COVID-19 vaccine's effect on pregnant women and nursing mothers

Doctors say pregnant women are at a higher risk of developing complications from COVID-19. That has many wondering if the coronavirus vaccine is safe for them and their unborn child. Nikki Battiste spoke with Dr. Andrea Edlow, a Maternal-Fetal Medicine specialist at Massachusetts General Hospital, about a promising new analysis of the vaccine's effect on pregnancy.

Video Transcript

NIKKI BATTISTE: Pregnant women have more to worry about during the coronavirus pandemic. Doctors say they're at a higher risk of developing complications from COVID-19. A study from the University of Washington found the mortality rate among pregnant women with the illness is 13 times higher than other patients around the same age. So obviously, pregnant women want to know if the coronavirus vaccines are safe for them and their unborn children. The CDC released new research this week showing promising results the analysis found on 30,000 women who got either the Moderna or Pfizer vaccines.

Joining us now to talk more about the new findings is Dr. Andrea Edlow. She is a maternal-fetal medicine specialist at Massachusetts General Hospital. Dr. Edlow, one of the things these studies are trying to determine is how the vaccines can affect not only pregnant women, but their unborn babies. What's been learned so far?

ANDREA EDLOW: So far, all the safety data for all three vaccines that have emergency use authorization look reassuring. And American College of OB/GYN, as well as the Society for Maternal Fetal Medicine has said that pregnant women should have access to these vaccines, as well as lactating women. And the decision whether or not to get it depends on an individual conversation between each pregnant individual and her physician or care provider.

NIKKI BATTISTE: There are now three coronavirus vaccines available for people in the US. Is one better than another for pregnant women? If so, why?

ANDREA EDLOW: This is a common question from patients that we see all the time. The answer is no. The best vaccine to get is the vaccine that is available to you when you sign up for your appointment. And they've all been shown to be highly efficacious. And they all have very similar safety data that are known about them in pregnancy and lactation.

NIKKI BATTISTE: Dr. Edlow, as you know, Johnson & Johnson's vaccine is different from the Pfizer and Moderna vaccines in that it uses an inactive virus that causes the common cold instead of mRNA. Can you explain why this vaccine is still safe for pregnant women?

ANDREA EDLOW: Yes. That's also a common question that we get all the time. So the adenovirus vector is inactivated. It is not a live virus vaccine. And so while live virus vaccines are not recommended in pregnancy, this is something completely different.

It's what we call replication incompetent. It cannot replicate in the body, and it's inactive. So it just uses that common cold inactivated virus to deliver a piece of the spike DNA to your immune system so that you start to make antibodies. It's not dangerous. It's not a live vaccine.

And all the safety data on the Johnson & Johnson vaccine looked very reassuring. In fact, it's-- that adenovirus factor has been used before in the Ebola vaccine, as well as in HIV vaccines that have been given to over 1,000 pregnant individuals, and there are no safety signals that the FDA or others have seen in those data when reviewed.

NIKKI BATTISTE: We spoke with Dr. Anthony Fauci during our vaccine special "A Shot of Hope." He said so far there are no signs the vaccine is not safe for pregnant women or their unborn children. The CDC and the American College of Obstetricians and Gynecologists have given similar guidance. With that information in mind, what is your advice to expectant mothers who are still on the fence about the vaccines? And I know some of these women.

ANDREA EDLOW: So for each pregnant individual, it really is a personal decision that that person needs to make with their care provider. And it depends on several factors, including how much is the virus circulating in your community, what is your occupation, what is your risk level, what are your medical comorbidities, such as high blood pressure, diabetes, or pre-existing lung disease, or immune suppression.

And we know that being pregnant itself is a risk factor for severe COVID-19. So it's really balancing against the risks of getting COVID-19 in pregnancy with the chance that you would contract the virus and the unknowns about the vaccine that are theoretical that still exist because, unfortunately, pregnant and lactating women were excluded from the vaccine trials.

We do have some-- some reassuring data from a preprint that we posted on med archive in our own group that shows that pregnant and lactating women make very comparable levels of antibodies to the COVID vaccine compared to nonpregnant individuals of the same age, and all those levels are much higher than the titers that are achieved from natural infection with COVID. So all of this is reassuring to date.

NIKKI BATTISTE: I wanted to ask you on a personal note, I am a new mom, a new nursing mom. And like other nursing mothers, I've wondered what the benefits might be to my baby if I were to get a vaccine. Can you speak any more to that on what's been found?

ANDREA EDLOW: Yes. So we have seen in several studies that are now posted as preprints, none of which have gone through the peer-review process, so that process still is taking place for these papers, but in our study and others posted, they did see passage of maternal antibody into breast milk. And we know that maternal antibodies in breast milk can be protective to neonates against virus. So all the information that we have so far suggests that the COVID-19 vaccine, similar to other vaccines, can help protect babies by passing into breast milk and passing into the umbilical cord as well.

NIKKI BATTISTE: That's good news.

ANDREA EDLOW: Not the vaccine itself, but the mom's antibodies, to clarify.

NIKKI BATTISTE: Very good news.

ANDREA EDLOW: So lactating women, good news for lactating women, I think.

NIKKI BATTISTE: This is another question I've heard from some friends, are there any concerns about long-term effects of vaccines for women who may want to have a child in the future?

ANDREA EDLOW: Yeah, so this is a common question that we get. And all of the potential links between infertility and-- and the COVID vaccine have been disproven. They are not scientific. It is very safe for people who plan a family in the near future or the far future. So I would certainly encourage non-pregnant individuals to get it without any hesitation or concerns for infertility. That is unscientific and unproven.

NIKKI BATTISTE: So any concerns for women who are undergoing fertility treatments, another group that's-- was hit really hard during the pandemic? Some women had to postpone these treatments.

ANDREA EDLOW: Yes, no concerns. Again, not only are those concerns unproven, they've been disproven. There are no-- there's no homology between the RNA that is in the vaccines and any kind of placental tissue. That is unscientific. That is not true.

NIKKI BATTISTE: A lot of good news. Dr. Andrea Edlow, thank you.

ANDREA EDLOW: Thanks for having me.