One shot of COVID-19 vaccine better than none for pregnant Canadians, expert says
TORONTO -- Some pregnant Canadians aren’t able to get fully vaccinated before their due date because of the extended interval between doses.
Many provinces have prioritized vaccinating pregnant people against COVID-19 as their risks for severe disease are increased and they can pass antibodies on to their babies, but some soon-to-be parents worry about getting a second dose before giving birth.
“I immediately calculated out where the 16-week interval would put me in my pregnancy. I was 25 weeks with the first dose. The 16 weeks would put me at 41 weeks,” Kristen Goettlicher told CTVNews.ca in an email Friday.
She was able to get her first dose in early March as an essential worker, as she is a medical laboratory technologist in Thunder Bay, Ont. Now, she worries that her body will be dealing with enough at the time and adding her second shot to the mix might be too much.
“Whether this baby is early, on time, or late, my body will be preparing or recovering from child birth,” she said.
And from those she knows who have had a second dose, it was often accompanied by fever and fatigue and she doesn’t want to risk being rundown while in labour.
But a fertility expert says that even one dose is better than none.
“There's been a lot of confusion and the bottom line is that women who are pregnant or planning to conceive should get the COVID-19 vaccine,” Dr. Caitlin Dunne, partner and co-director with Pacific Centre for Reproductive Medicine, told CTVNews.ca in a Zoom interview on Friday.
Even just one dose can help protect both parent and baby as the parent will pass passive antibodies on to the fetus, she added.
“Those IgG antibodies are going to pass through the placenta to the baby, and then before the baby has a chance to make its own immunity, the baby's going to be getting antibodies from the mother, which can provide some protection in the newborn stage,” she said.
The National Advisory Committee on Immunization (NACI) recommends a “complete vaccine series” of the COVID-19 vaccine in pregnant people, with preference for the mRNA vaccines. When asked for clarification on the recommendation, NACI’s Dr. Caroline Quach referred CTVNews.ca to Health Canada who did not provide clarification prior to publication.
With more provinces adding pregnant people to their high priority lists for the vaccine, some Canadians are just getting the opportunity to receive their first shot in their last few weeks of pregnancy.
“If a woman is pregnant, and she receives the vaccine and then delivers one or two weeks later, her baby will probably have received some passive immunity, but it may not be as strong as it would have been had more time elapsed,” said Dunne.
But, for Dunne, it’s of the utmost importance that pregnant people get vaccinated as soon as they’re able to because they are at higher risk of severe disease and complications from COVID-19.
“We know that pregnant women are at higher risk of complications from COVID-19 than women of the same age who are not pregnant,” she said. “If you look at the data right now we see that about five to 10 per cent of pregnant women who get COVID-19 will require hospitalization and two to four per cent may require admission to the ICU. Those are very serious complications.”
But for people in Goettlicher’s position, who are worried that a second dose could tire her out right when she needs energy for delivering a baby, she’s unsure if she should put off getting her second dose until her baby arrives if she can’t get it sooner.
“I’m considering not getting the shot at this time,” she said.
She said that at the time of her first dose, she had a long conversation with her doctor and obstetrician about the risks. As a front-line worker in a medical lab, she felt it was in her best interest to get the vaccine. Upon getting it she had to disclose her pregnancy to the clinic and sign a consent form, but her informed consent was on the basis of having her second dose just a few weeks later, not months.
“If I’m legally obligated to disclose my health information, why is there no legal obligation to follow the timing for the second dose that was in effect on the date of signing that consent form?” she said.
And after giving birth, the only way to pass antibodies on to the baby is through breast feeding, which isn’t always an option for every parent.
For people who are concerned about the risks of getting the COVID-19 vaccine while pregnant, Dunne said that the COVID-19 vaccine is safe for pregnant people.
“The COVID-19 vaccine, from everything we've seen so far, is safe in pregnancy and is not linked to increased complications like miscarriage.”
The New England Journal of Medicine recently published data on 30,000 pregnant people who received an mRNA vaccine, and data continues to be collected. The study found no obvious safety issues in pregnant people who had one of the mRNA vaccines during their pregnancy.
“There is accumulating data about the safety of the vaccine and pregnancy, particularly around the mRNA vaccines which have more data because they were approved earlier,” said Dunne.