Why pregnant women should resist ‘vaccine fatigue’
January 9, 2024
In early December, one of the Ob/Gyns in our office alerted me to a story on CNN Health about a 6-month-old baby who developed respiratory syncytial virus (RSV) after her pediatrician’s office ran out of a new RSV antibody therapy for infants. The baby’s mother, a doctor, said she didn’t pursue the therapy further because her baby was relatively healthy. But after seeing her baby struggle for three days in intensive care, she wished she’d pushed harder.
While the pediatric RSV vaccine remains in short supply, a new maternal vaccine given to pregnant patients is widely available to help protect newborns. It’s one of four immunizations we recommend to all pregnant patients – RSV, influenza, COVID-19, and Tdap (whooping cough and tetanus) – that have been proven to significantly reduce the risk of infection and severity of illness.
However, there is an alarming trend of “vaccine fatigue” setting in across the U.S.
Data from a 2023 research survey showed that about half of pregnant women did not get a flu or Tdap vaccine during the 2023 flu season. The survey also found that vaccine hesitancy during pregnancy increased between 2019-20 and 2022-23:
- Flu vaccine hesitancy increased 8% and actual vaccination declined 10%.
- About 73% of women did not get a COVID-19 booster before or during pregnancy.
- Although Tdap vaccinations increased 10% during the survey period, about 20% of participants reported hesitancy.
Vaccine fatigue is prevalent in our own community and practice, too. More pregnant patients are declining vaccines that can protect them and their infants against severe respiratory diseases.
We understand that getting four vaccines during pregnancy can feel like a lot, but we only recommend these immunizations because they are proven to be safe and effective in protecting you and your baby. If you’re feeling hesitant about getting vaccinated, talk with your health care provider and ask questions about each vaccine to ease your mind.
Flu vaccine
Why is it important during pregnancy?
The flu put about 650,000 people in the hospital during the 2022-23 flu season and caused about 58,000 deaths, according to the Centers for Disease Control and Prevention (CDC). Pregnant and postpartum women are at significantly higher risk of serious flu complications compared to nonpregnant people.
Getting a flu shot is safe during pregnancy and helps protect pregnant patients and babies. Pregnant women who get a flu shot pass along the antibodies that protect against the virus to their newborns – babies aren’t eligible for a flu shot until they are 6 months old.
When should pregnant women consider getting a flu shot?
The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics recommend that pregnant people get an annual flu shot as soon as it’s available, at any stage of pregnancy.
COVID-19 vaccine or booster
Why is it important during pregnancy?
Although the overall risks are low, pregnant women are more likely to get very sick from COVID-19 than nonpregnant people. Infection during pregnancy increases the risk of complications that can harm the pregnancy.
In September 2023, the U.S. Food and Drug Administration (FDA) approved updated COVID-19 vaccines, and the CDC recommended them for everyone 6 months and older.
Vaccination is the best protection against COVID-19 hospitalization and death. Vaccinated mothers will pass antibodies to the fetus in pregnancy, protecting them until they are eligible for their own vaccination.
When should pregnant women consider getting a COVID booster?
The COVID-19 booster isn’t seasonal. Instead, it depends on when new booster doses come out and how long it’s been since your last COVID-19 shot. ACOG recommends that all adults, including pregnant and breastfeeding women, get an updated COVID-19 vaccine at least two months after their most recent dose. Despite what some social media rumors have suggested, studies show the vaccine is safe for pregnant women during any trimester.
RSV vaccine
Why is it important during pregnancy?
While RSV appears as a common cold in most people, babies are at increased risk for severe illness. In fact, it is the leading cause of hospitalization for infants. In 2023, the FDA approved two new tools aimed at preventing severe RSV infections in babies.
The first is an RSV vaccine for pregnant women, which allows antibodies to pass from the mother to the fetus. The second is a monoclonal antibody therapy for infants and toddlers, which has been in short supply nationally. This therapy provides an infusion of prefabricated antibodies that teach the immune system to produce antibodies against RSV.
When should pregnant women consider getting the RSV vaccine?
Ideally, expecting mothers should get the RSV vaccine between 32 and 36 weeks of pregnancy.
The CDC recommends that infants younger than 8 months at the start of RSV season should get the monoclonal antibody therapy. However, infants whose mothers received the RSV vaccine during pregnancy and at least 14 days before delivery do not need to get the monoclonal antibody therapy because they will already have the antibodies in their system.
Tdap vaccine
Why is it important during pregnancy?
Pertussis, more commonly known as whooping cough, is a contagious disease that causes violent, uncontrollable coughing that makes it hard to breathe. While not as prevalent as it was in the past, whooping cough is still around, and it is especially serious for babies.
About half of babies who get whooping cough end up in the hospital, and most of the deaths each year due to whooping cough are in babies younger than 3 months old.
Infants can’t be vaccinated until they are 2 months old, so they must rely on maternal antibodies to fight off pertussis infections. Even if expecting mothers have had a previous Tdap vaccine, their level of antibodies decline over time. This means a woman should be immunized during every pregnancy for maximum benefit to each baby.
When should pregnant women consider getting the Tdap vaccine?
Tdap boosters are safe during pregnancy, and the CDC recommends all pregnant patients, even those who had been previously vaccinated, should get a dose of Tdap in their third trimester of pregnancy, ideally between 27 and 36 weeks.
Tips to keep yourself and your baby healthy
Beyond vaccinations, good hygiene habits will add a layer of protection from viruses. Reinforce these habits at home with family and guests:
- Wash your hands often with soap and water for at least 20 seconds each time.
- Cover coughs and sneezes with a tissue or shirtsleeve.
- Don’t share drinking glasses or silverware.
- Clean and disinfect high-touch surfaces, such as doorknobs, phones, and toys.
- Avoid contact with people who have cold-like symptoms.
- Try not to touch your face, mouth, or eyes.
- Stay home as much as possible when you or your children are sick.
- Wear a mask if you have symptoms and must be around people.
- Encourage family members and others who will be around the new baby to be vaccinated as well!
As we enter peak season for respiratory viruses, don’t let vaccine fatigue cloud your decision-making. Talk with your health care provider about which vaccinations to get and when to provide maximum protection for you and your baby.
If you would like to make an appointment with one of our Ob/Gyns, call 214-645-8300 or request an appointment online.
