The large majority of patients tell me at their antenatal visit how they are fully COVID vaccinated, had their first shot or have their appointment for their first shot. CONGRATULATIONS! COVID Vaccine Hesitancy in Pregnancy

There is a small minority who have decided not to be vaccinated while pregnant or at all. They typically tell me they have either done their own research or else family or friends have told them not to get vaccinated because of supposed dangers of the vaccines. I feel so sad for these women as they have made the wrong decision.

I don’t think these patients are mainstream COVID antivaxxers. Their motivation in making this decision is the vaccines are so new, fear about possible dangers of the vaccines and as well they want to protect their baby.

In doing their own research they would have used social media and ill-informed family and friends as their source of information. If they had used reputable medical websites and medical research articles and believed the informed opinion of their medical doctors they would not have come to this conclusion. Such patients often have a history of anxiety. They often have gone to inaccurate social media sites that have frightening information that reinforced their anxieties and concerns about vaccinations.

These negative COVID vaccine social media sites are the domains of the antivaxxers who use them to promote their fictitious views and blatant lies. They have on their side an occasional health care professional, naturopath, or scientist. A couple of patients sent me YouTube videos done by such people as they were concerned about what they said. On checking further these “authorities” have been discredited by mainstream colleagues because of their wacky antivaccine views.

As more Australians are being vaccinated and the antivaxxers are losing their antivaccination battle they are becoming more aggressive in their campaign. In the news it is reported they have been putting up fake QR check-in codes outside supermarkets which take people to their social media sites. They have vandalised COVID swab and vaccination centres. That is disgusting. Why give such people the time of day? But sadly, some pregnant women who want to protect their babies are caught by their evil web and so make the wrong decisions.

I only want what is best for my patients and am so sad for the minority who have been misled about the safety of COVID vaccination.

These antivaxxers usually don’t publicise the dangers of being infected with COVID. But some of their followers are so scarred by not only the vaccines but by getting a COVID infection that they are taking drastic measures to stay COVID safe including even selling their house and moving out of Sydney.

I would like to address pregnancy concerns about vaccination that I am hearing from patients.

“There have been no long-term studies on the long-term effects of the COVID vaccines”.

This is the fear of some women who have decided to not be vaccinated while pregnant. They are worried that the vaccine will have an adverse long term health implication for their baby.

There is no known or suggested (by reputable medical sources) adverse long-term health concerns in the offspring of women who have been vaccinated in pregnancy.

It is illogical to have such fears as the vaccine does NOT cross the placenta, so your baby will not be exposed to the vaccine. (1)

All pregnant women want to protect their babies. But women who have decided not to be vaccinated for this reason have done their research using the wrong sources and so have come to the wrong conclusion. To protect their babies, they should be vaccinated.

The counter argument is there have been no long-term studies on the long-term effects on an infant if a woman is infected with COVID while pregnant.

While it is not known, it is more logical to be concerned, COVID infection in pregnancy rather than the vaccine could have long term adverse health implications for a baby. Babies can be infected with COVID by their mothers while in the womb. While the COVID virus and COVID vaccine antibodies can cross the placenta the actual mRNA COVID vaccine DOES NOT cross the placenta and get into the unborn baby (1).

The vaccines protect baby from COVID infection

It is thought COVID vaccine will give baby some COVID protection after birth, as the antibodies cross the placenta and will be in breast milk (1). It is the same logic as whooping cough vaccination in pregnancy.

What about other vaccines administered in pregnancy?

There is never this hesitancy about other vaccines (whooping cough and flu) administered in pregnancy. Pregnant women are very keen to have these vaccines. The flu virus mutates each year and so a new formula flu vaccine must be developed each year. But a pregnant woman does not say: “I won’t have the flu vaccine as there have been no long-term studies on the long-term effects of this year’s flu vaccines”.

The vaccines are so new.

Yes, for COVID but mRNA technology isn’t new. mRNA research has been happening since the early 1990s (2).  Human trials of vaccines using mRNA technology have been happening for the last decade (3). Because there has been a lot of research into mRNA before the COVID pandemic the mRNA vaccines could be developed quickly. Moving forward mRNA will be the basis of further vaccines for further new virus infections in the future.

What about risks of you getting infected with COVID while pregnant to your unborn baby?

Some women are asking: “Will COVID vaccination cause miscarriage?” This is another antivaxxer myth. There is no evidence of this.

In contrast any nasty infection, including COVID, in pregnancy can cause miscarriage and stillbirth. I heard the husband of a woman who was intubated in ICU with COVID infection talking on the radio. They were in the USA. He said they were both COVID antivaxxers. His wife was in advanced pregnancy and their baby had died in her uterus while she was intubated in ICU with COVID. He wishes they have both been vaccinated.

With much still unknown about COVID-19 and neurodevelopmental complications, it is feared there is an increased risk of baby developing congenital birth defects if a woman is infected in early pregnancy (4).

It is known that if you become infected with COVID you are more likely to have pregnancy complications. As well, your unborn baby may not to grow well (intrauterine foetal growth retardation). You may go into preterm labour and baby deliver earlier than would have been the case and have all the challenges and risks of prematurity. If you became infected with COVID while pregnant you put your unborn baby’s life and wellbeing at risk.

Surely these know and suspected COVID risks for your baby are more important considerations than the unknown, and not thought to be true concerns about the vaccines.

COVID risks for the pregnant woman.

