For many parents-to-be, the noise around vaccine safety is loud and confusing

[5 min read]

In this article: 

• There are a lot of opinions about vaccine safety swirling around out there; many of them aren't from experts or based on science. 
• For pregnant people, having a clear understanding of what vaccines do and how they protect parent and baby is critical. Some illnesses can be extremely harmful to a developing fetus. 
• A Providence Swedish advanced practice midwife offers some vaccine guidance for parents, and shares her approach to working with patients so they have a full understanding of vaccine recommendations and their own healthcare options.   

A lot of big decisions come with pregnancy. Among them is how to protect your health and the health of your baby. Vaccines are among the most important tools for ensuring a healthy pregnancy; they are also often the most misunderstood. Many experts and professional organizations, including the American College of Obstetricians & Gynecologists (ACOG), strongly recommend staying up to date with vaccinations during pregnancy. Yet, many new parents are understandably confused by the mixed messages about vaccines from government officials, social media influencers and vocal vaccine skeptics. 

Shaee Davis, CNM, ARNP, DNP, an advanced practice midwife at Swedish’s First Hill campus, says that it’s important to meet patients where they are in the vaccine, or any, conversation.  

“With hesitation, typically with vaccine recommendations in pregnancy — or in just for caring for people generally — my approach is really asking questions. It's a lot of anticipatory guidance, education and teaching in pregnancy,” says Davis, who is also a lecturer and faculty advisor at the University of Washington. “From that initial visit we go through a review. There's a lot of education that's ongoing on so we really understand what people are thinking. We're not just doing blood work; we discuss what the actual blood work is for. We don’t just say, ‘Okay, this is your vaccine’.”

Why are pregnant women at a higher risk for serious illness?

Unvaccinated pregnant women are more likely to become seriously ill from infections such as influenza, COVID‑19, whooping cough (pertussis) and respiratory syncytial virus (RSV). Studies consistently show that unvaccinated pregnant women face higher risks of hospitalization, pneumonia and pregnancy complications. COVID‑19, for example, has been linked to increased risks of intensive care admission, preterm birth and stillbirth.

“If you get the flu when you’re not pregnant, you may feel sick and sniffly, even with a low-grade fever,” Davis advises. “But pregnancy changes the way your body responds to illness, so that your body doesn’t fight the fetus growing inside you. When pregnant people get sick, they tend to get sicker and require additional medications or even admission to the hospital and sometimes the ICU.”

Health experts recommend several vaccines during pregnancy because they are safe, effective, and protective for both mother and baby. Davis is committed to providing information to empower parents and help them decide what’s right for them.

“A lot of times, certain populations and demographics we see don’t plan their family, whether it’s culturally or because of racial disparities or economic status — there are many things that hinder health access,” she says. “So, the most important thing is to make sure that everything is caught up. It’s about continuity of care.”  

The most important vaccines during pregnancy

“I’m really letting parents know that this is shared decision-making,” she continues. “I want them to know that they are in control. It’s their choice. It’s their power. There are times when a parent may ask about the research on a certain vaccine and I tell them that nothing is 100%, so we look at the risk versus the benefit.” 

Vaccines strongly recommended during include:   

·         Flu – Recommended during any trimester. It reduces the risk of severe illness in pregnancy and helps protect newborns during flu season.

·         Tdap (tetanus, diphtheria, and pertussis) – Recommended during every pregnancy, ideally between 27 and 36 weeks. This vaccine protects babies from whooping cough, which can be life‑threatening in the first months of life.

·         COVID‑19 – Recommended at any point during pregnancy. Vaccination lowers the risk of severe maternal illness and pregnancy complications.

·         RSV – Given late in pregnancy to protect infants from respiratory syncytial virus, a leading cause of infant hospitalization.

Additionally, minimizing the risk of exposure to infections is beneficial to maintaining health and wellness. This includes avoiding travel to areas where certain infections are prevalent; maintaining good hygiene practices such and handwashing, cooking foods adequately and consuming clean water; and assuring household members are up to date on their vaccines.

Vaccines protect two lives

When a pregnant woman is unvaccinated, both she and her baby lose important protections. Because babies cannot receive many vaccines right after birth, they benefit from "passive immunity" which occurs when antibodies are passed from the pregnant person to the fetus.

In fact, babies whose mothers received a COVID‑19 vaccination show higher levels of protective antibodies for several months after birth, when compared with babies whose mothers did not receive the vaccine during pregnancy. Similarly, maternal RSV vaccination has been shown to reduce infant hospitalizations by more than 80%.

“My goal is to provide education prior to and throughout pregnancy — and postpartum — through what we call motivational interviewing,” says Davis. “We ask questions first, as opposed to telling the patient what to do. I recommend certain things, but I allow the patient to make their own decision and often they say ‘Oh, ok, I didn’t know that because I didn’t have a solid understanding and I haven’t seen the evidence.’ [Vaccine skepticism] is often based on lack of information.”

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About the Author

There's a reason why more babies are born at Swedish every year than any other health system in western Washington - bringing babies into this world is our mission. The Swedish Pregnancy & Childbirth Team is committed to giving you relevant and actionable insights on how to care for yourself and your child as you navigate the trimesters of your pregnancy.

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