COVID Vaccination in Pregnant and Breastfeeding Individuals

As U.S. vaccine distribution expands to include younger healthier populations, questions about vaccine safety in women of childbearing age have become more urgent. @UTSWMed's Catherine Y. Spong, MD and @emoryhealthcare's Denise J. Jamieson, MD, MPH, both eminent obstetrician/gynecologists, join JAMA's Q&A series to discuss the safety of the Pfizer/BioNTech and Moderna vaccination in pregnant and nursing moms, and in women trying to get pregnant. Recorded February 8, 2021.

Topics discussed in this interview:
0:00 Introduction
0:55 Viewpoint co-authored by Dr Jamieson
2:16 Viewpoint co-authored by Dr Spong
3:09 Risks of COVID-19 for pregnant persons and fetuses
6:35 Zika and pregnancy, differences from COVID-19
8:14 Delivery and postpartum for COVID-19-positive pregnant persons
11:35 Testing for vertical transmission
12:32 COVID-19 vaccines and pregnancy
15:50 Advice to pregnant persons about COVID-19 vaccines
18:55 Vaccine availability across States
20:12 Differentiating between vaccines
22:08 Professional society recommendations
23:04 Legal liability, risks versus benefits
25:04 Vaccine preferences among pregnant persons
28:00 Previous infection and vaccination in pregnant persons
29:29 Vaccinated individuals helping with infant care
31:23 Breastfeeding and vaccine risks
32:37 Excluding pregnant and lactating persons from clinical trials
34:14 Ongoing trials
35:36 Can vaccinated family members transmit COVID-19
36:28 Antibodies in breastmilk
37:10 Surprises with COVID-19 and pregnancy

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[JAMANetwork]

Topics discussed in this interview:
0:00 Introduction
0:55 Viewpoint co-authored by Dr Jamieson
2:16 Viewpoint co-authored by Dr Spong
3:09 Risks of COVID-19 for pregnant persons and fetuses
6:35 Zika and pregnancy, differences from COVID-19
8:14 Delivery and postpartum for COVID-19-positive pregnant persons
11:35 Testing for vertical transmission
12:32 COVID-19 vaccines and pregnancy
15:50 Advice to pregnant persons about COVID-19 vaccines
18:55 Vaccine availability across States
20:12 Differentiating between vaccines
22:08 Professional society recommendations
23:04 Legal liability, risks versus benefits
25:04 Vaccine preferences among pregnant persons
28:00 Previous infection and vaccination in pregnant persons
29:29 Vaccinated individuals helping with infant care
31:23 Breastfeeding and vaccine risks
32:37 Excluding pregnant and lactating persons from clinical trials
34:14 Ongoing trials
35:36 Can vaccinated family members transmit COVID-19
36:28 Antibodies in breastmilk
37:10 Surprises with COVID-19 and pregnancy

[davidskupien]

Last week, I had a friend twice test positive on a hiv rapid test just prior to delivery. The hospital forced hiv antivirals, then later determined the rapid tests were false positives with more comprehensive hiv test. False positive was believed to be from a covid vaccine shot provided a week prior to delivery. A side effect (false positive hiv), which with time will be shown to be a side effect. They also had to delay already started induced labor, only later to restart it.

[kaykay]

Thank God I was fine when I had covid. My baby was fine too and I am so grateful for such a blessing!!

[GC-fbpc]

Why not get some actual molecular biologists on?

[patrickdowling]

Why is pregnant "person" so important to you. Only biological WOMEN can be pregnant. Would she have been wrong if she said pregnant WOMAN?

[jennifermoreno]

Pregnant and breastfeeding women. There, I fixed it for you.

[asmrwarlock]

My 25-year old daughter was pregnant when she got covid. She recovered from it pretty fast, less than a week. But she ended up losing the baby. We were never really sure if it were the covid that killed the baby or not. The doctors told her and her husband that not enough was known about covid to determine it. I'm glad to see at least someone is testing and researching this now.

[loliejean]

This was so helpful. I was trying to become pregnant prior to the release of the vaccines. I work in healthcare and needed to be vaccinated for the safety of my pts. My OB told me she could not advise me because there was not enough known. I chose to put trying to get pregnant on hold until after I was fully vaccinated. Not an easy decision as I am almost 40 and waiting puts a pregnancy at greater risk for baby and me, and more difficult.

[AK-cicd]

I’m curious. Why is covid infection and illness more risky during the last trimester? Wouldn’t it be riskier earlier in the pregnancy when the fetus is still developing? Please educate me.

[autd]

Great conversation! If I’m understanding this correctly as a currently pregnant woman whose risk of exposure is low, I shouldn’t take on the risk of the vaccine... and maybe wait until I’m breastfeeding.

[alexchinn]

Thank you for this important information and thank you Dr. Bauchner for using the term pregnant person.

[searracadenhead]

what about a preemie infant who is breast feeding. I'm on the fence getting vaccinated prior to ending on BF journey. She spent 63 days in the NICU and was on oxygen

[sarahparker]

Thank you for this.So much information out there is incorrect or completely ignores pregnant and lactating moms in this pandemic.

[kimlarsen]

I have Alpha 1 Antitrypsin deficiency (A genetic form of COPD) yet I still can't get on a list. Angers me.

[patcamardo]

What if you have food allergies like peanuts?

[Aisha-]

This is very interesting and informative. It's really important to know how the covid affects pregnant women and unborn and newborn children. Pregnant women are as likely to get exposed to covid as nonpregnant people.

[highlansubi]

Thanks for the This is from a worried brand new father.

[laceyemery]

I appreciated that the moderator said "pregnant people" but then the MDs just went straight to "women." Ugh! Let's not erase the trans experience from pregnancy. Not all people who give birth are women!

[meowmeowmeow]

thank you for "pregnant persons" <3 no use in going backwards, lets progress :)

[magdalenamiamor]

It’s frustrating that although the moderator is using inclusive language, the doctors continue to use gendered language. There are DEFINITELY non-binary people and trans men who also get pregnant.