Immunologist: Vaccination against COVID-19 promotes healthy pregnancy by protecting both mother and child

The CDC issued a urgent health notice for women currently pregnant, planning to become pregnant or breastfeeding on September 29, 2021. The statement reiterated the importance of vaccination in preventing serious illness and death from COVID-19. It also highlighted the significant gap in vaccination rates among pregnant women who are less than half as likely to have been vaccinated as a member of the General public.

The CDC’s advice also drew attention to growing racial gaps in immunization during pregnancy, with less than 16% of pregnant black women who report having been vaccinated.

As an immunologist who studied immune responses to COVID-19 since the start of the pandemic, I know the reason for the agency’s urgency is clear. Pregnancy is a significant risk factor for serious illness and death from COVID-19, for both mother and child. Detailed research on pregnancy during the pandemic has shown that mothers who contract COVID-19 are five times more likely to be admitted to an intensive care unit and 22 times more likely to die than their uninfected counterparts.

The same study found that mothers infected with COVID-19 during pregnancy are twice as likely to require intensive care for their newborns or to lose their children soon after birth.

As a father of two, with a third scheduled for December, I understand the intense stress health decisions can bring during pregnancy. Regarding our own high-risk pregnancy, my wife – who is a healthcare worker – was recently given the green light to receive a Pfizer recall following her recent FDA / CDC approval. Even with high medical skills and my own expertise as an immunologist, I would be lying if I said the decision was easy.

Data is hard to listen to when it conflicts with our gut feelings, but it can be when people need it most. In this case, the data is clear: COVID-19 poses a significant threat to mother and child, and vaccination can help mitigate that risk.

Immunology of pregnancy is complicated

Pregnancy is an immunological tightrope. At the most basic level, the job of a maternal immune system is to take in a foreign organism that consumes considerable resources and allow it to develop without worry for months. It doesn’t come naturally – to prevent the identification and rejection of a growing fetus as a parasitic invader, the maternal immune system undergo an overhaul which fundamentally alters their responses to infection in order to support pregnancy.

But these changes don’t completely stop immune responses. Compromising immune function to a point where infections are allowed to rage would not be an effective survival strategy for the mother or child.

Instead, a new partnership is entered into. The maternal immune system selectively chooses not react to foreign tissues and cells associated with the growing fetus, and instead enters a coordinated dance. Over the course of nine months, it will guide the attachment of the placenta to the uterine wall, promote fetal growth and development, and ultimately initiate work to start the delivery.

It is complicated work and requires a certain dose of Immuno-Zen: an environment of calm and balance is carefully maintained around the uterus. But inflammation – a catch-all term used to describe the physical manifestations of intense immune activation – is a threat to that balance. Researchers have long understood that serious infectious diseases, which frequently trigger intense inflammatory immune responses throughout the body, pose a serious threat to the mother-fetus duo. The list of infectious diseases that can complicate pregnancy it’s long.

So it’s no surprise that COVID-19, which can wreak havoc on normal immune responses across both uncontrollable inflammation and misdirected antibody responses, made this list.

Vaccination protects mother and child

This balance that the immune system undergoes during pregnancy is precisely why vaccination is so important. If there is no doubt that to get vaccinated activates the immune system – this is exactly what it is supposed to do – this mild immune response vaccine is a far cry from the risks pregnancy faces if the mother contracts COVID-19.

When your body encounters a harmless SARS-CoV-2 lookalike in the form of the vaccine, the immune system is trained to recognize the virus in a safe and controlled environment – without the threat of an actual COVID-19 infection. This way, if you come across the real virus, your immune system is much more prepared and able to fend off it. As a result, your immune system will be less likely to resort to high inflammation, high risk tactics that he would have to deploy against a serious infection.

Even with a vaccine that is not 100% effective due to decline in antibodies or the emergence of delta variant, studies have shown that the reduction in symptoms associated with partial protection is sufficient to reduce the risk poor outcomes in mother and child.

COVID-19 vaccines also protect the baby

In addition to the maternal protection offered by vaccines, a new study revealed that antibodies created in response to the COVID-19 vaccination can also be effectively transmitted to the baby through the umbilical cord blood. This finding is critical because although COVID-19 infections have not been shown to directly infect the fetus in utero, infection can be transmitted from mother to child during childbirth.

In one study, nearly 15% of children delivered by cesarean section mothers infected with COVID-19 who test positive for the virus after birth. At this early stage of life, newborns do not yet have the ability to effectively produce antibodies on their own. Instead, they are completely dependent on their mother – they keep the antibodies that were shared with each other in the blood before birth and transfer new ones through breast milk.

Medical decisions about pregnancy are difficult, and the urge to protect the pregnancy by leaving it alone is strong. It may seem like the small risks associated with vaccination are preventable – so why take the risk? The problem, of course, is that the virus doesn’t let you choose. Choosing not to vaccinate is, unfortunately, a choice to roll the dice with a virus that has killed millions and led to catastrophic results for both mother and child.

COVID-19 vaccines have been shown safe and effective during pregnancy. And now, research has clearly shown that they can be an ally of the maternal immune system, helping it maintain a healthy and balanced environment for a thriving pregnancy.

Matthew Woodruff is an instructor in human immunology at Emory University

This article is republished from The conversation under a Creative Commons license. Read it original article.