Despite benefits, COVID-19 vaccination rates low in pregnant women

LILO H. STAINTON, HEALTH CARE WRITER | JANUARY 31, 2022 

NJ Spotlight News

 

More than 12,000 New Jerseyans have tested positive for COVID-19 while pregnant, according to state records, and close to two dozen became so sick they were hospitalized in intensive care. It’s a diagnosis that also raised the chances their babies would be delivered preterm or even stillborn.

It is not yet clear how many fatalities may have resulted — maternal deaths involve extensive review in New Jersey — but a Franklin mother of four apparently died of COVID-19 earlier this month, just three weeks after delivering her youngest child, according to a recent news report.

“Pregnant women are at higher risk for severe infection from COVID resulting in hospitalization, (intensive-care) admission and need for a ventilator,” state health commissioner Judy Persichilli said.

“COVID infection during pregnancy is also associated with higher rates of preterm delivery — especially for people of color,” Persichilli said, as Black women are more likely to have other conditions that can lead to early delivery. “I encourage all pregnant women to get vaccinated and to speak with their obstetricians if they have questions.”

Vaccination rates trail public at large

Despite the protection the shots provide, COVID-19 vaccination rates among pregnant women have remained lower than for the public at large. This is particularly true among Black and brown mothers-to-be, a group that already faces higher maternal health risks than white women. National data indicates just over one in four pregnant Black women has been vaccinated since the pandemic began.

In New Jersey, state officials, reproductive health experts and community leaders are working to change this statistical picture by vaccinating more pregnant women, particularly women of color. And while case counts and hospitalizations continue to decline, advocates said the push to protect pregnant women from the coronavirus must continue.

“We had delta. We had omicron. The next (COVID-19 variant) is coming,” said Dr. Juana Hutchinson-Colas, an OB/GYN based in the New Brunswick area who is a member of the New Jersey Black Women Physicians Association, a leader in the grassroots effort.

“They are getting stronger and they are picking up the pace,” she said. “I’m not resting easily.”

To meet this challenge, the association has partnered with community groups, health care providers and a leading health insurer to organize clinics in schools, churches and other sites in places where vaccinations lag. A recent event in Trenton attracted first lady Tammy Murphy, who has championed reproductive health through the Nurture NJ program. A clinic in New Brunswick enabled some 400 people to get vaccinated, including entire families who had yet to receive a single shot, the group said.

“It’s a matter of being in the community,” said Dr. Pamela Brug, an NJBWPA leader who works with Hutchinson-Colas. According to the state, Passaic, Ocean and Cumberland counties have had the highest number of pregnant women diagnosed with COVID-19.

Historical mistrust

But access to the vaccine is only one hurdle in getting pregnant women of color vaccinated, they said. In many Black and brown communities, people have been hesitant to embrace the COVID-19 shots because of deep, historic mistrust of the medical system — a system that used Black people as guinea pigs on multiple occasions. Others lacked trust in a vaccine that was finalized quickly under a campaign dubbed “Warp Speed” and awash with politics, advocates explained.

“We had time (as a society) to get used to the MMR (vaccine) and the other ones” recommended for pregnant women, Hutchinson-Colas said. “This came so quickly and sometimes there was just too much information.”

The implications are clear in data compiled by the federal Centers for Disease Control and Prevention. Since the pandemic began, less than 43% of all pregnant women have been immunized against COVID-19. Protection varies significantly, with nearly six in 10 Asian women being vaccinated, while just 38% of Hispanic moms and 26.6% of Black moms received all their shots. Data for New Jersey was not available.

Parents’ concern is understandable, clinicians said. “A pregnant person always thinks about their unborn child,” Brug commented. “Am I going to — 10 years from now, 20 years from now — am I going to regret that I had this vaccine?”

But the risk of COVID-19 infection is far more dangerous to both mom and baby than side effects of the vaccine, Brug and her colleagues stressed. Communities of color have generally faced higher risks under the pandemic, with housing and job situations that increase their chances of infection and sometimes limited access to testing and treatment. Advocates said these factors also underscore the need to immunize pregnant women of color, a group that already experiences higher rates of birth-related complications and death, when compared to white women.

Scientific evidence of safety

With billions of people now vaccinated worldwide — including nearly 6.6 million New Jerseyans — and a growing stack of studies showing positive results, experts are confident the shots are safe, including for pregnant women. “Last year we were just rationalizing (the safety for pregnant women), based on our scientific knowledge,” Hutchinson-Colas said. “Now we have the data.”

In New Jersey just over 10% of all babies are preterm, Brug said, but COVID-19-infected moms delivered early nearly 13% of the time. Preterm infants are more likely to face developmental or learning delays, psychological problems and other chronic health issues. On the plus side, only 1% of babies born to infected mothers in New Jersey also tested positive for the virus, state officials said, a far lower rate than recorded nationwide.

Pregnant women or new moms with COVID-19 also face higher risk of illness themselves, when compared with those who aren’t pregnant, experts note. That means a greater chance of being hospitalized, admitted to intensive care or put on a ventilator and a 70% increased risk for death, studies show.

Nationwide, nearly 167,000 cases of COVID-19 have been diagnosed in pregnant women and almost 28,000 have been hospitalized as a result, the CDC reports. Some 267 pregnant women died of the infection. Some 35% of the cases have involved white women, while nearly one-third were diagnosed in Hispanics and 13% found among Black moms, the data show.

The state has taken numerous steps to address the racial disparities in maternal health outcomes through Nurture NJ, and the partnerships formed have also led to efforts to help pregnant women stay safe during the pandemic. The New Jersey Maternal Care Quality Collaborative, a task force formed to address these issues, compiled a list of resources to help residents navigate the birth process during COVID-19. The information is available in a dozen languages, from Arabic to Tagalog on a state Department of Health website.

“Everything in life is a risk versus a benefit,” said Dr. Gloria Bachmann, director of the Rutgers Robert Wood Johnson Medical School’s Women’s Health Institute, who praised the grassroots work being done by the NJBWPA and its partners. “I could get into my car to go home and get in an accident. Or I could get home safely, no trouble at all.”

When it comes to the COVID-19 vaccines and pregnancy, “the benefits are so clear,” Bachmann said.

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published this page in News and Politics 2022-01-31 03:08:41 -0800