Respiratory Virus Protection During Pregnancy: Flu, COVID-19, Tdap and RSV Vaccinations
The rate of respiratory infections is on the rise nationwide, with the Centers for Disease Control and Prevention (CDC) reporting a spike in hospitalizations in the first week of December. And they say there’s an “urgent need” to increase vaccination coverage for these sometimes-serious illnesses.
But are these vaccines safe for pregnant women? Much of the advice received during pregnancy revolves around avoidance – avoid soft cheeses, hot tubs, and certain medications, to name a few. Yet one thing pregnant women should not avoid is getting vaccinated against Flu, COVID, Whooping Cough and RSV.
Pregnancy, Newborns and Respiratory Illnesses
Respiratory illnesses during pregnancy can cause dehydration, high fevers, and other concerns that can put pregnant people at risk for preterm birth and labor. Respiratory illnesses like RSV and Pertussis (also known as Whooping Cough) are also very dangerous for babies while they’re still too young to be vaccinated.
“That’s why we recommend being vaccinated against these illnesses. We are taking care of two patients in front of us – mom and baby – and weigh risks/benefits for both of them. The risks of these vaccines are either non-existent or extremely small and the protection is so important,” says Claire Rodriguez, Certified Nurse Midwife with Sentara Midwifery Specialists in Hampton, Virginia.
Pregnancy and the Flu Shot
Exposure to the virus that causes influenza can harm pregnant women and their babies. First, women who contract influenza are more likely to develop significant illness and subsequent complications. In addition, when pregnant and fighting the flu, the baby may be at risk of complications including possible low birth weight, preterm delivery, increased rates of birth defects, and increased rates of spontaneous abortion.
Getting a flu shot during pregnancy can help prevent the chances of being hospitalized with the flu by about 40 percent. Infants whose mothers did receive the flu vaccine have an added bonus of passive protection through breast milk during nursing – and this is the protection your baby needs since they can’t be given a flu shot until at least six months old.
Pregnancy and the COVID Shot/Booster
A wealth of data has demonstrated that COVID during pregnancy may be damaging not only to the mother’s health but also to her baby. Research shows that the consequences for mothers include an increased risk of pneumonia and severe illness leading to hospitalization, intensive care, intubation, and, in rare cases, death. Some studies have identified increased risks of preeclampsia, which causes dangerously high blood pressure. COVID infection also increases the risk of prematurity and stillbirth.
On the other hand, data on both the safety and effectiveness of the vaccines in pregnancy is very reassuring. A large review of studies, including studies of close to 2.4 million pregnant persons, found no evidence of pregnancy-associated safety concerns of COVID vaccines, and the vaccines have not been associated with miscarriage, preterm delivery, stillbirth, or birth defects.
COVID vaccination in pregnancy also results in maternal protection against COVID and transfers protective antibodies to the baby, regardless of the timing of vaccination during pregnancy.
Protecting Babies Pertussis (Whooping Cough) and RSV
Babies can’t be immediately vaccinated against the dangerous respiratory viruses Respiratory syncytial virus (RSV) and Whooping Cough, also known as Pertussis. However, newer vaccinations given later in pregnancy can protect moms and their babies.
“The protection comes from antibodies made by the mother during pregnancy that are passed through the placenta and breast milk,” explains Rodriguez.
RSV is a viral illness that causes symptoms such as trouble breathing. It’s the most common cause of inflammation of the small airways in the lungs (bronchiolitis) and pneumonia in babies. It can be particularly dangerous for infants and young children. Whooping Cough is a highly contagious disease that causes severe coughing and difficulty breathing and can be serious, even deadly, for babies less than a year old.
In most regions of the United States, RSV season starts in the fall and peaks in the winter, but the timing and severity of RSV season can vary from place to place and year to year. The CDC is currently reporting a rise in RSV-associated hospitalization rates among young children.
The American College of Obstetricians and Gynecologists recommends an RSV vaccine for women who are 32 through 36 weeks pregnant from September through January to protect their baby against severe RSV illness for up to six months after birth. The Tdap shot protects babies from Whooping Cough and should be taken when taken by pregnant women between 27 and 36 weeks of pregnancy – as early in that window as possible.
Will a Vaccine Cause the Illness?
“Patients ask us if these vaccines can cause the illnesses they’re being vaccinated against, particularly if they have side effects like a low-grade fever or feeling tired,” says Rodriguez.
“These vaccines are dead, so they can’t make you sick. What you’re experiencing is your body recognizing the disease and responding to it. It doesn’t mean you’re sick or having an allergic reaction to the vaccine itself,” she continues. If you need pain relief, take acetaminophen. This over-the-counter medication is safe during pregnancy.
Prevention Matters
The stats associated with vaccinations preventing serious illness for both mom and baby are compelling:
- A report published in September 2023 found that getting a COVID vaccine during pregnancy lowered the chances of COVID hospitalization for babies. Over 75 percent of babies hospitalized with COVID were born to women who did not receive the COVID vaccine.
- Studies have shown that getting a flu shot can reduce a pregnant person’s risk of being hospitalized with flu by an average of 40 percent. Flu vaccination during pregnancy also reduces the risk of flu illness and hospitalization in babies during the first few months of life when babies are too young to receive flu vaccines.
- Clinical trials showed that giving the RSV vaccine to pregnant people reduced the risk of their babies being hospitalized for RSV by more than 50 percent.
“We encourage our patients to talk with us about these vaccines and ask questions,” says Rodriguez, adding, “We always want to be sure our patients feel heard.”
More Resources:
Respiratory Virus Vaccination for Pregnant People
Are Covid-19 Vaccines Safe During Pregnancy? The Science Says Yes
By: Amy Sandoval