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LUMBERTON — Area health care providers are urging pregnant and nursing women to receive a COVID-19 vaccination.

Only about 22% of pregnant women have received at least one dose of a COVID-19 vaccine, according to the federal Centers for Disease Control and Prevention. One reason could be conflicting information that causes uncertainty about the safety of the vaccine, an issue that has been before the medical community for less than two years.

“There are, understandably, no long-term studies to validate safety at this time,” said Don McKinley, M.D., doctor of obstetrics and gynecology at UNC Health Southeastern.

In order to break through the fog of fear, UNC Health Southeastern physicians and caregivers discuss the benefits and risks of getting a vaccination with patients. One fact presented to patients is the danger COVID-19 presents to pregnant women.

According to the CDC, “Pregnant and recently pregnant people are more likely to get severely ill with COVID-19 compared with non-pregnant people. If you are pregnant, you can receive a COVID-19 vaccine. Getting a COVID-19 vaccine during pregnancy can protect you from severe illness from COVID-19. If you have questions about getting vaccinated, a conversation with your healthcare provider might help, but is not required for vaccination.”

There is no current evidence that any vaccines, including COVID-19 vaccines, cause fertility problems, according to the CDC. But, data are limited.

“Claims linking COVID-19 vaccines to infertility are unfounded and have no scientific evidence supporting them,” information given to UNC Health Southeastern patients reads in part.

UNC Health Southeastern staffers tell patients that the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM), the two leading organizations representing specialists in obstetric care, recommend that all pregnant individuals be vaccinated against COVID-19. The organizations’ support of vaccination during pregnancy reflects evidence demonstrating the safe use of the COVID-19 vaccines during pregnancy from tens of thousands of reporting individuals over the past several months, and the current low vaccination rates and concerning increase in cases.

“Data have shown that COVID-19 infection puts pregnant people at increased risk of severe complications and even death,” a release from the ACOG and the SMFM reads in part.

The two medical organizations point to the increased risk posed by the COVID Delta variant as another reason pregnant women should get vaccinated. People who have recently delivered and were not vaccinated during pregnancy also are “strongly encouraged” to get vaccinated as soon as possible, according to the two medical organizations.

“ACOG encourages its members to enthusiastically recommend vaccination to their patients. This means emphasizing the known safety of the vaccines and the increased risk of severe complications associated with COVID-19 infection, including death, during pregnancy,” said Dr. J. Martin Tucker, president of ACOG. “It is clear that pregnant people need to feel confident in the decision to choose vaccination, and a strong recommendation from their obstetrician–gynecologist could make a meaningful difference for many pregnant people.”

UNC Health Southeastern doctors and other caregivers tell their patients there are risks, as there are with all immunizations, according to the health care system. There are mild side effects. They include injection side reactions, fatigue, chills, muscle pain, joint pain, headache and fever.

“So far, the data show no increased risk of miscarriage, birth defects, preterm birth, or stillbirth,” said Dr. Stuart Shelton, Cape Fear Valley Perinatology’s Maternal Fetal Medicine specialist. “Basically, there’s no increased risk of any adverse pregnancy outcomes. Data are still being collected and analyzed.”

Shelton is the only maternal fetal medicine specialist, or perinatologist, in Cumberland County, and has been practicing in Fayetteville for 19 years, according to Cape Fear Valley Health.

“I think the vaccine is safe, and I tell the patient that her risk of pregnancy complications is much higher if she gets COVID infection than it is with the vaccine,” Shelton said. “And right now, we don’t know of any increased risks associated with the vaccine. If it was one of my family members or friends, I would highly recommend they get the vaccine without any reservation.”

In a bid to collect more data on the issue, the CDC has established the v-safe COVID-19 Vaccine Pregnancy Registry and is inviting people to participate.

“The registry is collecting health information from people who received COVID-19 vaccination in the periconception period (within 30 days before last menstrual period) or during pregnancy. The information is critical to helping people and their healthcare providers make informed decisions about COVID-19 vaccination. Participation is voluntary, and participants may opt out at any time,” according to the CDC.

People wanting to participate must be enrolled in v-safe, a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after a person receives a COVID-19 vaccine. Through v-safe, a person can quickly tell CDC about any side effects after getting a COVID-19 vaccine.

“Depending on your answers to the web surveys, someone from CDC may call to check on you and get more information. V-safe will also remind you to get your second COVID-19 vaccine dose if you need one,” the CDC website reads in part.

Anyone who wants to participate in v-safe can register online at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/register-for-v-safe.html

The New England Journal of Medicine included v-safe data collected from Dec. 14, 2020, to Feb. 28 in an article published on April 21.

The results were, “A total of 35,691 v-safe participants 16 to 54 years of age identified as pregnant. Injection-site pain was reported more frequently among pregnant persons than among nonpregnant women, whereas headache, myalgia, chills, and fever were reported less frequently. Among 3958 participants enrolled in the v-safe pregnancy registry, 827 had a completed pregnancy, of which 115 (13.9%) resulted in a pregnancy loss and 712 (86.1%) resulted in a live birth (mostly among participants with vaccination in the third trimester). Adverse neonatal outcomes included preterm birth (in 9.4%) and small size for gestational age (in 3.2%); no neonatal deaths were reported. Although not directly comparable, calculated proportions of adverse pregnancy and neonatal outcomes in persons vaccinated against Covid-19 who had a completed pregnancy were similar to incidences reported in studies involving pregnant women that were conducted before the Covid-19 pandemic. Among 221 pregnancy-related adverse events reported to the VAERS (Vaccine Adverse Event Reporting System), the most frequently reported event was spontaneous abortion (46 cases).”

The conclusion was that preliminary findings did not show obvious safety signals among pregnant people who received mRNA COVID-19 vaccines.

According to the CDC, mRNA vaccines teach cells how to make a protein that triggers an immune response inside the body. The benefit of mRNA vaccines is people vaccinated gain protection without risking the serious consequences of getting sick with COVID-19.

“However, more longitudinal follow-up, including follow-up of large numbers of women vaccinated earlier in pregnancy, is necessary to inform maternal, pregnancy, and infant outcomes,” the Journal of Medicine article reads in part.

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