Thread by @bopinion

Last week, the WHO recommended against giving pregnant women the Moderna or Pfizer vaccines. It later backtracked, but the damage was already done.

The mixed messages around pregnancy and Covid-19 vaccines need to stop trib.al/IAKGhwN

The limited evidence available suggests pregnant women are more at risk from Covid-19 than from the vaccine.

“Shame on everybody for not including pregnant females at every stage along the pipeline,” says Sabra Klein, an immunologist at Johns Hopkins trib.al/IAKGhwN

Without question, the early stages of vaccine development should have included:

💉Testing vaccines on pregnant animals
🤰Enrolling pregnant women in clinical trials

Pregnant people deserve better advice than the vague “ask your doctor” trib.al/IAKGhwN

The CDC has reported that people who are pregnant are more likely to experience more severe Covid-19 and be hospitalized than the general public.

Another report showed that getting infected during pregnancy may create adverse outcomes like preterm birth trib.al/IAKGhwN

Covid-19 doesn’t pose as much danger as the Zika virus, which caused a rash of severe birth defects, but it’s bad enough that for most pregnant women, the risk of getting the disease outweighs any potential dangers from the vaccine, Klein explains trib.al/IAKGhwN

There are biological reasons behind why pregnant women may react differently to the virus, and possibly to the vaccine.

Parts of pregnant immune systems are damped down to prevent reactions that may hurt the growing mass of cells that make up the fetus trib.al/IAKGhwN

"While it’s important to be able to fight infection, from an evolutionary standpoint, the most important thing going on in your body is your pregnancy and keeping your baby alive,” said Klein.

That means a vaccine might not work as well trib.al/IAKGhwN

And on the other side, she says, it’s possible an exuberant response would harm the pregnancy.

But that risk can’t be considered out of context. The fact is, it’s hard to avoid infection with SARS-CoV-2, especially for women in the high-risk professions trib.al/IAKGhwN

The WHO ultimately left the vaccine decision up to women and their doctors – which isn't that different from the CDC’s guidance.

And it did recommend the vaccine for pregnant health care workers at high risk of exposure trib.al/IAKGhwN

It’s unfair to put the vaccine decision burden on women without adequate information and amid too many negative stories.

What’s critical now is that pregnant women getting the vaccines are closely monitored trib.al/IAKGhwN

With lots of additional pre-clinical work going on to study how the vaccine works against new variants of the virus, researchers could start including pregnant animals.

It isn’t too late to make up for past mistakes trib.al/IAKGhwN