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Bill Klaproth: Let's talk about COVID-19 vaccine in pregnancy. Why the vaccine is safe? Does a vaccinated mother pass along immunity onto her unborn child? And is one vaccine better than another? Well, let's get answers to those questions and many others with Liane MacPherson, a certified nurse midwife at MarinHealth Medical Center.

This is The Healing Podcast brought to you by MarinHealth. I'm Bill Klaproth. Liane, thank you so much for your time. It is great to talk with you. So let's start here. Can you help us understand if the COVID vaccine is safe for women who are pregnant?

Liane MacPherson: Of course, this is really an ongoing topic that we see in our patients all the time. There's a lot of evidence about the safety and effectiveness of the vaccination during pregnancy and that body of evidence is growing. So the benefits of getting COVID vaccines far outweigh any known or potential risks of vaccination in pregnancy.

Bill Klaproth: Yeah. And does not getting vaccinated put the baby as well as the mother at risk?

Liane MacPherson: So if you're not vaccinated, you're more likely to be symptomatically infected and sick basically, and maybe even severely ill. So even if you're using masks and social distancing, pregnant people are still at increased risk for a more severe version of the disease compared to people who aren't pregnant at all.

Bill Klaproth: And of course, if the mom is sick, that's not good for the baby.

Liane MacPherson: Exactly. So the mother is sort of the carrying case. And if she becomes unstable, then obviously it threatens the baby too, sure.

Bill Klaproth: So does a vaccinated woman pass some degree of COVID-19 immunity to her unborn child?

Liane MacPherson: Well, we're not really sure how much immunity or protection is getting transferred from the mom to her baby. But there was a study that came out in September in the American Journal of Obstetrics and Gynecology that measured antibodies in the umbilical cords of the babies that were born, and 36 of the newborns that were tested all had antibodies. So that's pretty exciting, that their mothers were vaccinated and the antibodies were then showing up in the newborns.

Bill Klaproth: That is good news and good to hear. So when it comes to vaccines, is there one vaccine versus another that is better or that has been approved?

Liane MacPherson: All the vaccines that are authorized for use in the US have been proven to be very safe and effective at preventing some severe outcomes from COVID-19. And it's interesting, I think because there's been so much media attention to the numbers of, you know, these very high percentages, but these are great vaccines and they're all very, very highly safe and effective.

Bill Klaproth: So then what about for women who are planning to get pregnant? Does the vaccine impact her chances of conceiving?

Liane MacPherson: This is a very common concern. Right now, we don't have any evidence that vaccine causes any loss in fertility. And in fact, there's recommendations for vaccination if you're considering getting pregnant in the future coming from the CDC. And as of now, also for the male side of the fertility couplet, there's not any detrimental effects for the male fertility either.

Bill Klaproth: Okay. Well, that's good to know as well. What about for a woman who has had a baby and then gets vaccinated? Is that safe then for that woman to be breastfeeding?

Liane MacPherson: Absolutely. So according again to the CDC, this is where the information that we lean on a lot in our profession, recommending for all people five years or older, including people who are breastfeeding, sure.

Bill Klaproth: Okay. So that's not a problem then. Okay. So earlier, you told us that it is possible for a vaccinated woman to pass some degree of COVID-19 immunity to her unborn child. Can she do the same, pass some degree of COVID immunity to her child through breast milk as well?

Liane MacPherson: There's a lot of data being collected on this currently. Just in August, there was a one reported study that identified antibodies found in breast milk after vaccination. So it's looking promising, but again, these are some early studies, but we're hopeful.

Bill Klaproth: So I know there are a lot of women that are skeptical, right? Which is totally understandable. So just curious, who made the determination that the COVID vaccines are recommended in pregnancy? Was it the CDC?

Liane MacPherson: So the CDC issued a call to action in the form of a health advisory, which we see these in different times of health crisis for those who are pregnant or for those who even expect to become pregnant, recently pregnant and lactating mothers. And so the advisory comes partly in response to the data in August reporting the highest numbers in a single month of COVID-19-related deaths of pregnant individuals. So that's really important.

