COVID-19 Vaccine

Effective Friday April 23, all pregnant folks are now eligible to receive the COVID-19 vaccine with the addition of pregnancy to the list of “highest risk” health conditions under Ontario’s Guidance for Prioritization of Phase 2 Populations for COVID-19 Vaccination.

The SOGC position statement supports the use of ALL AVAILABLE COVID-VACCINES approved in Canada in ANY TRIMESTER of pregnancy and during breastfeeding.

For those individuals residing in Thunder Bay and surrounding areas, please visit https://tbrhsc.net/vaccinations/ to book your vaccine appointment or call (807) 935-8100.

For individuals in the District communities, please contact your respective Family Health Teams, or visit https://www.tbdhu.com/districtvaccines for more information.

Vaccine Information & Research Articles

Factsheet on COVID-19 vaccine in pregnancy and breastfeeding from the Provincial Council for Maternal and Child Health

Society of Obstetricians and Gynaecologists of Canada: COVID-19 vaccination in pregnancy

Pandemic Pregnancy Guide on Instagram

This social media account is developed by physicians, obstetricians and residents at St. Michael’s Hospital to help pregnant people navigate their COVID concerns.

CNN News Article, “Covid-19 vaccine for 5- to 11-year-olds is safe and shows ‘robust’ antibody response, Pfizer says”

Better Outcomes Registry & Network (BORN) Ontario: COVID-19 Vaccination During Pregnancy in Ontario: Surveillance Report #2, Reporting Interval December 14, 2020 to June 30, 2021

Conclusions:

    • 28% (almost 40,000) received at least 1 COVID-19 vaccine during their pregnancy (between December 2020-June 2021).
    • Out of 13,000 pregnant people who received 2 doses of a COVID-19 vaccine during pregnant, 84% received 2 doses of the SAME vaccine and 63% received the 2nd dose within 4-8 weeks of dose 1.
    • The percentage of pregnant people receiving COVID-19 vaccines increased from <1% in December 2020 to over 45% in June 2021.
    • For those who have already given birth, the data from this report DO NOT suggest any pattern of increased risk of poor pregnancy or birth outcomes

Research Article: SARS-CoV-2 Antibodies in Breast Milk After Vaccination

Conclusions:

    • Antibodies in breast milk do not make it into the baby’s bloodstream, but rather coat the mouth, throat and gut and then eventually get digested.
    • The antibodies on the mucosal surface work by fighting off infections at the body’s entrance. This is different and less effective than being vaccinated in pregnancy, which can transfer antibodies into the baby’s bloodstream
    • Presence of antibodies against COVID-19 in breast milk was HIGHER in mothers who had been lactating for greater than 23 month.
    • Antibody transfer through breastmilk confers only some level of immunity compared to a child being fully vaccinated or vaccination during pregnancy and there are many unanswered questions regarding the immunity conferred. More research is needed.

Research Letter: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccination in Pregnancy

Conclusions: COVID-19 vaccination in pregnancy is associated with a very good antibody response and does NOT damage the placenta. This provides evidence against the internet myth that the spike protein on COVID-19 (also encoded for by the COVID-19 vaccine) shares genetic similarities to syncytin-1 (an important protein for placental development), thus can damage the placenta. These findings dispute the false claim that our antibodies attack the spike protein, perhaps they can also attack syncytin-1 and damage the placenta. (Shanes et. al, 2021)

Research Article: Association Between BNT162b2 Vaccination and Incidence of SARS-CoV-2 Infection in Pregnant Women

Conclusions: In this retrospective cohort study of pregnant women, BNT162b2 mRNA vaccination compared with no vaccination was associated with a significantly lower risk of SARS-CoV-2 infection (0.33% in the vaccinated vs 1.64% in unvaccinated group). (Goldshtein et. al, 2021)

Conclusions: Compared to the miscarriage rate across all pregnancies (12.5%-18.7%), receipt of the mRNA COVID-19 vaccine preconception or prior to 20 weeks’ gestation is NOT associated with increased risk of miscarriage. This adds to the growing body of evidence supporting the vaccine is safe & effective in pregnancy. (Zauche et. al, 2021)

