In HearSway

Dr. John Byron has been helping bring new life to the world since before many of us were alive — in places like the 67th Evacuation Hospital in Wurzberg, Germany during Operation Desert Storm.

As someone who has delivered thousands of babies (and experienced one of Moore County’s first recorded cases of COVID) Dr. Byron has literally seen it all — so we asked him for his opinion on the risks and benefits of the coronavirus vaccine for pregnant women.

“My answers are provided to offer opinions, which will continue to change as we accumulate data,” he says. “The most important thing patients need to realize is that each person has their own set of unique circumstances; both physical and environmental, which should be considered in the provider /patient discussion of the patient’s personal decision to vaccinate or not.”  

Our Q&A is below:

In a previous interview about vaccines, Dr. Gretchen Arnoczy said medicine is about weighing potential risks and benefits. What are the risks associated with contracting COVID during pregnancy or while breastfeeding?

Because a pregnant woman’s body is working harder as pregnancy progresses, there are unique circumstances that can place the mother and fetus at risk when we think about COVID-19. 

The mother’s physiologic workload increases throughout the 40 weeks, and conditions such as COVID pneumonia, for example, may exasperate the maternal workload and impair fetal circulation. Also, the infection itself may affect the uterus or other organ systems, possibly resulting in preterm labor or worsening of preexisting conditions.

Depending on the course of the disease, breastfeeding issues generally happen because a mother needs to isolate from her baby to prevent neonatal infection.

Dr. Byron donates plasma for COVID research at UNC. (Courtesy of Dr. Byron via the Fayetteville Observer)

Along those same lines, what are the potential risks surrounding the COVID vaccine for women who are pregnant, breastfeeding or wanting to become pregnant?

Currently, data on COVID vaccines are generally limited in pregnant women. However, the risks would generally be the same as for those not pregnant plus the unknown concerns.

Compared to COVID itself, the risks are probably much lower. I have not seen data that discourages the vaccination of women prior to conception or postpartum, and I would highly recommend it.

Will getting vaccinated allow me to have a more comfortable labor and delivery experience, with more people in the room?

Visitation protocols are changing as the pandemic changes. Thankfully, things are headed in a better direction in our community. The protocols are designed to keep ALL of us safe.

My observation has been that there is minimal change in the delivery experience. I may say that it is even more meaningful given the close bonding experience of those present.

Did any of the COVID vaccine trials include pregnant women or women who became pregnant after receiving the vaccine? If so, did any of them experience harmful outcomes?

The COVID vaccine trials intentionally did not include pregnant women, however, the trials do follow those who may have become pregnant shortly after receiving the vaccine. Data is limited now but we expect more to be released from trials designed for pregnant women. 

Dr. Byron pictured shortly after returning to work following his recovery from COVID

Pregnant women are routinely vaccinated against the seasonal flu and whooping cough. How does the vaccine differ from those?

COVID is a “new” disease and the mRNA vaccine technology,  although not new, is new for this virus. Thankfully, the response of our immune system is not new, and the COVID vaccines seem to work similarly in our bodies.  

If a pregnant woman gets the vaccine, should she wait until the second trimester, or schedule it around other vaccines?

I think the vaccine would be best to receive at a time at least 10 days before or after any other vaccination. Also, I think waiting until after 28 weeks may be the least risky, with the second vaccine coming after 34 weeks. Again, this needs to be based on individual considerations. However, the risks of receiving the first dose after 20 weeks are probably minimal and much lower than the risks associated with COVID itself. 

How do I get the vaccine?

Moore County is outpacing the state in vaccine distribution, and you can schedule an appointment with no wait. Vaccination is open to anyone 18 and older (and as young as 16 with parent or guardian permission). Get more information and register online here.

What should I do if I choose not to vaccinate?

Generally, I’d advise those who are pregnant to be vigilant about social distancing and masking, especially when you are around those who haven’t been vaccinated or you are inside. I can’t underscore enough how important it is to continue following the three Ws.

Get the full report on vaccinating pregnant and lactating patients from the American College of Obstetricians and Gynecologists.

Read more about Dr. Byron and his team here.

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