And also there was a statement earlier in the summer of a strong medical consensus of I think it were more than 20 national organizations that joined together and said, "We recommend the vaccination of the pregnant individuals against COVID-19." These are things like ACOG and the American Academy of Family Practice and the American College of Nurse Midwives and maternal-fetal medicine specialists in high-risk pregnancy. So it was a really compelling sort of unionized recommendation, which was really saying, "Yeah, we need to get pregnant people vaccinated."

Bill Klaproth: Right. So all across the medical community. That's good to hear that they are recommending the vaccine. So if a pregnant woman had the Pfizer vaccine say more than six months ago, should she get a booster now or wait until after delivering?

Liane MacPherson: Yeah, we're generally saying if you're eligible for your booster, go for it. And pregnancy is actually considered one of the certain medical conditions that qualify you for a booster. So you're good to go, basically. If your time is up and you're eligible, we recommend that.

Bill Klaproth: Okay. Good to know. So then let's touch base on some other vaccines. What about the flu shot? Should pregnant women get a flu shot?

Liane MacPherson: Right. I mean, it sort of drifted off into the front of our minds because of all the COVID attention, but yeah, we really need to remind ourselves there's other viruses that can impact expectant birthing people and pregnancy creates these changes in the body, like an immune system, and it makes us more prone to severe illness just from the regular flu. So the CDC says, "Yeah, if you're pregnant, your babies are at increased risk for flu-related complications as well," so more likely to be hospitalized with the flu for instance than non-pregnant women.

And the CDC also says getting a flu shot in any trimester is fine. So flu shots have been given to millions over the decades with a really excellent track record. So it's important though with the flu shot to remind pregnant people to get the shot and not the nasal spray, so that's just something to bear in mind. But in postpartum and breastfeeding, absolutely fine for the regular flu shot, yeah.

Bill Klaproth: Okay, well, that again is really good to know. And then how about TDAP, when in pregnancy is that recommended and why is that important?

Liane MacPherson: Right. So TDAP or this is the pertussis vaccine is also recommended for pregnant women during each pregnancy in order to protect their infants. So when they're the most vulnerable and not old enough, the newborn, they haven't started their own vaccine series yet, because that doesn't happen until they're two months of age, pertussis really can be life-threatening to babies. So the best time is between about 27 to 36 weeks, so in the middle end of pregnancy and it maximizes the mom's ability to create this antibody response and passively sort of protect the baby.

Bill Klaproth: Right. So really important to consider that. And then what about women who are pregnant or planning to become pregnant and are still unsure about getting the COVID vaccine or any other vaccines for that matter? Who should they speak with for help making that decision?

Liane MacPherson: This is really such a good conversation to have with your primary care doctor, meaning your OB-GYN or your midwife or your nurse practitioner and make sure that you get all your questions answered, but there's just a lot of great evidence to say it's a good thing to get all these protective vaccines and really keep pregnant women safe and healthy.

Bill Klaproth: Yeah, well, Liane, this has really been informative. Last question, anything else you want to add to share with us about why the vaccine is safe in pregnancy?

Liane MacPherson: In taking care of women and watching some of the stressors and the things they have to worry about, just taking some of these manageable and preventable diseases out of the picture during pregnancy is such a gift and makes things less stressful, both from the clinician and the receiving end as we've taken care of women with COVID. It's such a relief when we hear of women coming in and their vaccines are all done. We just don't have to be as concerned about how that process looks for them.

Bill Klaproth: Yeah. Really, really important on that. Well, Liane, thank you again. This has really been informative and you've really helped answer a lot of questions that I know a lot of women have. So thank you so much. We appreciate it.

Liane MacPherson: You are so welcome. Thank you very much.

Bill Klaproth: And once again, that's a Liane MacPherson. And for more information, please visit mymarinhealth.org. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for topics of interest to you. This is The Healing Podcast brought to you by MarinHealth. I'm Bill Klaproth. Thanks for listening.