Research Article: Efficient Maternal to Neonatal Transfer of Antibodies against SARS-CoV-2 and BNT162b2 mRNA COVID-19 vaccine

Conclusions: The mRNA vaccine DOES NOT cross the placenta. The protective antibodies against COVID-19 your body makes after receiving the vaccine DO cross the placenta. It takes about 15 days after the first vaccine dose for fetal protection levels to match the birth parent’s. (Beharier et. al, 2021)

Research Article COVID-19 mRNA vaccine is not detected in human milk

Conclusions: The mRNA vaccine is not detected in human breast milk samples collected 4-48 hours after vaccination. These results strengthen the recommendation of ABM and WHO that lactating individuals who receive the anti-COVID-19 mRNA-based vaccine should continue to breastfeed their infants uninterrupted. Only the protective antibodies transfer through human milk.

Conclusions: Of pregnant women eligible for COVID-19 vaccination, less than one third accepted COVID-19 vaccination during pregnancy and they experienced similar pregnancy outcomes. There was lower uptake among younger women, non-white ethnicity, and lower socioeconomic background. This study contributes to the body of evidence that having COVID-19 vaccination in pregnancy does not alter perinatal outcomes. Clear communication to improve awareness among pregnant women and healthcare professionals on vaccine safety is needed, alongside strategies to address vaccine hesitancy. This includes post-vaccination surveillance to gather further data on pregnancy outcomes, particularly after first trimester vaccination, as well as long-term infant follow-up. (Blakeway et. al, 2021)

Conclusions: Preliminary findings did not show obvious safety signals among pregnant persons who received mRNA Covid-19 vaccines. However, more longitudinal follow-up, including follow-up of large numbers of women vaccinated earlier in pregnancy, is necessary to inform maternal, pregnancy, and infant outcomes. (Shimabukuro et. al, 2021)

Planning your Vaccine – BC Centre for Disease Control & Ministry of Health

CDC Information about COVID-19 Vaccines for People who are Pregnant or Breastfeeding

Sunnybrook Hospital COVID Vaccine FAQ for Pregnant, Breastfeeding or Trying to Conceive 

Article “COVID vaccine in pregnancy triggers strong immune response in mom, babies”

Pause on AstraZeneca Vaccine Roll Out

As of May 11, 2021, Ontario has paused the rollout and administration of first doses of the AstraZeneca vaccine out of an abundance of caution due to an observed increase in the rare blood clotting condition, known as vaccine-induced immune thrombotic thrombocytopenia (VITT).

The decision to pause is also based on the increased and reliable supply of the Pfizer and Moderna vaccines and the downward trend in COVID-19 cases across Ontario. This allows for the province to pause administration of first doses of AstraZeneca to look at the data and information to be able to provide direction for second doses.

Read the full statement from the Ministry of Health here.

COVID-19 VACCINES AND BLOOD CLOTS FAQS – Thrombosis Canada

COVID Vaccine & False Link to Infertility

Health Canada will only approve vaccines if they are safe and effective, which includes impacts on fertility. There is no evidence that the COVID-19 vaccine decreases fertility or harms the placenta or fetus.

The mechanism of action of this mRNA vaccine and existing safety data provide reassurance regarding the safety of COVID-19 mRNA vaccines during pregnancy. The false theory that the COVID-19 vaccines cause infertility is based on the disproven idea that one of the spike proteins in COVID-19 and the Syncytin-1 protein (which help placenta development) are the same. They are not.

If you are trying to become pregnant now or want to get pregnant in the future, you may receive a COVID-19 vaccine when one is available to you.  You do not need to avoid pregnancy after receiving a COVID-19 vaccine. You do not need to do a routine pregnancy test before getting vaccinated.

False Claim COVID Vaccine Shedding

Individuals who have received a COVID-19 vaccine cannot shed or release any of the vaccine components. Your menstrual cycle cannot be affected by being near someone who received a COVID-19 vaccine. None of the vaccines authorized for use in the Canada contain a live virus so it is not possible to shed it.

Many things can affect menstrual cycles, including stress, changes in monthly schedule, problems with sleep, and changes in diet or exercise. Infections may also affect menstrual cycles.