This is a special bonus episode of the Mommy Labor Nurse Podcast, where we are going to dive into all things COVID and the COVID vaccine during pregnancy.
I get questions about these topics all the time in my DMs, and totally understand that there is a lot of confusion and uncertainty surrounding pregnancy and COVID-19. As you know, I am a healthcare professional, but I decided that this wasn’t a topic I wanted to cover completely on my own.
I wanted to have an OBGYN come on here so that we could have this discussion together. And I was so fortunate to be joined by board-certified OB-GYN, Dr. Marta Perez of @dr.martaperez over on Instagram.
She regularly shares evidence information surrounding COVID during pregnancy and the COVID vaccine, so I thought she was the perfect person to talk about myths and facts in a level-headed, evidence-based manner.
Here’s a glimpse into what we talked about:
- I’m nervous about getting the COVID vaccine during pregnancy
- How does the vaccine protect me during pregnancy
- When is the best time to get the COVID vaccine during pregnancy?
- Can we talk about the myth surrounding the COVID vaccine and infertility?
- COVID and menstrual cycles
- What happens if you do get COVID during pregnancy?
- About Dr. Marta Perez
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I’m nervous about getting the COVID vaccine during pregnancy
Okay so by far the most asked question/comment surrounding COVID and pregnancy had to do with the vaccine. So many of you commented that you were nervous and had questions surround its safety. Things like, “What are the possible long-term effects? and “How can it be approved for pregnant women when it hasn’t been out that long?”
Let me start off by saying that I understand where you are coming from! We are all trying to do our best during pregnancy to keep our babies healthy and safe.
Here’s a bit of what Marta had to say to set the stage for her 3-part answer:
“I do a lot of vaccine counseling among pregnant and postpartum people. So, I always say that the first thing I start with is talking about safety. I think that there’s kind of three things I want to make sure we cover about safety.
The [first] one is a concern about [immediate] side effects. The second is concerns about serious adverse events. And the third is a concern about long term safety.”
Immediate side effects after the COVID vaccine in pregnant people (13:26)
When we look at immediate side effects, you can expect to have 12-24 hours of local, self-limited side effects that then disappear completely! Yes, you might feel pretty crappy – especially after the second shot – but the side effects should go away after a day or two.
Dr. Perez explains that to date ~150,000 pregnant women have gotten vaccinated. A study looked at the first 30,000 pregnant people that received the vaccine and found that there was no increase of risk of these immediate, side-effects such as fever, headache, or exhaustion following their shot.
She also touches on the important point that if you are concerned about fever as a side-effect and that affecting your pregnancy, that you should keep in mind that the short-duration fever that *might* follow your vaccination is a far lower risk than the often more extreme and long-lasting fevers that accompany COVID infection.
Serious adverse effects following vaccination in pregnancy
Dr. Perez set the stage for this common question so well,
“So, I see people having two main concerns about serious adverse events. And I see them making some mistakes. One is how commonly they happen and the other is mistaking a serious adverse event with a coincidence.”
Specific to pregnancy, she hears people talking about someone getting the vaccine and then having a poor pregnancy outcome like a miscarriage or early labor.
Before she gets into those claims, she makes a great analogy about the likelihood of a true adverse reaction. She explains that your risk of a true reaction is about the same as your risk of getting struck by lightning this year.
She continues the analogy to say,
“When it’s storming outside, and you have to go pick up your kid from school, or you have to go to the store to get groceries or whatever, you’re still going to go do those things. You’re not going to limit what makes sense in your life, just because of the risk of getting struck by lightning.
Same thing with approaching a vaccine decision, those really rare things happen, but they shouldn’t be dictating your life and your health decisions the same way, you’re still going to go to the store during a thunderstorm most of the time.”
Specific to the risk to your pregnancy outcome, she sites the same first 30,000 pregnant patients to get vaccinated and says that researchers are not seeing any increased risk of negative pregnancy outcomes. This includes:
- No increased risk of miscarriage
- No increased risk of preterm birth
- No increased risk of preeclampsia
- No increased risk of NICU admissions
And this is something that is being actively tracked, monitored, and followed.
You’ll hear us dive a little more into the misinformation and claims surrounding the vaccine and miscarriage, which is one that is floating around quite a lot.
I want to leave you with one more quote from this part of the episode,
“I think pregnant people can be really reassured that we are gathering a lot of data. And I have not seen one instance of data that looks suspicious, all of the data has been super reassuring, which makes sense scientifically.
Given all we know about vaccines, how vaccines work, how pregnancy works, we see this like we can draw parallels to other vaccines like flu vaccine and TDAP. And we know that those things are incredibly net positive benefit for pregnant people and their baby.”
Long term effects of the COVID vaccines, especially as a pregnant person
Dr. Perez shares that as a doctor, the long-term effects are the thing she is LEAST concerned about surrounding the COVID vaccine. She totally understands why others are concerned about this, but she explains that because she went to medical school and has spent so much time learning about how vaccines work she has total confidence that there will not be adverse long-term effects.
