Myth: It’s risky to be vaccinated when pregnant

Dr. Johanna Nynas is an obstetrician/gynecologist at Sanford in Bemidji. She said misinformation about the vaccine causing miscarriages or stillbirths are not based in science.

“With the COVID vaccine and pregnancy, I think some of the misconceptions come from the fact that the vaccine is relatively new,” she said. “People are concerned about whether it has been fully tested and the answer is yes. The science is there. We have the baseline research.

“In regards to pregnancy specifically, the novel vaccines (Pfizer and Moderna) should not have any effect on pregnancy whatsoever. They use your body’s own immune system to create immunity against the virus.

“The Johnson and Johnson vaccine is a more traditional vaccine that can also be used in pregnancy. With that vaccine there is a slight increased risk of blood clots in the brain. There were six cases and it was put on hold for a while. Also with the Delta variant, real-life protection from COVID in the last numbers I saw was around 70 percent with Johnson and Johnson. With Pfizer, the data showed it was 96 percent effective against Delta with two doses.”

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Nynas said women who got the vaccine early on in the pandemic when they were pregnant have been monitored through the CDC reporting system.

One of the largest studies came out in June in the New England Journal of Medicine that looked at over 35,000 women who were pregnant when they got their vaccine. The study found no greater risk of adverse pregnancy outcomes – such as miscarriages, stillbirths or delivering smaller babies or delivering early – compared to non-vaccinated women.

“Having the vaccine did not increase the risk of those bad pregnancy outcomes,” she said. “That was very reassuring.”

Data that came out in April also showed that women who have been vaccinated against COVID do pass some antibodies onto their babies through both the placenta and breastfeeding. Studies are ongoing to determine how long the immunity lasts.

Nynas said the risks for pregnant women who are unvaccinated are much higher.

“We’re seeing women who are pregnant and develop severe COVID are three times as likely to require admission to the hospital intensive care unit as their peers and twice as likely to require mechanical ventilation,” she said. “They are also at higher risk of having a baby that’s born prior to 37 weeks.

“We also see higher rates of complications in women who do not get severe COVID, but test positive. They have 2.6 times the risk of preeclampsia, which is a severe disorder in pregnancy which can cause issues with blood pressure, kidney and liver function, platelets and bleeding.

“We see twice the risk of babies being small and an increased risk of preterm labor and stillbirths. Those are the types of complications we see from COVID and pregnancy.”

“I understand vaccine hesitancy,” Nynas said, “but at the same time I think people are not recognizing the potential complications that can happen to them and their baby from COVID. We know the vaccine has been tested. We know it’s effective and can help prevent cases and severe disease. It also helps prevent community spread and transmission, so we can get ahead of this thing. The risks of COVID in pregnancy are greatly underestimated.”

Nynas also tells patients that in the U.S., more than 150,000 pregnant women got the vaccine and zero women in that group were hospitalized due to complications from the vaccine.

Vaccines and religious morality

Nynas said when she talks with patients about the vaccine her focus is on facts, not beliefs.

“It’s hard to address someone’s deep religious belief,” she said. “My approach is to offer them the opportunity to ask questions about the vaccine and pregnancy or about my reasons for choosing to be vaccinated. I let that guide the conversation. I find that’s a much better approach.

“The challenge we have right now is the world is riddled with misinformation that gets shared. You can read a publication in a well-respected journal and get two totally different interpretations on that data based on how you choose to spin the information. That’s what we’re struggling with, both as a society and in medicine with vaccine hesitancy. People don’t know who to trust.

The bottom line is you need to trust your healthcare provider and have these conversations to be armed with facts.”

Myth: Vaccination is a personal choice

CHI St. Joseph’s Community Health Director Marlee Morrison said vaccines have been the solution to major public health emergencies throughout history, including smallpox, polio, and measles, but they rely on wide public adoption to work.

“Vaccines provide personal protection against COVID-19, but they also reduce the spread of the coronavirus in the community,” she said. “During the past month, COVID-19 cases have spread rapidly due to the more contagious Delta variant, particularly among unvaccinated people. If someone becomes infected, they can pass the virus to older people or high-risk people with other conditions who could become severely ill.”

Morrison said that it is a choice to get vaccinated, but added there are consequences to all decisions.

“Choosing not to get vaccinated for COVID-19 puts you at risk for more severe infection, and makes you a vehicle to spread the virus to others including family members, co-workers and friends,” she said. “Decreased vaccination rates in communities also prolong the pandemic and increase the risk of mutations which may cause more severe disease. The unvaccinated have higher rates of severe disease, hospitalization,and death.”

Ayi said when there is a respiratory airborne illness, it is not a matter of personal choice any more.

“That is why, when you have a patient with tuberculosis, the state can force them to stay at home, because when they go out they’re spreading the illness. COVID-19 should not be any different. If someone gets COVID and their personal choice affects thousands of other people around you, it’s not your personal choice any more because your personal choice now infringes on the health of other individuals. When the vaccine is available, it ceases to be a personal choice and becomes a public health matter.”

Myth: The pandemic is over

Morrison said, with the Delta variant dominant in Minnesota, case counts and positivity rates have increased since the beginning of August.

“The Hubbard County seven-day positivity rate for Aug. 23-29 was 15.48 percent and that increased to 17.61 percent for Sept.1-7,” she said.

“Community transmission in Hubbard County is high. With the high level of spread and increases in cases we are seeing in our county, it is important to follow basic public health measures, frequent hand washing, staying home when sick, masking indoors in public, getting tested for COVID-19 when exposed or symptomatic, then isolating and following all guidance to stop the spread. And of course, please get vaccinated if you are 12 or older.”

Dr. Bertha Ayi is an infectious disease physician at Essentia Health in Fargo. She said daily trends of cases in the U.S. are higher than they were in January and March. “We are about twice what we were in the summer of last year,” she said. “We’re approaching the rates we were at last November. I think we’re going to see more cases if we don’t get more people vaccinated. We haven’t reached that herd immunity needed to reduce transmission. We have more than 100 cases per week per 100,000 population, which is really high. The pandemic is not over.”

Myth: The vaccines are used to track people

Morrison said there is no vaccine microchip and the vaccine will not track people or gather personal information into a database.

Dr. Ayi said it’s not possible to implant any device with the vaccine. “The needle is a very fine micro-needle and there’s no need to track anybody who has been vaccinated,” she said. “The Vaccine Adverse Events Reporting System is used for people to report any side effects so they can be monitored. Some people also think the vaccine is a chemical that’s being put in their bodies and will have long-term side effects. We just want to encourage people that it’s safe, it’s effective.”

Myth: I had COVID so I don’t need the vaccine

Dr. Jeremy Cauwels is the chief physician for Sanford Health and Dr. Gregory Johnson is the chief medical officer for the Good Samaritan Society. They encourage vaccination, even if you’ve already had the virus.

“There were participants in the trial who had already had COVID. They were vaccinated. We don’t have the greatest confidence that just getting it will keep you immune. We grew up with chickenpox parties. That’s not working on this one,” Johnson says.

“Some people don’t develop a durable immune response when they get the virus, and we don’t know if the immunity after getting the virus is going to decrease over time,” Cauwels said. “Getting the vaccine is one way we can make sure somebody is walking around knowing they’re immune, rather than thinking they’re immune and could possibly get sick again.”

As more of the population gets vaccinated in 2021, Cauwels said the level of immunity will increase and spread of the virus will begin to decrease.

“This vaccine is the best way to protect you and the ones that you love and it’s the best option that we have right now to avoid repeating 2020.”