Pregnant and breastfeeding people are facing abysmal vaccination rates and increasing health risks from the Delta variant, and they urgently need to be vaccinated, experts warn.
Only one-third of pregnant adults in the US have received the Covid vaccines – less than half the vaccination rate of all American adults. And stark disparities exist among different communities, with only 15.6% of Black pregnant people vaccinated so far.
At the same time, pregnancy is a risk factor for serious illness from the coronavirus. Being pregnant and unvaccinated doubles the risk of needing intensive care for those who have Covid, and leads to a 70% increased risk of death. In August alone, 22 pregnant people died from the virus.
Births are also more likely to be premature or stillborn, and newborns may also struggle with Covid infection.
It’s also important to vaccinate breastfeeding parents, both to form a cocoon of immunity around newborns and to pass antibodies through the milk, experts say.
New research reveals the Delta variant is hitting pregnant people harder than ever before. A study published this month found the hospitalization rate for pregnant patients more than doubled since last year, because of the Delta variant.
“Prevention is really key here, because there’s no proven or approved cure for Covid-19,” said Emily Adhikari, lead author of the study as well as a maternal-fetal medicine specialist and assistant professor at University of Texas Southwestern medical center.
“We’re very concerned that this is hitting a relatively under-vaccinated group because pregnant patients have lagged behind the rest of the population in getting the vaccine. And because they’re more vulnerable to severe illness – it’s bad now,” Adhikari told the Guardian.
Anna Euser was 32 weeks pregnant when the shot was offered to her late last year, and she took it immediately.
At that time, there were no data from the clinical trials about how well the vaccines worked in pregnant people. But Euser is an obstetrician/gynecologist and an associate professor of maternal fetal medicine for the University of Colorado School of Medicine. She had seen first-hand the way Covid wreaks havoc on pregnant people and their families.
“I felt very comfortable with the benefits of the vaccine, and the importance of getting it to protect both myself and my daughter, because that was one of the few things I could do to protect her,” Euser told the Guardian. “This was really the one strategy we have to try to protect both ourselves and our children.”
Now, thanks to volunteers like Euster, we do have data on how safe and effective the vaccines are among pregnant and nursing people. She was one of 827 participants in a study finding the vaccines were very safe.
But because of the rise of cases and lagging vaccination rates, Euser is now having difficult conversations with some of her unvaccinated patients: what happens if they need to deliver the baby early to help the parent fight off Covid? Who will make decisions for the baby if the parent is intubated and can’t talk?
“We really are trying to do the best for our patients and recommend vaccination, but there’s a lot of baseline hesitancy in many people,” Euser said.
Part of the reason is because pregnant and breastfeeding people are frequently bombarded by misinformation and disinformation campaigns.
“We’re dealing with coordinated misinformation campaigns, and they definitely target pregnant people,” Dr Cecília Tomori, director of global public health and community health at the Johns Hopkins School of Nursing, told the Guardian. “Fertility, reproduction and children are main anti-vax targets from way back.”
Because of the lag in established data on the safety and efficacy of the vaccines among these demographics, misinformation had plenty of time to take root, she said. And disparities in health mean that some communities are suffering more from low vaccination and high case rates.
“It’s just devastating to watch that unfold,” Tomori said. “It’s a rollercoaster cascade of disaster.”
Practitioners feel very confident recommending the vaccine as safe and effective, Euser said. “The vaccine is one of the best-studied things out there.” There’s much more evidence on the safety and efficacy of vaccines than there is, for instance, on experimental treatments like monoclonal antibodies and other medications, as well as using ECMO, a type of life support machine, in pregnancy.
Now, amid the wave of cases and deaths, experts are pleading with pregnant and breastfeeding people to speak with trusted sources of information, like their doctors, about getting vaccinated.
“We have still seen, with this last surge, younger and younger patients coming in extremely ill, and that tells us that we’re not quite getting through to all the patients,” Adhikari said. But the vaccines “really could potentially be life-saving”.