Here’s what she had to say,
“Vaccines are just short instruction manuals that your body [uses and then] gets rid of, and your body does the rest… the vaccine doesn’t stay around in our bodies for a long period of time, it’s only in our bodies for hours. And then it’s gone. Because our body processes it. And then your body naturally does the rest, and protects you from COVID and protects you specifically from the aspect of the virus that’s trying to get into your cells.
A vaccine is in your body for like, less time than the cookie you ate yesterday. You know, it’s just a really short instruction manual for your body. So, like I said, these serious adverse events, things like allergic reactions, or other major health problems. Those show up within minutes to weeks of getting a vaccine, they don’t show up months later.
And we’ve been monitoring this vaccine for over a year now – the trials were last summer – and millions and millions of people have gotten it, about 130,000 pregnant people have gotten it. And I do not have suspicion about long term problems we didn’t know about.”
Marta goes on to talk about how she is much MORE concerned about the long-term effects of COVID infection itself, not any likelihood of long-term vaccine effects.
How does the vaccine protect me during pregnancy
In this part of the episode, Dr. Perez gives us a really great lesson on mRNA vaccines and the way they work. Then she talks specifically about how during pregnancy, the mRNA doesn’t cross the placenta but antibodies and other aspects of the immune system do transmit freely between mom and baby.
She also makes the extremely important point that a healthy pregnant mom IS a healthy baby. By protecting mom from COVID, and keeping mom healthy, her growing baby is at less risk. If mom has COVID, and then fevers and has low oxygen levels, that means lower oxygen levels and higher risk for baby.
She goes on to explain how protection and antibodies from the COVID vaccine might pass through breastmilk as well, so be sure to tune in to hear more about that!
When is the best time to get the COVID vaccine during pregnancy?
The best way to answer this, again, is with a direct quote from Dr. Marta Perez,
“COVID is a pandemic. So we need people protected as soon as possible. So the best time to get vaccinated is right away. Yeah, there is no benefit to leaving yourself susceptible.
Please take it from me. I see it every day it is that so the best time to be vaccinated as soon as possible, whether you’re planning to conceive, pregnant, just delivered, just get it as soon as possible.”
Tune in to hear some more specific caveats and nuances surrounding this, but the short answer is definitely to go get it ASAP barring very specific circumstances.
Can we talk about the myth surrounding the COVID vaccine and infertility?
Again, Dr. Perez confidently discounts the claims surrounding the COVID vaccine and infertility as misinformation. She says that there is no evidence that COVID itself, OR the COVID vaccine has any effect on the ovaries at all.
“The American Society of Reproductive Medicine, which is the organization of REI doctors have said from the beginning, absolutely get the COVID vaccine, if you want to conceive, get it in the middle of your IVF cycle, get it before, get it after, get it as soon as you can!
Because COVID poses a much bigger risk to your reproductive health, your pregnancy, your fertility, your chances of getting fertility treatments, if you’re COVID positive, you know, it can delay cycles, and everything. So please get it.”
COVID and menstrual cycles
Next, Dr. Perez touches on this, which is another common thing that comes up both with COVID infection and after women get the COVID vaccine. She explains that there are reports and accounts of this – and that is because the cells in our endometrial lining do contain immune cells.
She goes on to say that people who report spotting between periods or heavier periods around the time of their vaccination is essentially just a unique immune response (just like the fever or chills some people get).
She referenced an article by OBGYN, Dr. Jen Gunter (@drjengunter) that you can find here:
- The COVID-19 Vaccine and Menstrual Irregularities
- Is there a Better Time in the Menstrual Cycle to get Vaccinated against COVID-19?
What happens if you do get COVID during pregnancy?
We wrapped up our conversation by talking about what happens if you do get COVID during pregnancy. Dr. Perez shared specific advice on how to care for yourself, what to take to manage symptoms, and red flags to be on the lookout for.
She reiterates that you are at a higher risk of severe infection as a pregnant person, and you can go from being mildly symptomatic to getting very ill, very quickly.
“If you are a pregnant person, and you have not been vaccinated, you should get with your loved ones, get a piece of paper and start writing down what your request would be if you are seriously ill on a breathing tube in a medically induced coma, what your wishes would be for the baby?
What your wishes would be? Who is it going to make decisions for you? Would you want to be an organ donor in the event that you pass? Because this is happening. This is happening.”
This is an episode that I am so proud to air and share with all of you, and I truly hope that this presentation of information has made the decision to get vaccinated a little bit easier for you <3
About Dr. Marta Perez
Dr. Marta Perez is a board-certified OB-GYN and Assistant Professor at WashU School of Medicine in St. Louis, MO. She works as a laborist, exclusively caring for pregnant patients in the hospital and during birth.
She is a mom to a pandemic baby and wife to a pediatric cardiac critical care doctor. When not working, she enjoys running, cooking, yoga, and creating educational content online.
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