This blog post contains citations and links that you can visit or click to get more details about the COVID-19, pregnancy and other relevant information. Updated as of October 18, 2021.
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| Fully vaccinated at 20 weeks AOG |
What made me do it? Two primary reasons.
1. To protect myself, my son and the upcoming baby
When my husband tested positive for SARS-COV-2 virus in July, I was deeply worried that my son and I might have also contracted the virus, it was mentally exhausting...fortunately though, we both tested negative. While it could mean that we’re probably immune or maybe, we just did well in exercising safety protocols upon learning my husband’s results, I knew that the natural immunity or the strict COVID management could not protect us until only-God-knows-for-how-long-this-pandemic-would-last. There is just one clear and plausible solution — to get vaccinated.
Based on the studies, pregnant women have been observed with higher risk of developing severe COVID-19, compared with non-pregnant women[1], even worse that the latest data published by UK Obstetric Surveillance System (UKOSS) show that most pregnant women admitted to hospital in need of ventilation and intensive care admission were progressively caused by the Delta variant[2].
There were Facebook posts shared publicly citing the OB isolation scenes and reported surge at the Southern Philippines Medical Center (SPMC), which almost paralleled with what was happening in hospitals from other countries, battling with this new and more dangerous COVID variant (see screenshots below).
A similar spike in trend has been
observed in children with the Delta variant[3],
although referencing the data published, the number of pediatric cases is generally fewer compared with the
case count in adults. This observation would not however, assure me as a parent that my son
is ultimately protected from severe illness caused by the virus, apparently,
the only way to do that (since the vaccine administration on kids is currently pending review) is to surround him with fully vaccinated people[4].
Thankfully, my immediate family (parents, sister, bro-in-law) and my husband have already
been fully vaccinated, so my vaccination should help complete my son’s circle of defense
especially that we are the ones whom he interacts with the most.
Like any other vaccines administered to pregnant women for Influenza and Tetanus, Diphtheria, Pertussis (Tdap), research on COVID-19 shots further shows "that the antibodies produced by vaccination cross the placenta and may provide some protection to newborn babies[5]". If you are a bit terrified by the crossing the placenta phrase, check out this video to help you understand what this actually means. Indeed through the vaccine, I would be likely providing immunity to my baby as soon as he or she comes out—knowing that the hospital might not be the safest place to welcome a newborn in this unfortunate time. There are other resources you can examine further like whether the messenger RNA (mRNA) could harm the fetus or even alter the mom's and baby's genetic code (just because DNA and mRNA share those NAs, it does not mean that they are the same). Personally, I have never been this schooled about this new vaccine type until I had to do personal research on its safety. You can learn more about them through the Youtube playlist that I have prepared on Pregnancy and COVID vaccines here.
Moreover, the vaccine effectiveness has been significantly confirmed by the Centers for Disease Control and Prevention (CDC), providing protection against COVID-19[6]. Locally, the Philippine General Hospital (PGH) has published confirmed case profile relative to the vaccination status, showing no fully vaccinated have been critically intubated.
2. Strongly recommended for pregnant women by medical institutions and practitioners (in other words, COVID-19 vaccines are generally safe!)
“As the leading organizations representing experts in maternal care and public health professionals that advocate and educate about vaccination, we strongly urge all pregnant individuals – along with recently pregnant, planning to become pregnant, lactating and other eligible individuals – to be vaccinated against COVID-19.” This was the joint statement between at least 20 different medical organizations, including the American College of Obstetricians and Gynecologists (ACOG) and Society for Maternal-Fetal Medicine (SMFM) on the vaccination of pregnant women against the disease[7]. In the Philippines, the Department of Health (DOH) recently listed pregnant women under the expanded A3 priority group or Persons with Comorbidities, adding that the vaccines are generally safe for these individuals[8]. These references, along with the medical clearance obtained from my OB-GYN and common advice given by other practitioners I have watched on Youtube, all point to the fundamental principle that there is no way that these people, or institutions, would harm the pregnant women or the unborn babies, it is just illogical and unethical.
Further, it is interesting to note that as of October 12,
2021, there were 166,153 V-safe registry participants who reported that they
were pregnant at the time of vaccination[9].
The said registry aims to “collect health information from people who received
COVID-19 vaccination in the periconception period (within 30 days before last
menstrual period) or during pregnancy”. Although the figures have yet to be reviewed by the CDC, there were no specific
safety signals observed in pregnant people from the registry with 5,104 officially enrolled individuals. If you're wondering why pregnant women were not included in the clinical trials for the vaccine, these were ultimately due to the ethical issues surrounding the subject (and I understood that, besides, there are now real-world data to support the vaccine efficacy and safety).
Perhaps, one of the most compelling data I have gathered is that there are no differences seen in COVID vaccinated pregnant women compared with the background rates of adverse pregnancy outcomes. This easily translates to that regardless of whether you are vaccinated against COVID-19 during pregnancy or not, the same risks are presented[10]. Refer to the table below – these were the screenshots from the original article published at ACOG. I highly recommend that you read through the entire material to get thorough details on the study conducted.