Based on data from other similar viruses, like SARS and MERS, pregnant women are at risk of more severe COVID-19 infection. (5)

A pregnant woman’s immune system is ‘depressed’ in pregnancy. And so, she is more likely to be infected with COVID and have a more serious infections with consequently admission to ICU and even death.

In pregnancy a woman has a reduction of the lungs’ capacity and inability to clear secretions and so she is more vulnerable to a serious COVID respiratory infection

During pregnancy, there are higher levels of circulating coagulation factors. COVID effects the coagulation system and so there is the increased possibility (not yet proven) of more COVID thromboembolic events with associated mortality for pregnant women.

There are over 1000 new COVID infections each day in NSW. Pregnant women are infected with COVID in Sydney today. I have been advised there are about 70 pregnant women being managed by Westmead Public Hospital with a COVID infection. There are children in Westmead Children’s Hospital ICU sick with COVID infections

There are long term adverse health risks for you if become COVID infected.

As well the immediate health risk to you and your baby if you are infected with COVID, there are the long-term implications of having a COVID infection (6). There can be long term lung damage and respiratory problems, long term heart damage and heart problems, ongoing coagulation concerns and risk of further thromboembolic disease, cyclical bouts of fatigue, headaches, months of complete exhaustion, mood swings, and other symptoms neurological and psychologic health problems and need for repeated hospital readmission.

Can I get COVID after I am vaccinated?

Yes. While vaccines are over 90% effective in preventing a COVID infection, they are not 100%.  If you did get COVID infected after vaccination you would have only a low viral load, which would mean it is very unlikely you would get sick and need hospitalisation and also much less likely you will infect others.

The effectiveness of the vaccines wears off over time and so ‘top-up’ doses will be necessary. There is increasing evidence that to change vaccines for the ‘top-up’ is best. My wife and I both are fully vaccinated with Astra Zeneca COVID vaccine. We will be requesting Moderna vaccine for our top-ups.

But I will stay at home and not get infected

The pregnant woman who worried about the possible long-term effects of the vaccine on her baby is not necessarily an antivaxxer. Indeed, she has often made the decision she will get vaccinated once she has her baby.

Some women who have decided this will tell me she will socially isolate while pregnant to make sure she does not get a COVID infection.

While social isolation will reduce risk of getting infected, it will not eliminate it. It is unrealistic to isolate yourself and your family members at home, so no one interacts with anyone during the pregnancy. But this is what would be needed to really protect yourself. With home deliveries there can be interaction with couriers. What about your children’s education? They will most likely go back to school and so could be exposed to COVID. They will want to play with their friends who could have COVID. What about your job and your husband/partner’s job? Most jobs require some interaction with other people either clients or work colleagues. What about your family? When this lockdown has ended will you continue to isolate from them? A patient told me her next-door neighbour who was pregnant was anxious about having the vaccine and so decided to self-isolate instead. Her sister came over to help her get things ready for her baby. Her sister infected her with COVID. Her sister said she had had a negative COVID swab a few days prior. You cannot conclude if you interact with someone who has had a recent negative swab you will not be exposed to COVID.  Occasionally swab results are inaccurate. As well someone can get infected with COVID after the COVID swab has been taken.

Myths about COVID-19 Vaccines

Popular myths include the COVID pandemic is a government conspiracy, so the governments of the world can take control of you and take away your freedoms or the vaccine has a microchip that is injected into you so the government can collect data on you, or Bill Gates is behind the pandemic to make more money (as he donated money to develop vaccines). What total nonsense! There is good CDC (Centre for Disease Control article on this topic titled ‘Myths and Facts about COVID-19 Vaccines’ (7) and another by Boston University titled ‘Myths vs. Facts: Making Sense of COVID-19 Vaccine Misinformation (2). But conspiracy theorists will not change their ideas, no matter how strong the evidence is to the contrary, so please don’t listen to them and don’t get into an argument with them.

Steph made an excellent Facebook comment in her reply to this post: ‘Sadly, there is a lot of rubbish reports circulating on how it may affect fertility and how the vaccine is shrivelling our ovaries ? such rubbish!’ Thanks Steph for your comment. I agree 100%. There is absolutely no known or suspected basis to the claim of the antivaxxers that COVID vaccination will reduce fertility (1, 8). It is medically such an illogical comment. This ridiculous lie has been put out there by antivaxxers to cause fear and so make women hesitate about being vaccinated.
If these antivaxxers had any integrity they would only state what is true, behave in a law-abiding, honourable and loving way and stop their fear campaign with all its lies and myths.

COVID is not going away

COVID is going to be with us for many years. Because of vaccines having a limited duration of effectiveness and because of COVID virus mutations (and the current vaccines are not as effective against new strains), there will be booster vaccine shots needed to stay protected. I suspect it will end up like the flu vaccine where you need a new shot each year. Indeed, Novavax is developing a combined COVID-19 and influenza vaccine (9)

Vaccines are now being given to 12-year-old children and overseas even young children will be vaccinated (10). It is not inconceivable at some time it will be included in National Immunisation Program for infants.

Full vaccination is now mandatory for some places of employment (the list of employers will grow) for airline travel and will be for many venues. I read in USA some parents are insisting on full vaccination of parents for children to come to birthday parties. Those not vaccinated will sadly be locked out of mainstream society and out of employment. There are very few health conditions that will prevent you from being vaccinates. So sadly, a decision not to be vaccinated is usually a personal choice that will have huge implications for you and your family.



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