Mothers and Babies and the “Triple-Demic”

As summer moseyed toward fall, headlines warned of a potential “triple-demic”: COVID-19, flu, and Respiratory Syncytial Virus (RSV). COVID hospitalizations and deaths were at their lowest since the pandemic began for most of the summer, but the numbers were creeping up. Flu and RSV rates were unusually low in the first two years of the COVID pandemic, largely due to isolation and other COVID precautions, but were rising again as the pandemic ebbed and most of us returned to our normal activities.  

And long-term effects are possible, even with mild COVID.
All these respiratory infections can be deadly. According to the Centers for Disease Control and Prevention (CDC), an average of 35,000 Americans per year died from the flu over the last decade. RSV kills 100-300 children under 5 and 6,000-10,000 adults annually. It’s too soon to know what will become the typical annual death rate from COVID, but nearly 1.2 million Americans have died thus far. Weekly deaths this summer ranged from 474 to more than 1,100.
People over 65, those with underlying health conditions such as lung and heart disease, people with weakened immune systems, obese people, and very young children are especially vulnerable to flu, RSV, and COVID. Another condition that makes these infections particularly dangerous is pregnancy.
Pregnancy brings a host of physical and emotional changes. Prospective parents hope for many things, but above all they want healthy babies. It’s understandable that some women have hesitated — or refused — to get the COVID vaccine. Mistrust of vaccines, already widespread, was made worse by a flood of COVID misinformation. Even the World Health Organization in 2021 advised women not to get the new mRNA vaccines because their effectiveness and risks in pregnancy were not yet established.
That is no longer the case. Research has shown that COVID-19 vaccines are safe for pregnant women!
This matters because pregnancy puts you at high risk of getting COVID. Having COVID during pregnancy increases your risk of severe disease, hospitalization, and death. It raises the chances of preterm birth and stillbirth. The risk to mothers and their babies is too high. The common vaccination side effects — pain at the injection site, fever, muscle and joint pain, headache, fatigue — are minor compared to the effects of COVID.

From the best research to date, here is what you should know:

• Study after study has found no ill effects from getting vaccinated while pregnant. The outcomes for you and your baby are like pregnancy outcomes if COVID did not exist.

• The COVID vaccines are as effective if you are pregnant as they are for everyone else. They may not always prevent COVID, but if you do get infected your risk of severe illness leading to hospitalization or death for you or your baby is much lower.

• The vaccines do not cause infertility or miscarriage.

• You cannot get COVID from the vaccine.

• You can be vaccinated during any trimester — the sooner the better!

  • It’s okay to get your COVID vaccination along with other vaccines routinely given during pregnancy, including flu and TDAP (tetanus, diphtheria, and pertussis).

  • Fever during pregnancy from any cause, including flu and vaccine side effects, is associated with adverse pregnancy outcomes. Acetaminophen in moderation is recommended — ask your healthcare provider.

• Vaccination during pregnancy seems to be associated with a favorable Apgar score in newborns and fewer preterm births.

  • Mothers vaccinated for COVID and flu while pregnant pass their antibodies on to their newborns, helping to protect infants who are too young (under 6 months of age) to be vaccinated themselves.

• Vaccination while breastfeeding is safe; babies likely receive protective antibodies along with their milk. 

• Vaccination just makes sense for all of us, but especially for those of us who may be pregnant. 

• The new COVID vaccine is effective against the latest Omicron variants. This year’s flu shot (for everyone 6 months and older) is effective against the current circulating influenza virus. And several new tools can protect against RSV, the leading cause of infant hospitalizations: 

• Adults 60 and older can get one of the first-ever RSV vaccines, Abrysvo or Arexvy — your healthcare provider should help you decide.

• Nirsevimab, an antibody injection, is recommended for all infants younger than 8 months, unless their mothers got an RSV vaccination at least 2 moths before delivery. Another antibody, Palivizumab, is for some high-risk children up to 24 months of age.

  • Pregnant women should get the Abrysvo vaccine during weeks 32 through 36 of pregnancy to prevent severe RSV disease in their babies.
Let’s meet the triple-demic with these triple blessings by getting the shots each of us needs.

Michael Heyd, a retired medical librarian from Fairfield Township who spent more than forty years searching the literature for professional hospital staff, is a member of Let’s end COVID!
Published 10/7/23

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