Op-Ed: Despite our efforts to convince them, too many pregnant patients will not get the COVID vaccine – Community News
Covid-19

Op-Ed: Despite our efforts to convince them, too many pregnant patients will not get the COVID vaccine

In our high-risk pregnancy clinics, there are three vaccine conversations that we have with patients on a regular basis.

First, there are patients who have been vaccinated against COVID-19 and are counting down the days until they can schedule a booster shot. Then there are patients who accept vaccines against flu and Tdap (tetanus, diphtheria, whooping cough), but not against COVID-19.

The third conversation is with expectant mothers who refuse not only a COVID-19 vaccination, but also other vaccines recommended during pregnancy.

We have that third conversation with patients at least once a day and we run out of topics to talk about. We tell these women that if they get COVID-19, they are 15 times more likely to die, 14 times more likely to be intubated, and much more likely to have a preterm birth than those who are uninfected or who have been vaccinated.

Whatever we say, these patients fear that the COVID vaccine will harm them or their babies, despite the overwhelming evidence to the contrary. They repeatedly turn down the opportunity to protect themselves and their babies from the coronavirus.

Our patients are not alone in their hesitation. As of Nov. 6, only 35.3% of pregnant women in the United States had been vaccinated against COVID-19, according to the Centers for Disease Control and Prevention. The numbers are even lower among pregnant black women (20.6%) and Latina women (31.5%).

More than 24,700 pregnant women in the United States have been hospitalized with COVID-19. As of November 8, 227 people across the country died from COVID. The deadliest month for pregnant women during the pandemic was not in 2020, before vaccines became available, but last August, during the Delta variant wave.

These numbers do not lead our pregnant patients to meet our vaccination recommendation.

When vaccines were first approved, our patients’ fears were understandable. Because pregnant women were excluded from early COVID-19 vaccine trials, we OB-GYNs had little data to reassure them that they and their babies would be safe when vaccines first became available.

When compelling data came in showing that COVID-19 vaccines are safe for pregnant individuals and protect newborns, many expectant mothers and women planning to become pregnant had already decided the vaccines were dangerous, and it was too late to convince them otherwise.

We cannot take our vaccine hesitant patients on a tour of the ICU, giving them the opportunity to experience the trepidation we feel every time we don specialized protective equipment to enter the room of a pregnant patient who is ill with COVID .

There is no way to express to them the exhaustion and pain of trying to find COVID-positive pregnant patients a hospital bed and a nurse to provide care when calls from community hospitals come in with a patient they need to put through.

There’s no way to convey the sense of relief our entire team feels when we successfully discharge a mother who has survived COVID and countless other complications – although that feeling is inevitably linked with the frustration of knowing that a vaccination will cut her shot completely. could have prevented.

Hospital providers and staff are traumatized, overburdened and scarce. We know that when a pregnant mother with COVID arrives at the hospital, it can only be a matter of hours before she deteriorates and needs an emergency C-section.

During this surgery, at least a dozen people — including the surgical team, neonatal care specialists and anesthesiologists — arrive in an operating room without the typical equipment to avoid contaminating surgical supplies beyond those required for this procedure with the virus. We leave our ID badges and pagers outside. We put on N-95 masks and positive air-purifying respirators.

It’s hard to talk, breathe, or hear each other. A team clears the elevators and hallways to take the patient to the operating room, where we wait. When the transfer team leaves, they literally shut the doors, with us inside.

We’ve been doing this over and over for over 18 months.

An additional challenge for our fragile health care system is that we are also in a baby boom: our Seattle hospital had a record number of deliveries this summer. The contrast between our healthy, normal deliveries and our horrific COVID deliveries, happening at the same time, is almost too great to reconcile.

But until pregnant women are vaccinated against COVID, we have to do it again tomorrow.

Alyssa Stephenson-Famy is an associate professor of obstetrics and gynecology specializing in high-risk pregnancies at the University of Washington School of Medicine. Linda Eckert is a professor of obstetrics and gynecology specializing in infectious diseases and immunization, also at the University of Washington School of Medicine.