COVID-19 Vaccines and Women’s HealthFebruary 5, 2021COVID-19 vaccines and what it means if you're pregnant or nursingDr. Cecilia Gambala, MDPregnancy is a time of great excitement for expectant families. But with New Orleans still under COVID-19 restrictions, local pregnant and breastfeeding families are worried about metro infection rates. Cecilia Gambala, MD, Maternal-Fetal Medicine Specialist who sees Obstetrics and Gynecology patients at the Tulane Center for Women’s Health, agrees that “it’s a very complicated time to be pregnant.” Pregnancy and COVID-19 While the overall risk of experiencing a severe case of COVID-19 is low, pregnant people who contract the disease have an increased risk of severe illness. This increased risk in turn translates to higher rates of hospitalization and intensive care (ICU) admission and in some cases preterm birth. With these risks in mind, as the COVID-19 vaccine becomes available to people of childbearing age, those who are pregnant or breastfeeding may have questions about vaccine risks and benefits. Tulane doctors at the Tulane Center for Women’s Health recommend talking to your physician about your options, as each individual’s health and pregnancy is unique. Dr. Gambala agrees, noting that her pregnant patients are full of questions about what more they can do to protect themselves and their baby. “I tell them, the one thing to consider is vaccination, especially if you are a frontline worker or high-risk.” Is it safe to take the vaccine during pregnancy? Dr. Gambala stresses that the available COVID vaccinations are safe. “We encourage pregnant women to strongly consider the COVID vaccine. While the chance of contracting COVID-19 during pregnancy is low, the severity of the illness in pregnant women can increase their risk of both fetal and maternal morbidity.” These current recommendations align with those of the Centers for Disease Control and Prevention (CDC), the American College of Obstetrics and Gynecology (ACOG), and the Society for Maternal-Fetal Medicine (SMFM). All agree that mRNA COVID-19 vaccines should be offered to pregnant and breastfeeding individuals who are eligible for vaccination. Dr. Gambala notes that vaccinations are strongly recommended for “women working on the front lines (who) are at a higher risk of contracting COVID, such as healthcare workers and teachers.” She continues that the vaccine is important for “more vulnerable populations, like those taking therapy that suppresses their immune systems, are immunocompromised or have severe respiratory illnesses.” What is an mRNA vaccine? The goal of a vaccine is to fight a virus, which contains a core of genes (made of RNA or DNA) wrapped in a coat of proteins. To make that coat of protein, the RNA or DNA genes make messenger RNA (or “mRNA”).The COVID-19 vaccines use just a piece of that protein coat, and do not use the live (or weakened) virus that causes COVID-19. These mRNA vaccines also do not change a person’s DNA or affect or interact with a person’s DNA in any way. Can the vaccine harm the fetus? When asked this question, Dr. Gambala unequivocally states, “no.” She explains, “In our current understanding of non-live virus vaccinations like the mRNA COVID-19 vaccine, the vaccine does not enter into a person’s DNA or enter the nucleus of their cells, so you will not contract COVID-19 from receiving it. Therefore, we believe it is safe for pregnant women and getting vaccinated will not cause you to pass the virus to your baby.” What about breastfeeding? Just as during pregnancy, when a new mother is vaccinated, her body reacts by developing antibodies that protect her against COVID. These antibodies can be passed through the breast milk to the baby. Medical research from previous mRNA vaccinations seems to indicate that newborns of vaccinated mothers who breastfeed may benefit from those same antibodies. Can the vaccine affect future fertility? If you are considering getting pregnant soon or in the future, receiving the COVID-19 vaccine as soon as it is available to you is a great way to ensure that you and your pregnancy are protected. COVID-19 vaccination is not believed to affect future fertility. Remember, the mRNA vaccines are not live virus vaccines and cannot cause any genetic changes. What to do until you’re able to be vaccinated? The Tulane Center for Women’s Health physicians advise pregnant and breastfeeding people to adhere to the proven ways of preventing virus contraction: social distancing, diligent handwashing, and wearing a mask at all times. Dr. Gambala says, “We understand that it’s getting tiresome to do all these things. But it's really important when you’re going out into the environment, into the community. You really only know the safety of your own home... so it’s important to take these very few steps to prevent COVID-19.” For more information or to set an appointment with a women’s health specialist, email email@example.com, or call 504.988.8070. Tulane Center for Women’s Health 4720 I-10 Service Road W., Suite 302 Metairie, LA 70001 Trevor Wisdom is the Managing Editor of Nola Family Magazine.