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Pregnancy and the Covid vaccine: What trusted messengers can tell us
The people around us influence some of our most important health decisions and can be key allies in the vaccination effort
We all need people in our lives who can offer new perspective. We often rely upon them for clear advice in the face of a difficult decision.
The Covid-19 pandemic has been full of moments when we leaned on those who can offer that much-needed guidance — and the occasional reality check.
This was certainly true for many of my expectant and breastfeeding patients when they were deciding whether to get the Covid-19 vaccine. It’s given me a deeper understanding of the responsibility involved in being what the Centers for Disease Control and Prevention (CDC) has called a “trusted messenger.” Trusted messengers, the CDC says, are the people who are “essential to sharing timely information about Covid-19 vaccines and vaccination sites, answering questions, and addressing misinformation.”
My colleagues and I certainly hope to be the ones to play this role in our patients’ lives. This starts with building trust.
The Covid vaccine in pregnancy is safe
To earn our patients’ trust, we must be consistent in our messaging. Pregnant patients should be vaccinated because they risk severe complications, some grave, if they contract the virus itself. We communicate our recommendations, then back them up with the most current, evidence-based information from professional organizations like the Academy of Gynecology (ACOG) and the CDC.
“All eligible persons greater than age 12 years, including pregnant and lactating individuals, receive a Covid-19 vaccine or vaccine series,” the ACOG guidelines read. “Gynecologists and other women’s health care practitioners should lead by example by being vaccinated and encouraging eligible patients to be vaccinated as well.” The CDC recommends that everyone ages five and older get a Covid-19 vaccine.)
Share your story
I recently joined two colleagues to discuss the Covid vaccine in pregnancy on the 20-Minute Health Talk podcast.
Sarah Pachtman, MD, also a maternal fetal medicine doctor, proudly talked about getting her Covid booster shot at about 16 weeks into her pregnancy. She is a trusted messenger for her patients.
The other, Elizabeth Boyce, RN, was pregnant and in her third trimester when the first Covid vaccines became available in December 2020.
Reflecting on that time, Elizabeth told us, “I called my OB and his first reaction was, ‘If you have a chance to get it, you should get it.’ And that’s all that I needed. He was the most trusted person to me at that point in my life and he was about to deliver my baby. I took his advice and I got it two days later.”
Sharing stories like this is critical, because everybody has a different trusted messenger. For Elizabeth it was her obstetrician. But for her family and friends, she is their trusted messenger.
Each of us identifies with different types of communities, the ones where we feel the strongest connection. It may be a professional association, a sports league, a local environmental group or a support group. We each have our own ways of connecting with others and building trust.
Pregnant with Covid
That’s where I hope trusted messengers might help.
Health care workers have become adept at outlining the potentially deadly consequences of Covid-19. While many expectant moms fear the unknown, here is what we do know: Pregnancy is a risk factor for contracting severe Covid, which can affect and infect entire families. This novel virus can lead to intubations, health struggles of both parent and child, and an inability to care for a newborn.
We know the alarmingly low percentages of expectant mothers who’ve been vaccinated against the virus, particularly in communities of color.
“Only 31 percent of pregnant people have been vaccinated against Covid-19 and vaccination rates vary markedly by race and ethnicity,” the CDC says. “Vaccination coverage is highest among Asian people who are pregnant (45.7 percent), but lower among Hispanic or Latino pregnant people (25 percent), and lowest among Black pregnant people (15.6 percent).”
The vaccination rate for non-Hispanic whites is 76.5 percent. Finally, we know that the Covid-19 vaccine is safe in pregnancy. There is a substantial amount of data showing no safety concerns among the more than 160,000 pregnant people who have already received the vaccine.
Benefits of the Covid vaccine in pregnancy
Trusted messengers help us establish what we know.
Data from multiple vaccine safety monitoring systems, which includes the V-safe Covid-19 Vaccine Pregnancy Registry, shows the Covid-19 vaccine:
- reduces the risk for infection
- builds antibodies that might protect the baby
- does NOT increase the risk for miscarriage
We need to find more ways to boost these vaccination rates. Almost two years into the pandemic, many patients still struggle with the decision to get vaccinated.
Empowering expectant mothers
Trusted messengers are active listeners who hear with open minds, trying to understand where hesitancies — both historic and personal — may come into play. They understand the impact of the full range of influences on our medical decisions, from family and work environments to social media.
These emissaries conduct reasoned discussions, see another person’s perspective and make an effort to listen, as well as understand their concerns and fears. They know when and how to share their own experiences about making medical decisions during a difficult time.
Most important, trusted messengers know the difference between persuading someone and empowering them so they can feel good about making their own decision. And hopefully, that person will be able to make decisions independently in the future — and eventually even become wise, trusted messengers themselves, leading by example and sharing their experiences.
When it comes to important medical decisions, of course, I hope those who play this vital role are medical professionals. But they also can be knowledgeable family members, friends, clergy or members of a professional organization.
It’s no small responsibility to have this kind of trust placed in you, and trusted messengers know this, too.
They understand how quickly and easily information can be spun into misinformation or worse, disinformation. And they know, often instinctively, that a thoughtful, reliable source can make all the difference in making a sound decision with good health in mind.
Burton Rochelson, MD, is Chief of the Division of Obstetrics and Gynecology - Maternal Fetal Medicine at North Shore University Hospital and Professor, and a professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.
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