Now, if you will ask me, are these data sufficient? From all the journals I have read so far, almost every time, these institutions would recommend longitudinal follow-up, but with the new COVID variants popping up, I'd definitely be making critical decisions as soon as the data are immediately available. And if I may reference some parts of the article written by TIME Senior Correspondent - Charlotte Alter (whom I had an e-mail exchange with regarding the safety of her baby after getting the shots, see screenshot below), you know how the researchers would keep saying, "we see no evidence that it causes birth defects" which could just be paraphrased to "we have evidence that it doesn’t", but why couldn’t they? To quote the medical expert that she had a consultation with, “the absence of evidence, for scientific researchers, is as close as they get to evidence of absence”, further highlighting that theoretically, it's impossible to prove a negative. And that’s when it hit me, that is how scientific world operates and so these data are just as relevant as whatever you need to support decisions like the one I just made.
After collecting all legitimate and updated information on the COVID vaccines in pregnancy, let me briefly discuss the pros of the different vaccine brands largely available in the Philippines. The popular mRNA vaccines, Pfizer - Comirnaty and Moderna - Spikevax could easily be top of the list of preferences due to the relatively accessible literature demonstrating its safety and efficacy, although people should remember that any vaccine has been proven effective EXCEPT that pregnancy is a contraindication to Gamaleya - Sputnik V[11] (this vaccine must not be administered to pregnant women). Pregnant women may also be given with Sinovac - Coronavac and Sinopharm which are inactivated vaccines, that work comparably with Hepatitis B and Tetanus vaccines—their safety profiles have likewise been proven over time[12]. As illustrated in the screenshot below, a Coronavac-cinated mom from the Facebook group I joined - Team Bakunanay, shared this result, flaunting the amazing antibodies passed on to the baby right after she gave birth. While Oxford - Astrazeneca can also be administered to pregnant individuals, I just find the gap between doses (it could be as long as 12 weeks apart[13]) unfavorable as of the moment considering that I would be on my third trimester by the time of the next dose, that could expose me to the highest COVID risk during pregnancy. Meanwhile, the use of Johnson & Johnson - Janssen has been cited with a rare risk of thrombosis with thrombocytopenia syndrome (TTS)[14], but considering its pro in which recipients could get immediate protection via its single dose administration, pregnant individuals should be given fair chance on evaluating the benefits vs. associated risks of getting this shot.
When should a pregnant get the vaccine shot? Pregnant women in their first trimester is one of the deferment criteria in the vaccination process flow published by the DOH[15] (so you'd likely to be rescheduled until the second trimester onwards). I got my first dose at 16 weeks (little past 3 weeks after my OB-GYN cleared me for the vaccination). PLEASE consult with your OB-GYN before getting the shot.
There were definitely other reasons why I chose to get vaccinated. For instance, the vaccine is free of charge here in the Philippines (at least for the priority groups listed), compared with the medical expenses to be incurred when admitted for COVID disease (even more expensive for ICU or critical admissions—I will share the data based on the actual amounts of PhilHealth claims in Davao Region, probably in another blog post—spoiler alert, the average cost goes as high as P500,000 per critical COVID case).
Finally, this may be my only "shot" at doing my part to end this pandemic. I think everyone hopes to get back to what we used to have…and I want to see my children live the most out of the lifetime…the “normal” way.
P.S. You can check the following tips if you are to embark the literate review journey that would help you decide whether to delay or immediately get the vaccine based on substantial and relevant information:
1) If you want to get the most updated publications and other resources related to Pregnancy and COVID vaccine, the SEARCH FILTERS from websites and social media will do a great job in providing you with the most recently uploaded contents (e.g. Search Keywords: COVID-19 vaccine in Pregnancy; Date Filter: This Week, This Month) 💻🔍
2) Take advantage of the hashtags used on the social media. I have been actively checking for vaccination rollout in Davao that I would explore common hashtags (e.g. #ResbakunaDavao), then filter the results by recent upload dates. Try it out! 📱
P.S.++ I had mild pain from my injection site for two days, other than that, there were no side effects from my first and second shots.
P.S.+++ I had been trying to obtain the data on vaccination for pregnant women in the Philippines, but my e-FOI request was denied as "the National Vaccination Operations Center doesn't have disaggregated data up to that level of classification". This is why I have been primarily referencing studies conducted and published in different countries due to the lack of available literature locally.
[10] https://www.nejm.org/doi/10.1056/NEJMoa2104983
https://hta.doh.gov.ph/2021/05/05/htac-guidance-for-health-care-providers-covid-19-vaccine-gamaleya/
[12] https://www.who.int/news-room/feature-stories/detail/the-sinovac-covid-19-vaccine-what-you-need-to-know
[13] https://doh.gov.ph/node/28139
[14] https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/JJUpdate.html
[15] https://www.canva.com/design/DAEe4fsH48c/RS3i4GzN90VGyAmZnJZvHg/view?utm_content=DAEe4fsH48c&utm_campaign=designshare&utm_medium=link&utm_source=sharebutton#5
