After initially being excluded, a change in guidelines will give pregnant health-care workers a chance to get the shot
“What to expect when you’re expecting, during a pandemic.”
The tagline to a popular Instagram page called Pandemic Pregnancy Guide plays off the popular series of books by the same name as it aims to offer real-time, science-based information for navigating one’s pregnancy journey which can be confusing already.
One of the areas advocates are now focused on, is informing individuals on the latest when it comes to vaccinations.
That’s because there has been conflicting information about vaccinating special populations such as pregnant and breastfeeding individuals, due to a lack of safety data that’s not readily available because they were left out of the COVID-19 vaccine trials.
The National Advisory Committee on Immunization (NACI) and The Society of Obstetricians and Gynaecologists of Canada (SOGC), now recommend that pregnant and breastfeeding women be offered the COVID-19 vaccine.
“If a risk assessment deems that the benefits of vaccination outweigh the potential risks for the individual,” a spokesperson said. “It is important to note that in every situation, your healthcare provider is always the best person to provide advice in light of one’s personal and historical medical history.”
But up until a few weeks ago, the Ministry of Health excluded pregnant women and those that are breastfeeding from accessing the vaccine citing a lack of safety data.
However, in a memo issued on Jan. 8, they updated their guidelines saying, “pregnant individuals in the authorized age group may choose to receive the vaccine after informed counselling and consent.”
Updated guidelines and having a choice
Despite this update, Dr. Tali Bogler, chair of Family Medicine Obstetrics at St. Michael’s Hospital says not all hospitals may be adopting the updated guidelines. She said she believes that may be putting pregnant women at risk.
“There are many places that are still not vaccinating pregnant individuals,” she says.
As a co-founder of the Pandemic Pregnancy Guide Instagram page, Bogler says having a choice, while being informed by evidence-based information is the most important.
“Right now, when we talk about this risk-benefit discussion in terms of pregnant individuals, it’s primarily for frontline health-care workers who we know are at a higher risk of contracting COVID-19,” she says. “How able are you to practice the public health guidelines to protect yourself if you’re not able to get the vaccine?”
Prior to the province updating its vaccine guidelines, Unity Health changed its guidelines to have its own special consent form for pregnant health-care providers who want to receive the shot.
Bogler, who has been vaccinated said she knows of several pregnant healthcare professionals who received the vaccine.
“They were really receptive and appreciative of being given the choice to be vaccinated, but also the information and support behind it,” she said. “I also received a knock on the door by a pregnant staff member who wanted to say thank you for the advocacy I had done around giving pregnant individuals the choice.”
Bogler adds that is a personal decision that individuals need to make with their health-care providers.
In an email to CityNews, Scarborough Health Network, Michael Garron Hospital and Sinai Health all said they’re giving pregnant staff members access to the vaccine. On their websites, University Health Network and Unity Health both say they’re following updated provincial directives when it comes to vaccinations for pregnant individuals.
Making informed decisions
Bogler says recent data from the U.S. show that pregnant women who contract COVID-19 are much more at risk of severe symptoms, including an ICU stay requiring mechanical ventilation, potentially preterm birth, higher rates of in-hospital deaths, preeclampsia, clots and heart attacks.
“We know that pregnant individuals over the age of 35 are more at risk of getting severe illness,” she said. “Pre-existing underlying health conditions put you more at risk while pregnant for getting more severe COVID-19 symptoms.”
Ontario is currently in the first phase of its vaccine rollout, which means frontline health workers who are at higher risk are prioritized to get the shot. It won’t be until at least August when the rest of the population will be eligible to get the vaccine.
Still, expectant and breastfeeding parents who aren’t part of the first phase, are among those weighing their options.
One mother’s story
Jennifer Cariati is 20-weeks pregnant with her second child, due in June.
She says being pregnant during a pandemic has been “a lot.” She went through fertility treatments, so following the clinic’s guidelines was already concerning. Now, she and her husband have to navigate the rapidly changing information about vaccine guidelines and the anxiety that comes with it.
“We’re very cautious about this,” she says.” “I think the missing piece is time for that information. This vaccine is still new, they’re still looking for risk or potential side effects.”
Though clinical trials excluded pregnant individuals from participating, there were people who later became pregnant that are now being monitored by vaccine manufacturers. Though limited, there is also data that is being collected from ongoing animal reproductive studies. This means, more data will be collected in future phases of the trials.
Bogler says by the time the vaccines are made widely available to everyone across Ontario, there will be more data available to help guide people’s decisions.
“What I hope is that people follow the most up to date and evidence-based information. It’s a very personal individual decision that should be guided and supported by their health-care provider, by their treatment provider,” she said. “Either way, they should be supported whether they choose to receive the vaccine or not given that they were told they shouldn’t be getting in and now they are given the choice.”