A question I get asked *a lot* is…

“What are the long-term effects on babies born after #COVID19 #vaccination in #pregnancy?”

So let’s talk about what we know… 🧵
Let’s start by looking at the effects at birth. We now have four large datasets from three countries telling us that babies born after vaccination in pregnancy are normal. 2/

USA

nejm.org/doi/full/10.10…

medrxiv.org/content/10.110…
But is there a possibility that something will emerge in these healthy babies, months or years down the line? 5/
Obviously we don’t yet have data on what these babies will be like at, say, two years old, but we can use what we know about vaccination in pregnancy to make some predictions, with high confidence. 6/
Like the other vaccines routinely given in pregnancy, mRNA COVID19 vaccines do not cross the placenta. So they don’t actually get into the baby. This reduces the risk of an unexpected effect a lot. 7/
And from this, we might say that we expect the long term effects of these vaccines on babies to be similar to other vaccines we give in pregnancy… and we’ve never detected any. 8/
But finally, one thing I think is worth remembering if you’re pregnant right now is that there’s something going round at the moment which *can* have a long-term impact on the health of your baby.

COVID. 9/
We know that catching COVID in late pregnancy makes it more likely that you and your baby will suffer from a number of poor outcomes.

I don’t want to scare anyone here. Lots of ppl catch COVID in pregnancy and are fine. But these are more likely. 10/

bmj.com/content/370/bm…
Among these, it’s about twice as likely, if you catch COVID in late pregnancy, that your baby will be born preterm.

And babies who are born preterm are more likely to grow up with various physical and leaning disabilities. 11/
So just thinking about long-term outcomes for babies, we have every reason to expect the healthy babies born after vaccination in pregnancy will remain healthy.

On the other hand, COVID does pose long-term risks to babies and vaccination can prevent them. 12/12

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More from @VikiLovesFACS

15 Jul
Lots of ppl are asking about this article in the Daily Mail. The headline implies we have no idea if the Moderna #COVID19 #vaccine is safe in #pregnancy, despite 1000's having had it.

We actually know that it's safe *because* 1000's have had it... 🧵

dailymail.co.uk/health/article…
Pregnant people were not included in the first rounds of the clinical trials. However, following good safety and efficacy results in the first rounds, both Pfizer and Janssen quickly extended their trials into this group. 2/
Pfizer's trial in pregnant people started in February, and Janssen's in March, both without much fanfare. This is simply Moderna following suit. 3/
Read 16 tweets
14 Jul
Periodically, I get a lot of heat for using gender neutral phrases like “pregnant people” or “people who have periods” rather than “women”.

So today, I’d like to take a few moments to explain why I do that, including some of my more personal reasons… 🧵
But let’s start by being clear that women are people!

So these phrases include pregnant women and women who have periods. 2/
Second, I am aware that the reason I get hear for this is because it’s inclusive of trans men, and some people have a problem with that. 3/
Read 11 tweets
1 Jul
This @NEJM paper on the safety of #COVID19 #vaccines during #pregnancy found no increased risk of miscarriage associated with vaccination.

So why is this person claiming that there was an 83% rate of miscarriage?

Short answer, a maths mistake... 🧵

nejm.org/doi/pdf/10.105… Image
*But first* I would like to make it really clear that almost all miscarriages happen because there was something wrong with the baby that made it unviable. 1/
You cannot avoid miscarriage by being a "more careful mom" and to suggest to someone who has had a miscarriage that they should have been more careful is just cruel. 2/
Read 19 tweets
30 Jun
Every day, I get emails from people who have noticed changes to their periods following the COVID vaccine. But we don't yet have enough information to know if this is really linked to the vaccine and, if so, how common it is. 2/
Since March, I have been saying "I'm sure someone is doing the kind of study that will find this out." I contacted some of the period tracking apps to see if they wanted to work with me on the kind of study that would find this out, but they weren't keen. 3/
Read 5 tweets
30 Jun
This study looked at the milk of 10 #breastfeeding people who had received an mRNA #COVID19 #vaccine. Key points...

🗝️ Anti-COVID antibodies are present in breastmilk and would be predicted to be protective.

🗝️ Minimal transfer of vaccine mRNA.

More detail below... 🧵
The finding that anti-COVID antibodies make it into breast milk after vaccination is in line with findings from at least six other studies. Too many to post one by one, but you can find links to them here, under question 7.

2/

drive.google.com/file/d/1_wHIYX…
The finding that there is "minimal" transfer of vaccine mRNA is worth looking at in a bit more detail. What exactly do they mean by that? 3/
Read 14 tweets
29 Jun
@RealNormalPod @lisadunn1978 Great question! What you've just described there is called a "challenge study" and is sometimes done, eg for malaria vaccines. But in the case of COVID, since it's potentially fatal and there's no cure it was considered unethical. 1/
@RealNormalPod @lisadunn1978 In the trials, what they did was vaccinate half the participants and give the other half a placebo (either salt water or a different vaccine). Then they regularly tested everyone to see if the people who got the vaccine were less likely to get a positive test than the rest. 2/
@RealNormalPod @lisadunn1978 In fact, not all the trials did this. AZ did and Moderna sorta did but Pfizer only tested people when they got sick. This is why we spent some time when the vaccines were new going "we know it stops you getting sick, but we don't know if it stops you getting infected." 3/
Read 7 tweets

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