Pregnant women should get the new CDC-approved Omicron-specific COVID-19 booster, according to the American College of Obstetricians and Gynecologists (ACOG).
In its newly updated guidance for doctors, ACOG recommends that “pregnant and recently pregnant people up to 6 weeks postpartum receive a bivalent mRNA COVID-19 vaccine booster dose following the completion of their last COVID-19 primary vaccine dose or monovalent booster.”
This advice follows that of the United Kingdom, which included pregnant women among the high-risk groups that should get the jab immediately when it approved a bivalent booster in early August. Americans got no such guidance — just a blanket CDC recommendation that adults over 18 get the shot, which was approved based on testing on mice, though preliminary human data is promising.
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Previously, pregnant women like me were a priority group for the vaccine: Our suppressed immune systems make us more susceptible to severe COVID-19, which is linked to higher rates of maternal hypertension, low birth weight, and even stillbirths. But I’d heard zilch about this booster and pregnancy. Many OBGYNs were awaiting ACOG’s determination — generally considered the gold standard in the field. And their patients were left wondering how to proceed.
I was one of those patients. Last week, I asked my OB about the shot. I am fully vaccinated and boosted, but I follow my doctor’s guidance on all things COVID-related.
My doctor sighed. She seemed frustrated and said she was still waiting for official guidance. “Everybody is asking me and I don’t have an answer,” she told me.
Since I’m a journalist, it’s my instinct — and my job — to get answers. That instinct flared hard in the face of a lack of crisp guidance from my OB, so I began to dig. I mined ACOG’s website and searched the CDC for specific guidance aimed at pregnant women. For days, I found nothing — except a bunch of people wondering the same thing on Twitter and Reddit. Questioners got every manner of reply, from those who’d already gotten boosted to OBYGNs offering evidence-based recommendations to detractors citing unfounded miscarriage myths. In other words, I found your typical online pregnancy information quagmire.
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Then, early in the morning on Tuesday, I noticed ACOG’s COVID-19 and pregnancy page had been updated. The organization now recommends the booster. Big news! But there was no press release, no media coverage. I reached out for confirmation: Yes, Christopher Zahn, ACOG’s chief of clinical practice, health equity, and quality, told me. After a deliberative multistep review process, ACOG now officially recommends an Omicron-specific booster for the pregnant.
Welcome news for those pregnant Americans who’ve been waiting and wondering for two weeks. And a scoop for me. But why did I have to track down this crucial health information myself, using my professional know-how?
It’s not the first time in the pandemic that women have had to seek out the data themselves on how vaccines affect their bodies.
No pregnant women were included in the COVID-19 vaccine trials, for the same reason they are systematically excluded from drug trials: It’s complicated and risky to experiment on pregnant women because scientists must worry about not only their health but also fetal development. But that exclusion fed confusion and pernicious rumors about vaccine safety during pregnancy, resulting in persistently lower rates of vaccination among the pregnant — despite their higher COVID-19 mortality rate.
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Today, the previously approved Moderna, Pfizer, and Novavax vaccines are proven safe for pregnancy and recommended by all reputable US medical institutions. We know this because of real-world data collected over the past two years by pregnant women who trusted the science behind the vaccines and used their own bodies to demonstrate why other people should, too.
Menstruation was another vaccine-testing oversight that compelled women to become science sleuths. Shortly after immunization began in the United States, in early 2021, some newly vaccinated women noticed that their period was unusual: really heavy with bad cramps, maybe, or really light, or a week late. They took their observations to Twitter, asking: Did the vaccine make your menstrual cycle weird, too? Yes, replied thousands upon thousands of women.
The public outcry about an undocumented vaccine side effect spurred two female researchers from the University of Illinois at Urbana-Champaign and Washington University School of Medicine in St. Louis to action. They conducted a survey asking 39,000 menstruating people about menstrual changes following vaccination. Their study, released in July 2022, found that half reported a delayed, heavier, or lighter period after getting the COVID-19 vaccine. The changes were temporary. Those respondents included trans men and postmenopausal women who‚ for hormonal reasons, hadn’t menstruated in years — until they got vaccinated.
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I’m grateful we have this information now. But a heads-up would have been nice back in March 2021 when I got jabbed — because my always-regular period was four days late and I thought I was pregnant.
I wasn’t then, but I am now. And with the guidance of ACOG and my doctor, I’ll feel certain that the new Omicron-specific vaccine will better protect me as life moves indoors for the winter. What I’m still scratching my head about is why the potentially life-saving information about the bivalent booster’s safety during pregnancy isn’t already headline news.
Catesby Holmes is a journalist based in Brooklyn. She was a 2021-22 Technology and Social Change Fellow at the Harvard Shorenstein Center.