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SOGH Statement on SARS-2 Coronavirus Vaccination – December 11, 2020

COVID-19 has led to almost 14 million cases and over 270,000 deaths in the US alone (1, 2) as of publication.  While hand hygiene, contact-related measures and masking are currently the best available protection against community spread (3), a number of vaccines are under development.  Vaccination is the ultimate goal to arrest the pandemic (3, 4). 

A large number of vaccines are undergoing safety testing worldwide.  Traditionally, pregnant women have been excluded from these trials. One of the preeminent specialty organizations involved in care of pregnant women, the Society of Maternal-Fetal Medicine (SMFM), has released a statement advocating for inclusion of pregnant women in ongoing studies, as well as vaccination of pregnant and lactating people when a vaccine (or vaccines) have completed Phase III trials (link here).  We at the Society of OBGYN Hospitalists endorse this practice.

Vaccinations are structured in a variety of ways; one of the most common is through utilization of an inactive form of the virus’ mRNA to induce an immune response in the host. Theoretically, this could also provide some degree of passive immunization in the neonate, a tremendous benefit during the current surge.  Another delivery method in current trials utilizes a viral vector; this method was used successfully in creation of an Ebola virus trial and was unintentionally administered to pregnant women without any clear evidence of harm to the pregnancy or the offspring (5).  In general, vaccines other than those that are live have been used in pregnancy to prevent a wide range of illness.  Data suggest that, much like influenza, pregnant women have more severe disease when infected with COVID-19, thus vaccination is even more important to offset serious morbidity.

Frontline healthcare workers, including OBGYN hospitalists, should be high priority for vaccination, and should continue to adhere to hospital safety protocols including hand hygiene, masking, and physical distancing.  In addition to providing immunity, vaccination may support public perception and acceptance.
For more information and frequent updates to this statement and to care guidelines, please visit https://www.smfm.org/covidclinical or https://www.acog.org/en/Topics/COVID-19.

REFERENCES

  1. JHU CSSE COVID-19 Data, accessed at https://github.com/CSSEGISandData/COVID-19 on 12/2/2020.
  2. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Inf Dis. 20(5):533-534. doi: 10.1016/S1473-3099(20)30120-1
  3. Lerner AM, Folkers GK, Fauci AS. Preventing the Spread of SARS-CoV-2 with Masks and Other “Low-tech” Interventions. JAMA. 2020;20892:10–1.
  4. Lyu W, Wehby GL. Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US. Health Aff (Millwood), 2020 Aug;39(8):1419–25.
  5. Legardy-Williams J, Carter R, Goldstein S, Jarrett O, Szefer E, Fombah A, et al. Pregnancy Outcomes among Women Receiving rVSVΔ-ZEBOV-GP Ebola Vaccine during the Sierra Leone Trial to Introduce a Vaccine against Ebola. Emerg Infect Dis. 2020;26(3):541.