COVID-19 Vaccine Q & A with Dr. Eleni Pittenger

Jan 14, 2021

Why did you decide to get the vaccine?

It was definitely a tough decision! I relied on my own research of the topic, advice from my partners (Dr. Love may have me blocked on his phone now after all my calls ;)), and advice from our maternal fetal medicine (high risk OB specialist) colleagues. We don’t have long-term data on the effects of contracting the virus during pregnancy NOR long-term data on the effects of receiving the vaccine during pregnancy.  I see patients daily in both the hospital and office setting using all of the appropriate PPE but I know that COVID-19 is all around us.  When it comes down to it, I feel my exposure risk is very high, the vaccination is extremely effective, and COVID-19 can be a more devastating disease with pregnancy.  Ultimately, I did what I thought  was right to protect myself, my pregnancy and my patients. This being said, I don’t think there’s a “right” or “wrong” answer with regard to vaccination. Everyone needs to make a decision they feel comfortable with, based on their level of potential exposure.

 

How pregnant are you?

I’m 25 weeks today! Due April 4, expecting a baby girl :) 

 

When did you get the vaccine?

December 18, I got the Pfizer vaccine through Beaumont. I will be due for my second dose (to complete the series) January 8, three weeks after the initial dose. 

 

What do we know so far about the consequences of pregnant women getting COVID-19 infection?

Although the absolute risk for severe COVID-19 is low, there is an increased risk of ICU admission, need for mechanical ventilation and ventilatory support (ECMO), and death reported in pregnant women with symptomatic COVID-19 infection, when compared with symptomatic non-pregnant women due to changes in the immune system. The extent of vertical transmission (passage of the virus from affected pregnant mom to fetus) is unclear but seems very rare (if at all) based on current evidence.   

 

What do we know about the efficacy of the vaccine?
The Pfizer-BioNTech COVID-19 vaccine data was primarily based on a large, randomized, double-blind, placebo-controlled Phase II/III clinical trial that enrolled >43,000 participants. After two months of follow-up the vaccine was found to be 95% effective in preventing laboratory-confirmed COVID-19 infection. In vaccinated participants who got the virus there was a reduced risk of severe outcomes compared to the placebo group.

 

Were any pregnant women included in the vaccine trials?

No but studies on pregnant animal models (through Developmental and Reproductive Toxicity (DART)) have been reassuring without any major safety signals.  

 

What does the American College of Obstetrics and Gynecology (ACOG) say about pregnant women getting the vaccine?

ACOG recommends that COVID-19 vaccines should not be withheld from pregnant individuals who meet criteria for vaccination based on ACIP-recommended priority groups.

 

Are there any immediate side effects of the vaccine?

The most common side effect is a local injection site reaction (muscle soreness where you get injected). Systemic effects (fatigue, headache, muscle pain, chills) are more common after the second dose. Average onset 1-2 days after the injection lasting an average of 1 day.  

 

References:

ACOG Practice Advisory: Vaccinating Pregnant and Lactating Patients Against COVID-19

https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/vaccinating-pregnant-and-lactating-patients-against-covid-19

 

The Advisory Committee on Immunization Practices’ Interim Recommendation for the use of Pfizer-BioNTech COVID-19 Vaccine-United States, December 2020

https://www.cdc.gov/mmwr/volumes/69/wr/mm6950e2.htm?s_cid=mm6950e2_w