番茄社区

Even without studies to guide them, pregnant physicians are moving ahead with COVID-19 vaccination because they say the benefits outweigh any potential risks.

Hilary Shapiro, MD, chief cardiology fellow at the University of California Los Angeles, after "lots of reading and discussing with my doctors."

Denise Vilchez Cardenal, MD, of Ob Hospitalist Group and St. Lucie Medical Center in Florida, got hers at 31 weeks. She said she had no fever or muscle pain and her only symptom was "a little bit of pain at the injection site a few hours later, just like the flu vaccine."

Her arm was sore the next day but she still went to work and completed her 24-hour shift as scheduled.

Cardenal told 番茄社区 that she felt the many benefits of the vaccine outweighed any potential risks, especially since she's on the front lines in a hospital and has cared for patients with COVID-19.

"The decision is very personal. It should be something that [pregnant women] discuss with their physicians," Cardenal said. "For my situation, I thought it was essential to get the vaccine to be protected, for myself, for my unborn baby, and for my family at home."

Cardenal has a husband and three other children at home: 4-year-old twins and a soon-to-be 3-year-old. She's the only family member who's been vaccinated.

She said she was also motivated by COVID-19's increased risks to pregnant women. "Pregnant women are a vulnerable population, with increased risks of ICU admission, being mechanically ventilated, and an increased risk of death," she said.

Cardenal added that there are a lot of medications that "we really don't know what the risks are" when it comes to pregnancy. "Sometimes you just have to weigh the [likely] risks versus the benefits," she said.

Both the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal and Fetal Medicine (SMFM) recommend that COVID vaccines be made available to pregnant women.

"ACOG recommends that pregnant individuals should be free to make their own decision in conjunction with their clinical care team," the group .

SMFM also offering the vaccine to pregnant healthcare workers.

Pregnant women were excluded from the phase III trials of the Pfizer/BioNTech and Moderna vaccines -- which isn't unusual for vaccine clinical trials. Typically, pregnant and lactating women are included in subsequent studies, well after basic safety is established.

Animal data are reassuring, showing no untoward effects on developing embryos, Linda Eckert, MD, of the University of Washington in Seattle, .

Also, the mechanism of action of the Pfizer/BioNTech and Moderna vaccines is reassuring in that mRNA doesn't cross the placenta, Eckert said: "It's degraded very quickly which is why they have to surround it with a fat particle to get it into your cells."

She added that studies will be conducted to gather more definitive data on COVID vaccines in pregnancy.

Cardenal said she checked a box about being pregnant when she signed up for the CDC's VSafe program, which tracks patients' symptoms post-vaccination.

She also signed up for a registry at the University of Washington that's looking into the safety of COVID vaccination in pregnant and lactating women.

Cardenal hopes her story will inspire other pregnant healthcare workers to gain confidence in the safety of the vaccine.

"It's important for us as healthcare providers to set an example for our community and for our patients," Cardenal said. "If we unite around the truth and science, we can bring down the reservations that some people may have regarding the vaccine, and for the greater good of humanity, decrease morbidity and mortality."

She said that ever since she shared her story about getting vaccinated on Facebook, "I've had some colleagues say to me, 'Oh, wow, Dr. Cardenal, you got your vaccine, now I am for sure going to get it.'"

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