The CDC Can’t Recommend COVID Shots for Pregnant Women, And Why Does It Matter? A Comment on O’Leary

In the same day that X was published, Secretary Kennedy sent a directive to CDC staffers stating that they would no longer accept the CDC’s recommendations to use COVID shots in children and pregnant women. The directive, viewed by NPR, ordered the CDC to remove these recommendations from their vaccine schedules.

The Trump administration’s decision to remove the COVID vaccine from the list of shots it recommends for pregnant women means insurance companies may no longer cover it–so it may cost hundreds of dollars out of pocket.

O’Leary says the decision will make it much harder for parents to get their kids vaccinations and pregnant people to get the shots. It’s difficult to have a discussion of clinical decisions when you’re in a ten-minute office visit, and more doctors may choose to keep the vaccines on hand.

Public health experts are alarmed by how the changes were made. “This is a very transparent process where people are able to see it,” said Sean O’Leary, a professor of pediatrics at the University of Colorado School of Medicine who represents the American Academy of Pediatrics on the vaccine advisory committee. “The data are shared publicly, the discussion happens publicly and then they come to a decision on how to recommend vaccines.”

CDC Recommendations for Vaccining Pregnant Women with the COVID Vaccine, Reply to a Comment on “Comments on ‘Hot Topics in Cardiology”

Even though children don’t get seriously ill from COVID, some do. According to the American Academy of Obstetricians and Gynecologists, pregnant women can still suffer serious consequences from the virus.

“I couldn’t be more pleased to announce that as of today the COVID vaccine for healthy children and healthy pregnant women has been removed from the CDC recommended immunization schedule,” Kennedy said in the video, “We’re now one step closer to realizing President Trump’s promise to make America healthy again.”

The process that reached the recommendation raises serious concerns about the reliability of the nation’s immunizations infrastructure and commitment by federal leaders to make sure families have access to immunizations, regardless of their ability to pay.

Being pregnant still puts you in a group that should get boosters according to research from the CDC and other researchers. The science is on the outside of the shots.

The CDC recommends that healthy children and pregnant women get the COVID vaccine, but Kennedy said on Tuesday it had been removed from the schedule.

Dr. Neil Silverman, a professor of clinical obstetrics and gynecology, directs the Infectious Diseases in Pregnancy Program at the David Geffen School of Medicine at UCLA. He said he still sees worse outcomes in patients who are pregnant. The risk of severe COVID fluctuated as new variants arose and vaccinations became available, Silverman said, but the threat is still meaningful.

A request for comment regarding the scientific literature that supports COVID vaccination for pregnant women sent to HHS’s Public Affairs office elicited an unsigned email unrelated to the question. The office did not respond when asked for an on-the-record comment.

“There is natural immune suppression so that the mother’s body doesn’t attack the developing fetus,” Rasmussen said. The immune system of the mother is not functioning at full capacity.

In addition to changing how the immune system works, being pregnant also makes women five times more likely to have blood clots. If they contract COVID, the risk of that is increased.

The virus that causes COVID can affect the vascular endothelium – specialized cells that line blood vessels and help with blood flow, Rasmussen said. In a healthy person, the endothelium helps keep the system running by producing chemicals that prevent blood clot. Research shows that in a person with COVID, the balance is thrown off and the production of those molecule is disrupted, which leads to blood clot or other blood disorders.

“If anything is interrupting those functions – inflammation or clotting or differences in how the blood is flowing – that’s really going to affect how the placenta is working and being able to allow the fetus to grow and develop appropriately,” she said.

It makes sense that we see the effects of COVID in the placenta, Silverman said. The placenta is a very particular collection of blood vessels and it is a vulnerable point for the virus.

Prahl said the connection between stillbirth and COVID may be changing given the immunity many people have developed from vaccination or prior infection. It’s an area where she would like to see more research done.

Prahl co-authored a small, early study that found no adverse outcomes and showed antibody protection persisted for both the mother and the baby after birth. “What we learned very quickly is that pregnant individuals want answers and many of them want to be involved in research,” she said. Later studies, including one published in the journal Nature Medicine showing that getting a booster in pregnancy cut newborn hospitalizations in the first four months of life, backed up her team’s early findings.

Vaccine Control and Prevention: Why the U.S. government is too slow in tracking COVID-19, or why we should not have forgotten the vaccine

She blames the delay on the scaling back of federal efforts to track COVID. “A lot of the surveillance of these data were pulled back,” she said. The Trump administration is further cutting money used to track COVID.

According to recent data from the Centers for Disease Control and Prevention, nearly 90% of babies who had to be hospitalized with COVID-19 had mothers who didn’t get the vaccine while they were pregnant. Medical data from 12 states was collected for the study. Severe outcomes occurred “frequently” according to the report, about 1,470 infants that were sick enough to be hospitalized due to COVID.

Excluding newborns hospitalized at birth, about 1 in 5 infants hospitalized with COVID required intensive care, and nearly one in 20 required a ventilator.

“I don’t want to be that doctor who just says, ‘Well, it’s really important. Everyone has their own priorities, even if you have to pay for it out of pocket, and that’s why you have to vaccination yourself and your kids no matter what. “I can’t tell a family that the vaccine is more important than feeding their kids.”

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