COVID-19 vaccinations can help protect Americans, including vulnerable populations like the elderly and chronically ill. But one vulnerable population has been excluded from vaccine research: pregnant and postpartum women and babies.
It’s especially important since research shows pregnant women might be at increased risk for severe illness due to COVID-19 compared with non-pregnant women.
According to a recent report by the Centers for Disease Control and Prevention, an analysis of approximately 400,000 women aged 15-44 years with symptomatic COVID-19, showed pregnant women were more likely than non-pregnant women to be admitted to the intensive care unit, require invasive ventilation, experience extracorporeal membrane oxygenation, and die.
But so far, pregnant and lactating women have been excluded from clinical trials for vaccines and therapeutics. It’s unclear when COVID-19 immunizations would be safely available for them.
“Risks for this population — pregnant and postpartum women and infants — will continue to increase while there is no evidence that a vaccine is safe for them and COVID-19 restrictions begin to ease as immunity levels in the general population increase,” says Dr. Rahul Gupta, chief medical and health officer, senior vice president and interim chief scientific officer at March of Dimes, a nonprofit organization committed to the health of all moms and babies.
Prioritizing mothers and babies
March of Dimes wants better research and data collection on how COVID-19 is impacting mothers and babies. The organization recently announced two grants to researchers to learn more about COVID-19’s impact on moms and babies.
“Better data collection is needed to ensure that we know the full impact of COVID-19 on moms and babies across the country,” says Dr. Gupta.
He worries that as immunity in the population increases, there will be less restrictions while pregnant and postpartum women (and their infants) will still be disproportionally vulnerable to the virus, compared to other populations.
The organization is urging Congress to prioritize pregnant/lactating women, including ensuring they can participate in COVID-19 clinical trials and be prioritized when therapeutics are available.
March of Dimes established the Mom and Baby COVID-19 Intervention and Support Fund to support the need for research, advocacy, education, resources, and support to help protect mothers, babies, and families.
“We have provided moms with critical items like face masks, blood pressure cuffs, and breast pumps, and have awarded research grants to study the impact of COVID-19 on maternal and infant health,” says Dr. Gupta.
Successful vaccination campaign
March of Dimes has been a vaccine research pioneer. The organization started 80 years ago as National Foundation for Infantile Paralysis, in search of a vaccine for polio, a disease that affects the central nervous system. They organized the largest clinical trial in U.S. history, enrolling 1.8 million children, leading the way for the eradication of polio in the United States. The race for a polio vaccine was funded by donors one dime at a time.
“COVID, just like polio, can be fatal and disabling and is easily transmitted from person to person,” says Dr. Gupta. “We know what works to reduce transmission rates, we’ve done this before.”
He and his colleagues know a successful vaccination campaign is possible. But it requires a community effort to make sure vaccines are easily available, and removing economic barriers like co-pays and cost sharing.
They want women of childbearing age to be prioritized for coronavirus vaccinations, even if they cannot get the vaccine during pregnancy because it has not yet been studied.
“Getting a vaccine can help protect them, their unborn child, and the child after birth,” says Dr. Gupta. “That’s a win for all of us as we race to stamp out this virus.”
Access to COVID-19 vaccines and therapeutics is especially important for moms in underserved communities, ensuring they have fewer complications from the pandemic during pregnancy.
Vaccinations protect children and families from preventable infectious diseases, yet many remain unvaccinated. Often, they skip vaccines because of misinformation about vaccine safety or they lack access because they’re uninsured.
March of Dimes is targeting those areas by supporting provisions to combat vaccine hesitancy and boost vaccination rates in the Lower Health Care Costs Act of 2019 and the Vaccine Awareness Campaign to Champion Immunization Nationally and Enhance Safety Act of 2019 (VACCINES Act of 2019).
While the pandemic has helped people better understand vaccines and why they’re important, more work needs to be done.
“Before COVID-19, state and local health departments across the country were struggling to respond to outbreaks of vaccine-preventable disease,” says Dr. Gupta, noting last year there were almost 1,000 confirmed cases of measles, the greatest number of cases reported in the United States since 1992.
Additionally, despite there being vaccines available, whooping cough, hepatitis A, hepatitis B, mumps, and seasonal flu also continue to spread across the country.
“Anything is possible”
During COVID-19, the Vaccine Tracking System included data that showed a decrease in children staying on the recommended vaccination schedule. Another concern is that Black and Hispanic Americans are more skeptical about vaccine safety, with systematic racism in health care being a reason for vaccine-hesitancy in these populations.
Dr. Gupta says that once a COVID-19 vaccination is available, there must be culturally competent tools available to educate the public and stress the benefits of receiving the vaccine.
The organization is calling to eliminate non-medical vaccine exceptions in states, which allow for a significant number of people to skip vaccinations. Skipping those vaccinations can put those individuals and the community at risk of getting serious diseases.
March of Dimes, a trusted resource for families, is providing families with information on COVID-19, educating them about vaccinations in general and advocating for better research for a better future.
“We cannot standby when we know that with a will, anything is possible,” says Dr. Gupta.
To learn more about how March of Dimes is supporting women and babies: https://www.marchofdimes.org/mom-and-baby-covid-19-intervention-and-support-fund.aspx