Scrolling through Instagram this last week, my Stories have been filled with friends basking in the unexpected sunshine, splitting pizzas around rickety pavement tables and clinking beers. I’ve been curled up at home, living vicariously through them, encouraging my closest friends to send me photos of their meals, manicures and haircuts. While I’m a little envious of their new-found freedom, these feelings are by far outweighed by my love for my slowly growing baby bump. I’m five months pregnant with a very wanted, very loved daughter, and I’ve been shielding since I found out she was on her way on New Year’s Eve.
The UK’s first lockdown coincided almost perfectly with my own; I left the house just five times in the 10 weeks that followed it, and only for medical appointments. I would have stayed home anyway, but I was experiencing hyperemesis gravidarum, an extreme form of sickness and vomiting in pregnancy.
It’s thought that thousands of women each year terminate wanted pregnancies because of how debilitating and excruciating it is. While I never considered it myself, I could absolutely understand why some do. Keeping food down was almost impossible, and I lost a stone in under three weeks. I was bedbound for six weeks by the subsequent exhaustion and weakness, and another four before I was even well enough to go for a walk around my garden. The nausea lasted 22 hours a day. Imagining what would happen if I caught Covid at the same time filled me with utter terror.
My husband and I already had Covid once, last March; between the two of us we covered every single known symptom. All of this is to say that I already know what Covid feels like; even a relatively mild case. And I already know the terror of being very poorly during pregnancy. So, for months now, I’ve been requesting a Covid vaccine; calling my GP every few weeks to ask for updates or any kind of special permission. As a journalist, I’ve seen so many details of lives being torn apart by catching the virus, including pregnant women who’ve missed the first weeks or days of their child’s life.
That’s not to mention the utterly harrowing stories. In March 2020, pregnant 28-year-old Mary Boateng went to the Luton hospital where she worked as a nurse “breathless, exhausted and weak” after collapsing at home; she had coronavirus. Her husband Earnest said that she was sent home the same day, but two days later returned, where she delivered prematurely. She died five days later in intensive care from coronavirus and multiple organ failure, leaving behind a little girl, also called Mary.
Other young, pregnant women have had their lives turned upside down by the virus, including Grace Victory, who was placed in an induced coma on Christmas Day 2020, the day after giving birth to the son two months prematurely. She was given a 5% chance of survival and yet beat the odds, waking up having missed the first 10-weeks of her son’s life. Mary was, and Grace is, a women of colour; I am too.
Thankfully, their stories are rare, but they are not non-existent. They’re also joined by statistics and facts that can’t be ignored. While pregnant women in the UK are said to be no more at risk of catching the virus, our UK government have stated that “pregnant women who do get symptomatic COVID-19 infection are 2 to 3 times more likely to give birth to their baby prematurely,” a sentiment that both the Joint Committee on Vaccination and Immunisation (JCVI) and the Center for Disease Control and Prevention (CDC) agree on.
The latter also found that pregnant people are more likely to require hospitalisation, with the Society for Maternal-Fetal Medicine estimating that while there, they are 3 times more likely to need ICU, and 2 to 3 times more likely to need advanced life support and a ventilator than an infected non-pregnant person. Another study from the British Medical Journal (BMJ) of over 11,000 pregnant women found that 25% of babies born to mothers with Covid needed neonatal admission at birth; an increase in admissions amongst pregnant people without Covid.
In other words, looking at the number of deaths in pregnant people with Covid is not at all a measure of how serious it can be.
Yet while being labelled as clinically vulnerable by the NHS, and some advised to shield in their third trimester in particular, pregnant people were excluded from early trials of the vaccine, meaning safety and risk data was non-existent. Dr Kristina Adams Waldorf, an obstetrician-gynaecologist with the University of Washington School of Medicine, has said that “the exclusion of pregnant patients from COVID-19 vaccine trials was a mistake”, noting that pregnant people are an “important group that is typically highly vulnerable to influenza infection.”
As such, when vaccines did launch in December, pregnant people in the UK were restricted from access. A four month wait for a green light followed,
which finally came to an end on 15th April after over four months. During this time, real-world data has been collected from pregnant people receiving the vaccine in US, where they have been allowed to make their own decision. This data tells us that no safety concerns have been raised after 90,000 pregnant people received either the Pfizer-BioNTech and Moderna vaccine (the AstraZeneca vaccine is not yet being administered there).
The CDC, the SMFM and the American College of Obstetricians and Gynecologists (ACOG) are now all in agreement; the vaccine should not be withheld from pregnant people. With the proviso of waiting until after the 12-week mark where possible, and encouragement of weighing up benefits with risks with their doctor if they wish, pregnant people in the UK will now be able to be vaccinated. And I will be at the front of that queue.
I’m aware that some people will think I’m out of my mind, but I am prioritising the views of scientists and academics with decades of knowledge and experience, and institutions like the CDC, the ACOG and the SMFM over people with none of these expertise. We’ve all seen how misinformation and disinformation spreads like wildfire, and unfounded claims have been rife. Infertility, for example, was claimed to be linked to the virus, no doubt frightening many- these have since been disproved by the ACOG.
We’ve also seen how information can be taken completely out of context; just look at the hysteria around the AstraZeneca vaccine and its links to blood clots. It was days before panicked chatter began to be overtaken by comparisons absolutely essential in contextualising such risks. As it turns out, the risk is around 4 in 1 million. Meanwhile, the risk of blood clots from using hormonal contraceptives- something that most, if not all, of the women in my life have done or still do- is roughly 1,200 in 1 million.
Posing my decision to Professor Beate Kampmann, Specialist in Paediatric Infection & Immunity and Director of the IMPRINT network at the London School of Hygiene and Tropical Medicine, she reassures me that “the benefits of the vaccines are absolutely obvious, and I would have no reservation in taking an mRNA vaccine myself if I was pregnant and in the second or third trimester. I have recommended them to my friends and colleagues too.”
“As a scientist and a doctor, I have worked with pregnancy vaccines for a long time, and I know that any woman asked to be vaccinated during that very special time gives this a lot of thought. Any person will be thinking about not just their own health but also the health of their baby.”
“Over the last year, we have gathered a lot of data from official pregnancy registers which confirm that COVID can have a serious impact on pregnant women, especially in the late stages of pregnancy, and especially if there are additional risk factors. There is a large safety database in non-pregnant people and although no specific trials are yet completed in pregnancy using the COVID-19 vaccines, we have safety data from thousands of women who have received the mRNA based ones.”
If I got Covid, and as a result something happened to my baby, I would never forgive myself. I have compared the risk that the vaccine poses to the risk that Covid poses and the choice is simple to me.
When making my decision, I really appreciated this explainer sheet from the CDC, that lays out the options without bias. Pregnant then Screwed was another invaluable resource.
I’d also encourage people to not judge others for their decision; I totally respect those waiting until after their baby is born, just as I hope they would see that my decision has come from collecting reliable information and acting out of love, and not fear or neglect.
For now, I’m looking forward to getting a call from my GP and starting my duty of protecting my little girl before she arrives here.