Pregnant women, considered to be at high-risk for complications if they contract COVID-19, were not included in the Pfizer and Moderna vaccine trials. It was a strategy to protect pregnant women from any potential risks, said Justin Brandt, assistant professor of obstetrics and gynecology at Rutgers Robert Wood Johnson Medical School.

As a result, there is not enough clear safety and efficacy data to determine if it's safe for pregnant women to get vaccinated.

He did, however, say the use of the vaccines in pregnancy is supported by the mechanism of the vaccine platform, which is theoretically safe for mothers and their unborn babies. The vaccine does not contain live virus. It does not have vaccine adjuvants to enhance efficacy. Also, the viral messenger RNA, which provokes the maternal immune response to fight against the virus, does not enter the nucleus of cells where DNA is stored.

Brandt also said the vaccine leads to antibodies that can cross the placenta and provide some protection for the baby. This is important during the pandemic when there's high prevalence of the infection in communities and before a baby is eligible for childhood vaccinations.

"But we know that pregnant women who are exposed to the virus itself and has natural infection, when we studied the cord blood of babies, there are COVID antibodies that are likely to provide some protection for a baby," said Brandt.

He also said that pregnancy is a risk factor for more severe COVID symptoms. CDC surveillance data shows pregnant women with COVID-19 are more likely to be admitted to intensive care, to be put on a ventilator and to die compared to non-pregnant women with COVID-19.

Pregnant women need to look at their own individual risk profile like diabetes and obesity when making a decision about whether to get vaccinated, said Brandt. While doctors don't have the safety data, they have some reassuring evidence in regards to the theoretical mechanism of how the vaccines work. When patients do the math for themselves, many will decide that the benefits outweigh the risks, he added.

Protocols are in place to test newborns whose mothers tested positive for COVID-19. "But reassuringly, we do not believe that the virus that causes COVID — SARS-CoV-2 — crosses the placenta and increases the risk of vertical transmission from mom through the placenta to baby," said Brandt.

He said that many neo-natal COVID infections are likely caused by exposure of that baby to other relatives who are infected with the virus.

So while there doesn't seem to be a high risk of vertical transmission from mom to baby, he said it's important not to expose the newborn to family who may be positive.

Continue wearing masks, washing hands and standing 6 feet away from each other.

Brandt said it's difficult for doctors to make recommendations about getting the vaccine when there's not enough safety data. That's why it's important to discuss the risks and benefits of the vaccine with pregnant patients so they can make their own decisions. Brandt said he wants his patients to know that he supports their decision to get vaccinated.

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