, one of the myths out there was that the COVID-19 vaccines affect fertility. Well we know that's not the case. And if you want to see the latest information about that, you go to our COVID-19 vaccine pregnancy fertility website, and it will show you the latest data and link to the actual science that indicates the emerging information showing that the vaccines don't affect fertility.
That's one site. A second site would be someone who's pregnant already and that also has information, all the accumulating information about what we know about safety, as well as effectiveness of the vaccines during pregnancy. And as more data accumulate, we continuously update the website. For instance, as we have more data about the protective effects of the vaccines to the infant, that data will be put up on our website and will be referenced on our website. I think the most important thing in terms of referencing the CDC resources is go back often to the website because we are continuously updating it with new information. I know that can be challenging in most situations outside of a pandemic, it may take three, five, six, seven years for us to have new treatments and new studies. In this situation, this can come out every month. There can be three, four, five new studies. So it's because of all the investment in the pandemic and all the work that's been done by healthcare providers around the country to study COVID-19 vaccines, COVID-19 infection and pregnancy, which is why there's so much information.
Dr. Vero Pimentel (35:55):
I go to these resources all the time to see what's new, what has been updated, to make sure that I'm still saying what is still correct factually, is there any new research that I can discuss with my patients who want to know the numbers? I have one final question for both of you. Many parents like Jen, our first guest, talk about how they are continuously reevaluating their environment and their family's comfort level as COVID changes. What advice can you give to women in this changing landscape moving forward?
Dr. J. Martin Tucker (36:28):
I think it's important for people to do just as Jen did to keep up, to study, to understand, to ask questions, to go to these reliable resources because things do change. There's no doubt about that. We've had changes in recommendations as we've talked about earlier throughout the pandemic. But I think that one message I would give to any parent, any pregnant patient after you distill all this down, vaccination is the way to go. It's safe, it's effective. There are both maternal effects, positive maternal effects. There are probably fetal and infant effects. Get your booster. And that's the message I would send to any pregnant patient.
Dr. Meaney-Delman (37:12):
And I would absolutely agree. Get vaccinated, get your booster if you're eligible. Many people are now eligible for their boosters just based on timing and of when the vaccines became available. And I agree, staying up to date, but not only staying up to date on the big picture, but also staying up to date in your community, knowing what is happening with COVID-19 in your community will allow you to tailor your family's activities, whether or not you're wearing a mask, whether or not you're social distancing, all of those things that really need to be tailored to the level of COVID in your particular community. Right now levels are low. Hopefully they will stay that way, but it may vary over time and it may vary by community.
Dr. Vero Pimentel (37:56):
Great advice from both of you. Thank you so much to Dr. Meaney-Delman and Dr. Tucker for taking the time today to share your knowledge and expertise with us. It was a pleasure talking to you. Thank you for being here.
Dr. J. Martin Tucker (38:09):
Thank you for having us.
Dr. Meaney-Delman (38:10):
Yes, thank you.
Dr. Vero Pimentel (38:17):
As Dr. Tucker and Dr. Meaney-Delman discuss, there are key public health recommendations regarding COVID-19 and vaccinations that have been researched, informed by medical experts. To learn more about these recommendations and for additional resources, visit ACOG at acog.org/COVID-19 or CDC at cdc.gov/COVID-19. Thanks for listening to this episode of Labor of Love. In our next episode, we're going to hear the story of a mom who got COVID-19 while pregnant.
Speaker 5 (38:52):
They told me I was positive for COVID, but they gave me a breathing treatment, sent me home. Not even four days later, my condition had gotten so bad I was rushed back to the emergency room where they then found that I had double infiltrate in both my lungs.
Dr. Vero Pimentel (39:07):
And we are going to explore with maternal health experts how COVID-19 can impact pregnancy and if the vaccine can affect pregnancy in any way.
Speaker 6 (39:16):
It probably is worse in the third trimester as the uterus is bigger, although we've definitely seen some severe illness and deaths even in the first and second trimester of pregnancy, which is why we recommend to women that they get vaccinated.
Dr. Vero Pimentel (39:37):
Until then, if you know of a pregnant woman who's unsure about getting vaccinated or how COVID might impact their pregnancy, share this podcast with them and rate and review this podcast wherever you are listening. This is Dr. Vero Pimentel, your fellow mom, OBGYN physician and host of Labor of Love. You can find me on Twitter at Dr. Vero Pimentel or on Instagram at Dr. Vero for moms. Thank you.