Dr. Connie Nasello, obstetrician and gynaecologist and chair of the OMA Section on Obstetrics and Gynaecology provides an update on the impacts of COVID-19 and vaccines during pregnancy.
Dr. Connie Nasello, obstetrician and gynaecologist and chair of the OMA Section on Obstetrics and Gynaecology provides an update on the impacts of COVID-19 and vaccines during pregnancy.
Spotlight on Health – COVID-19 and vaccines during pregnancy with Dr. Constance Nasello
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Georgia Balogiannis: In this podcast the Ontario Medical Association looks at current issues of interest in health care. Spotlight on Health gives you all the straight talk. We're Ontario's doctors and your health matters to us. I'm Georgia Balogiannis for the Ontario Medical Association.
Dr. Connie Nasello is an obstetrician and gynaecologist and chair of the OMA section on obstetrics and gynaecology and president of the Ontario Society of Obstetricians and Gynaecologists. In this episode, she provides an update on the impacts of COVID-19 and vaccination during pregnancy.
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Dr. Connie Nasello: What we're seeing now is still hesitancy about getting the vaccine into the arms of pregnant women. And, you know, this is a constantly evolving group, it gets bigger every day — there are 147,000 babies born in Ontario every year, it really is 147,000 women that are at risk for the very severe consequences of the COVID virus. In the spring, in the large teaching facilities in downtown Toronto, Mount Sinai, their entire ICU was filled with pregnant women, over 30 at one point, and the consequences of getting a COVID infection during pregnancy are magnified about five times what it would be when you're not pregnant.
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Dr. Nasello: What each woman needs to consider for themselves is, what is the data on the safety of the vaccines? Now, what's different about the messenger RNA vaccines, which we have recommended for pregnant women, is that there is no virus. Messenger RNA is like sending your cell an email, and when you open the email it tells your cell, well, “Get your act together, I want you to make this product,” and then you delete the email.
That really, in a nutshell, is how a messenger RNA vaccines work. And I think it is also phenomenal that messenger RNA vaccines were developed here in Canada by a female scientist and COVID is not the first virus it's been used against. This technology was used for a number of other viruses that were virulent but short lived, particularly the Ebola outbreak couple years ago.
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Dr. Nasello: I think it's important to understand that with the vaccine, there are exceedingly few people that actually have an allergic reaction to the one product that has the potential to cause that, and that's polyethylene glycol. Polyethylene glycol, for the average person, is actually the main component in many of the products that are used for constipation — they're used in children, they're used in adults. It also is one of the filler components in almost every pill that is on the market. So, it's impossible to not be exposed to polyethylene glycol.
Even that group of patients that have had an allergic reaction to the vaccination can actually be given their second vaccine under medical supervision and with medications that will prevent the anaphylactic response.
I think it is also important to understand that the vaccinations do not cause miscarriage. There is no effect of the vaccine on fertility. It does not affect menstrual cycles. So, I think that we have to take that into consideration.
Now, specifically looking at pregnant women, yes, we started out with a huge experiment in pregnancy. And the earliest people enrolled in that study were actually pregnant female physicians, pregnant female OB-GYNs. We understood the science, we understood this particular safety of this vaccine, which is now being rolled out to most of the world. In the US, we have data that over 100,000 women have been identified as receiving a vaccine in pregnancy.
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Dr. Nasello: We have actually known from very early days that the babies that were born of women that received the COVID vaccines actually transferred antibodies through the umbilical cord to their babies. That's the same mechanism that occurs with other vaccines that we recommend in pregnancy – the flu vaccine and the Tdap vaccine, the pertussis vaccine — and that is to be repeated in every pregnancy because those antibodies transfer to the infant and will protect the infant for at least six months.
A recent study came out in the Journal of Pediatrics that has looked at a larger group of postpartum and lactating women that received the COVID vaccines that had uneventful deliveries and newborn courses. They had antibody levels in the babies, but they also had substantial levels of antibodies in breast milk. It's still early days as far as how effective that is in the infant's gut, but it certainly can provide some protective antibodies to the mouth and the upper airway area. So, it's very important for newborns to have that protection until they can get a vaccine themselves.
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Dr. Nasello: You have to take a lot of what you hear on social media with a grain of salt. It is very easy to go down a rabbit hole and be somewhere else you didn't intend. We all know how easy that can be, particularly with vaccine information, with the virus information — we have to be very aware of that because the risks of getting COVID at any age group still has the potential of having some major illnesses that remain after the virus is cleared. You have to think of what happened with polio — that affected children for years.
These vaccines were tested collectively in over 100,000 women before it hit the market, and the polio vaccine was tested in less than 5,000 and parents and their children lined up for miles so that their kid could get vaccinated.
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Georgia Balogiannis: This podcast is brought to you by the Ontario Medical Association and is edited and produced by Jodi Crawford Productions. To learn more about the Ontario Medical Association, please visit oma.org.
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