May 20, 2021 at 5:00 am ET
Experts have warned since last year that the coronavirus is likely to move from pandemic to endemic, with COVID-19 becoming more like the common cold, an illness that circulates constantly. The recent dominance of faster-spreading variants has made such a prediction seem ever more likely.
That means the nation’s efforts to boost confidence in the COVID-19 vaccines are not just about vaccinating enough people now to end the pandemic, but also about long-term acceptance of the vaccines. We’ll very likely need booster shots annually, like getting the flu shot every year. In that context, I’m concerned that all the missteps we’ve made so far when it comes to vaccinating pregnant women against the coronavirus will have years-long consequences, endangering millions of women and their babies.
To avoid this, the nation must prioritize educating pregnant individuals and their health care providers about the safety and efficacy of this vaccine. At the same time, we must do more to better understand the impact of COVID-19 and the vaccines on the health of pregnant people and their babies. Our nation’s leaders must take action to protect pregnant people, especially those from Black and brown communities, now and after the pandemic ends.
The Centers for Disease Control and Prevention, March of Dimes — which works to protect the health of moms and babies — and leading medical organizations have said the vaccines should not be withheld from pregnant women. Even so, no nationwide COVID-19 vaccine confidence campaign has been aimed specifically at pregnant people or their health care providers explaining what we know so far and facilitating their decision-making about getting vaccinated, a communications gap with real consequences.
In that information vacuum, persistent myths have arisen, such as the idea that COVID-19 vaccines cause infertility (there’s no evidence of this) and that they alter your DNA (they don’t) and therefore could endanger a fetus (in fact, there’s some evidence the vaccines may protect fetuses). Research conducted last fall before the U.S. vaccination program began showed low levels of confidence among pregnant people, with many concerned that the vaccines would be unsafe for their babies.
At March of Dimes, we’ve heard stories of maternal health providers who unequivocally tell pregnant people not to get vaccinated. And states are telling us they need help educating pregnant people about the safety of the vaccines. At least 100,000 people to date have reported being pregnant when vaccinated, according to the CDC’s VSafe registry. Millions of additional pregnant people have yet to be vaccinated and need confidence that doing so is safe for them and their babies.
Pregnant people are not more at risk for contracting COVID-19 than others, but they are more likely to be hospitalized or die if they do become infected, according to a CDC analysis of national covid-19 data as well as a study of women in Washington state. Knowing that pregnant people are at elevated risk should have driven us to make sure they have access to and confidence in the vaccines.
Instead, the nation missed opportunities to ensure pregnant people could be confident in the safety of vaccines and to guarantee that public health officials and health care providers shared a consistent message about the importance of vaccination for those who are pregnant.
First, researchers didn’t study pregnant people in the initial vaccine trials, though medical and advocacy groups encouraged the Food and Drug Administration to include pregnant people.
Then, many states missed the opportunity to prioritize pregnant people in early phases of COVID-19 vaccinations, even though the CDC categorized them as high risk for coronavirus complications and leading organizations like March of Dimes said women should get the vaccine if they choose. Prioritizing pregnant people nationwide as soon as more data became available to support the safety of COVID-19 vaccines in this group could have sent an important message, showing that public health officials believed that pregnant women would benefit from early protection, like people with underlying conditions, frontline workers and the elderly.
Improving Data, Raising Awareness
Now that vaccination is open to all adults in the United States, we must work quickly to reach pregnant people and inform them. An important step lawmakers can take is to fast-track the Black Maternal Health Momnibus Act of 2021, which will require public health departments and the CDC to collect COVID-19 data related to pregnancy status so we can understand more about risks for and effects of COVID-19 during and after pregnancy. The act will also ensure pregnant and lactating women are not unfairly and unnecessarily excluded from future trials for COVID-19 vaccines and treatments. It will fund a robust effort to educate pregnant women, their employers and their health providers about COVID-19, including sharing information about the vaccines.
The Momnibus Act would also fund a national campaign to raise awareness about maternal vaccinations, including COVID-19 vaccines and other vaccines important during pregnancy, and boost maternal vaccination rates. Women from communities that historically have had low vaccination rates would be a particular focus, an important consideration as Black, Latino and indigenous women are disproportionately impacted by both the pandemic and the nation’s ongoing maternal health crisis.
The decision to get vaccinated is one a woman should make with her health care provider and the very best information in hand. America’s maternal mortality rates are already a national shame, a result of systemic failures that continue to haunt pregnant women.
We all owe women and their babies better than what we’ve given them during this pandemic.
Stacey D. Stewart is president and chief executive of March of Dimes.
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