The COVID Vaccine Wasn’t Tested on Pregnant People. Now They’re Worried.

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When Vicki Singer posted a photo of her sticker proclaiming that she’d been “COVID-19 VACCINATED” on Twitter, she didn’t anticipate being attacked. At a little over thirteen weeks pregnant, she just wanted to spread awareness and information about getting vaccinated while expecting. 

Then came the trolls. 

“This poor mama-to-be thinks it’s important to roll the dice and experiment on herself and her baby’s DNA,” one stranger wrote. Another replied with a suggestion that pregnant women shouldn’t get vaccinated at all.

Singer, an administration assistant to epidemiologists at Washington University in St. Louis, had decided to get vaccinated after talking to her OB-GYNs. Her husband teaches high school in-person, and Singer has cerebral palsy and asthma, which, her OB-GYNs warned, could put her at greater risk if she caught COVID-19. Pregnant people also face an increased chance of getting very sick and dying if they catch COVID-19, research has found. 

For other expectant mothers who spoke to VICE News, the decision about whether to get vaccinated was less clear.

Neither Moderna nor Pfizer-BioNTech knowingly included pregnant women in their trials, and up until recently the World Health Organization and the Centers for Disease Control disagreed about whether pregnant women should be vaccinated. The lack of consensus led to confusion about the potential dangers of getting the shot compared to remaining unvaccinated, for both a pregnant person and their baby. And even when expectant parents do finally make a decision, they’re often judged. 

“Of course, I can’t guarantee that nothing’s gonna happen. I can guarantee it’s a lot less than if I got COVID,” Singer told VICE News. “To have people on the Internet come and be like, ‘You’re doing this wrong’—I’m like, ‘What? I’m sorry? What?’”

It’s common for pregnant women to be left out of biomedical research in the U.S., but some evidence does suggest getting vaccinated is safe for them. Twenty-three people who participated in Pfizer’s vaccine study either became pregnant after being vaccinated or had pregnancies that were too early to be detected. Of those 23, 12 received the real vaccine other than a placebo; although more follow-up is needed, none of those women have reported any serious side effects.

Still, the WHO originally recommended that pregnant people not get the Moderna or Pfizer vaccines (unless they were at high risk of catching COVID-19). Other major medical groups—including the CDC and the American College of Obstetricians and Gynecologists—disagreed. Instead, they urged providers to let pregnant people make their own decisions about whether to roll up their sleeves.

After a mass outcry and rampant confusion over why, exactly, doctors couldn’t come to an agreement, the WHO reversed its opinion in late January. “We don’t have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women,” the organization said in a statement.

Even as a Columbia University doctor who specializes in infectious diseases, Emily Miller initially wasn’t sure whether to get the vaccine. After treating patients through New York City’s overwhelming spring wave COVID-19 cases, she knew first-hand how devastating the disease could be. But her pregnancy complicated the decision. 

“I remember asking a lot of the women that I work with, who weren’t pregnant as well but were moms and were also [infectious disease] doctors, ‘What would you do? Would you wait? Would you get the vaccine?’” Miller recalled. Miller’s OB-GYN pointed out that because she was still seeing COVID-19 patients, she still had a high risk of catching the virus. 

“For me, it just made sense to go forward and do it,” Miller said. “The scientist in me could not come up with a reasonable pathway that the vaccine could cause harm to the baby.”

Vaccines are typically safe, and pregnant women have been routinely vaccinated against various diseases since the 1960s. But it may take years or even decades for the full effects of the rapidly developed coronavirus vaccines—if there are any—become known. The specter of thalidomide also haunts the medical profession: Prescribed to treat pregnant women’s nausea in the 1950s and 1960s, the drug caused severe birth defects in thousands of children.

But so far, about 10,000 pregnant people have vaccinated with either the Moderna or the Pfizer vaccines in the U.S. Last Monday, Anthony Fauci, the top infectious disease doctor in the U.S., said that there have been “no red flags.” 

One study recently published in JAMA Pediatrics also suggests that pregnant women may be able to pass coronavirus antibodies onto their children. The study found that, among 83 new mothers in Pennsylvania, 87 percent of their newborns’ umbilical cords had antibodies, which may offer the kids some protection against the virus. In an editorial alongside the study, a researcher proposed that “maternal vaccination” could help newborns acquire antibodies.

“No one really knows the right answer in this scenario for certain,” said Danya Roshdy, a clinical pharmacy specialist who deals with infectious diseases in Charlotte, North Carolina. She’s also pregnant. “And a lot of pregnant people are going to their providers and asking these questions and not being given a straight answer.”

Because Roshdy helps take care of COVID patients, she knew acutely just how much damage the virus could do. She already knew she wanted to get vaccinated by the time she talked to her own doctor, who had no reservations.

“The COVID cases in my area were surging, and the risk of getting COVID seemed to be pretty high at that point,” Roshdy said. “I felt that I was more worried about actually getting COVID and getting really sick from COVID and having bad effects on my baby from the COVID virus itself, versus the vaccine.”

After her two shots, Roshdy only had mild side effects. For about 24 hours after her second dose, she developed chills and joint pain.

Miller got her first dose of the vaccine in December, and her second in January, after her healthy daughter was born. When she posted a photo of her pregnant self, mid-shot, on Facebook, a handful of pregnant friends and colleagues reached out for advice about whether they should get vaccinated, too. 

“I think I’ve been sort of the go-to person for a lot of my pregnant doctor friends, because I’m an also-pregnant [infectious disease] doctor, and a lot of them were having these same struggles,” Miller said. “For every woman, it’s a different sort of risk-benefit analysis.”

Emily Miller, a Columbia University doctor who specializes in infectious diseases, getting her COVID-19 vaccine. (Photo courtesy of Emily Miller)