COVID-19 vaccine logistics for pregnant and breastfeeding patients
February 16, 2021
As more community members become eligible for COVID-19 vaccinations, concerns are mounting that eligible pregnant and breastfeeding patients are being turned away from vaccine sites, including one in Chicago where a lactating mother and clinician made headlines in early February when she was denied a vaccine.
In a joint statement Feb. 3, the American College of Obstetricians and Gynecologists (ACOG) reconfirmed that pregnant patients who want a COVID-19 vaccine should get one. ACOG joined the Society for Maternal-Fetal Medicine, American Academy of Pediatrics, and other notable medical organizations in stating that denying vaccination to eligible pregnant patients is unethical and violates their health autonomy.
At UT Southwestern, we are currently offering vaccinations to eligible pregnant and breastfeeding patients and members of the community at our vaccination hubs.
In a Feb. 8 Viewpoint article on JAMA Network, my UTSW colleagues Emily Adhikari, M.D., and Catherine Spong, M.D., note that "physicians can empower women to make an informed choice."
Getting vaccinated against COVID-19 is a personal choice. We recommend talking with your doctor to clear up any questions or concerns you might have about your personal COVID-19 risks, the health of your pregnancy, or the vaccine itself. To help start your conversation, we've compiled a list of questions we've been answering for patients in the last few weeks. Take a look and jot down your own questions, then connect with your Ob/Gyn provider to gather the facts you need to make your decision.
COVID-19 vaccination education is key
Dr. Emily Adhikari, M.D., says the COVID-19 pandemic has highlighted the need for increased levels of education about the topic of vaccines and how they can benefit pregnant women and their babies.
Are all pregnant patients eligible now?
In Texas, pregnant patients are on the Phase 1B eligibility list, which means you can register for a vaccination appointment now if you want one. Lactating only is not enough to make you eligible right now, but you may get a vaccine if you meet other eligibility criteria.
Phase 1B also includes individuals 65 and older and age 16 and older with at least one common and chronic health condition that increases the risk of severe COVID-19 complications, such as kidney disease, heart conditions, sickle cell disease, obesity, and type 2 diabetes.
The Centers for Disease Control and Prevention (CDC) considers pregnancy a condition that increases the risk for severe COVID-19, but uses a slightly different classification and places people ages 16-64 with these medical conditions in Phase 1C. If you live outside of Texas, check with your state Department of Health to learn which vaccination phase your state is currently serving. To avoid being turned away at a vaccination site, you should also find out if there is any necessary documentation you need to support that you are pregnant.
Will I be safe after getting vaccinated?
While no vaccine is 100 percent effective, you will be more protected from clinically evident infection and severe complications – such as hospitalization, need for ventilator support to breathe, or death – if you are vaccinated.
Most pregnant patients likely are not at high risk for severe complications of COVID-19 infection due to pregnancy alone. However, common chronic conditions are shown to increase the risk of severe complications, particularly in patients who are black, indigenous, and people of color.
In the U.S., more than 40 percent of adults are obese and approximately 10 percent have diabetes – and roughly 20 percent don't know they have diabetes. If you have these or other chronic conditions that increase your risk for COVID-19, talk with your Ob/Gyn specialist about getting vaccinated. We can help you identify the personal benefits and risks of vaccination.
Does the vaccine protect my baby?
There is not enough data yet to know whether COVID-19 vaccination protects a baby in the womb or after delivery. A recent study found evidence that antibodies directed against the spike protein of the SARS-CoV-2 virus were transferred across the placenta to the fetus in women who had a COVID-19 infection in the past.
Vaccination during pregnancy against other respiratory diseases has made huge strides in reducing morbidity and mortality in infants. In their JAMA Network article, Drs. Spong and Adhikari note that influenza vaccination in pregnancy can decrease infant infection risk by 30 percent. Vaccinating pregnant patients against whooping cough (pertussis) can reduce infant infection by 85 percent.
The COVID-19 vaccines use a different technology from these established vaccinations, and data are limited right now. However, since there is no risk of getting COVID-19 from the vaccination (no approved formulations contain virus particles), the preliminary data suggest the risks outweigh the benefits for moms and babies.
Where can I get a vaccine?
Vaccines are available by appointment only due to limited supply. UT Southwestern's vaccine sites include:
- West Campus Building 3 (WCB3): 2001 Inwood Road, Ninth Floor, Dallas, TX, 75390
- Market Hall: 2200 Stemmons Freeway, Dallas, TX, 75207
- RedBird: 3550 W. Camp Wisdom Road, Dallas, TX, 75237
UT Southwestern patients: If you are eligible for vaccination, please check MyChart regularly for available vaccination appointments. Log in to your account, navigate to Quick Links, and click the "Schedule a COVID-19 Vaccine" icon. Get detailed scheduling instructions [PDF].
Not a UTSW patient? Not to worry. Eligible Texans can register in our COVID-19 Vaccine Registration portal. We open and close the portal in accordance with our vaccine supply. Please check back weekly if the portal is closed when you attempt to register.
The Texas Department of State Health Services (TDSHS) maintains a vaccination site database with details including total vaccines available by brand (Pfizer or Moderna). Find a vaccination site near you.
If you have difficulty using a computer or smartphone, enlist a loved one to help. You might also contact your local city government to find out what technology troubleshooting support is available in your neighborhood.
Does it matter which vaccine I get?
Both the Pfizer and Moderna COVID-19 vaccines are considered safe for pregnant and breastfeeding patients. Both proved about 95 percent effective in large clinical trials, and neither causes severe side effects in pregnant patients. You will need two doses of whichever vaccine you receive, with the second dose given three to four weeks after the first.
Related reading: COVID-19 vaccine FAQs for pregnant and breastfeeding women
How is the health system tracking pregnancy data?
Pregnant and breastfeeding patients are often excluded from clinical trials of new vaccines due to well-intentioned health concerns. Unfortunately, these exclusions can delay potentially lifesaving medical interventions.
If you receive the vaccine during pregnancy, ask your healthcare provider how they are tracking statistics of pregnant patients who get vaccinated. As Drs. Spong and Adhikari note in their article, secure, anonymized vaccination data from pregnant patients will become important to expedite access for future patients – and potentially allow them to be included in future vaccine studies.
You can also sign up to participate in the CDC’s V-SAFE post-vaccination checker. As of Jan. 20, more than 15,000 pregnant women have enrolled. We expect these types of resources will provide valuable information about pregnancy and COVID-19 vaccination in the future.
If a pregnant or breastfeeding patient meets the criteria to get vaccinated, she should be allowed to do so in accordance with state and local vaccination allocation plans. Even after you get vaccinated, it will be important to continue washing your hands, avoiding large indoor gatherings, wearing a mask, and social distancing – at least until a majority of the population gets vaccinated.
To visit with a doctor about getting vaccinated during pregnancy, call 214-645-8300 or request an appointment online.
Pregnant patients should weigh benefits vs. risks
For pregnant patients who are undecided about the COVID-19 vaccine, Emily Adhikari, M.D., says they should talk to their Ob/Gyn about weighing the benefits of vaccination against their potential risk of catching the virus, particularly in an area of high community spread.
