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With growing numbers of critically ill pregnant COVID-19 patients, doctors urge expectant parents to get vaccine

A pregnant and intubated COVID-19 patient is pictured in the surgical Intensive care unit at St. Luke’s Boise Medical Center in Boise on Tuesday.  (Kyle Green)

Ashlee George is on her second pandemic pregnancy, but this time she’s feeling safer.

George was seven months pregnant when everything shut down in 2020, and she recalled how scary it was to give birth at the time.

She had to be tested for COVID-19 with a long, deep nasal swab before giving birth in May 2020. Only her husband was allowed in the room, and he had to wear a mask the whole time. Despite her fears, she gave birth to her second child.

“She’s the epitome of a COVID baby; she cries around people,” George said, noting that her now-15-month-old doesn’t get out much around groups of people.

Ashlee George is pictured on Mother's Day 2020, her baby's due date.   (Courtesy photo/Andrew George)
Ashlee George is pictured on Mother’s Day 2020, her baby’s due date.  (Courtesy photo/Andrew George)

Protecting her newborn became the ultimate goal in 2020, as George hunkered down with her family.

When vaccines were available to the general public, George went to get her first dose, not knowing at the time that she was pregnant with her third child.

In between doses, she found out she was pregnant and consulted her doctor.

“We decided to go for it, and I did and was sick for 36 hours,” George said.

She has had reactions to injectable medications in the past, and her response to the second dose has been documented in others.

That was a scary time for George, however, as she felt the sickest she’d ever been in her life. And while that experience was difficult, she does not regret getting vaccinated, especially as case counts are rising again locally.

Nationally, George is in the minority. Just one in four pregnant women in the United States has been vaccinated, and local physicians are proactively encouraging their pregnant patients to get vaccinated.

The Department of Health does not track the vaccination rate of pregnant women in Washington, but the department is working to change that.

Pregnant women are more at risk for developing severe COVID-19, putting them at higher risk for hospitalization, needing intensive care and potentially going on a ventilator.

Underlying health conditions and older age also play a role in how severe COVID illnesses are for pregnant women.. Among the nearly 8,000 pregnant women studied with COVID-19, those who were older than 25 , worked in health care, had underlying conditions like lung disease, obesity or hypertension, had a higher risk of getting more severely ill.

Nationwide, 112,806 pregnant women have tested positive for the virus, and 135 deaths have been recorded among pregnant women who had COVID-19. No similar data exists at the state level, according to the Washington Department of Health.

With the delta surge, physicians are seeing this play out in ICUs.

Dr. Tanya Sorensen, maternal and fetal medicine physician at Swedish Health in Seattle, said for the first time during the pandemic she’s seeing a significant number of pregnant women get severely sick with the virus. Sorensen said some pregnant women are having to deliver babies prematurely in order to breathe adequately .

“Pregnant women need to get vaccinated – we need you to do it now,” Sorensen told reporters Aug. 30. “It’s heartbreaking to spend my day in the ICU taking care of women who are pregnant and (they) may not make it and maybe leave their babies motherless.”

Previously, there was no blanket recommendation that pregnant people get vaccinated. In fact, pregnant women were not included in the large clinical vaccine trials, so when vaccines were first made available, they were told to consult their doctor.

Lately, the Centers for Disease Control and Prevention as well as other medical organizations have changed their tune, with growing evidence that vaccines are safe and effective for pregnant people.

Now, there is some data tracking in place from the CDC and another study looking at more than 5,000 pregnant women who were vaccinated. The outcome data, however, is not as robust since not all these women have given birth yet. So far, all signs in the data suggest there are no untoward effects to the mother or fetus, said Dr. Mark Schemmel, a Providence Sacred Heart Medical Center obstetrics and gynecology specialist in Spokane.

“The biological plausibility is: Is there any reason to believe this vaccine is harmful?” Schemmel said. “No, there’s no reason it should be; everything argues it can’t be.”

While the hard data is lagging behind the anecdotal data, Schemmel said Providence hospitals in larger regions, like Seattle, Portland and Los Angeles, are seeing more pregnant women in hospitals with severe COVID-19. And while Spokane’s numbers are not mirroring those of larger cities, Schemmel expects that trend could soon play out as the delta surge continues to drive up case counts in the Inland Northwest.

Schemmel is recommending vaccines to his pregnant patients, and would even recommend them to his own daughters, he said.

“You do not, by bad luck and happenstance, want to end up in the ICU with people trying to decide whether they can prone you or ventilate you or what’s the right time to deliver your baby early,” Schemmel said. “You don’t want to be in that situation.”

Proning – flipping patients onto their stomachs to improve oxygen flow – is challenging due to the amount of staff members it takes to safely turn a patient over. For some pregnant women, the maneuver might be out of the question, depending on how far along they are.

Schemmel has had conversations with many patients who were willing to get vaccinated quickly, those wanting to wait for more data and those who refuse vaccines entirely. He said he has worked with patients to dispel some myths, including that the vaccine will cause infertility.

“There’s no biological plausibility or science to support that concern,” he said.

Hospitalizations are projected to increase for at least two more weeks in Washington, if not longer. State health officials expect that the delta surge will last longer in communities with lower vaccine rates. Spokane County, along with many rural Eastern Washington counties have lower vaccination rates than many counties in Western Washington.

There were 214 people on Friday who were hospitalized with the virus in Spokane County hospitals, and many procedures and surgeries have been canceled to make space for COVID patients.

“Our problem is that there may be a whole bunch of women in this situation given the current infection rates – that’s in part what’s creating this present sense of urgency, and that would really be sad for each of those women because for the majority of them it’s probably preventable through vaccination,” Schemmel said.

George’s baby is due New Year’s Day 2022. She has actually been able to see her doctor in-person in recent months (masked, of course), and this pregnancy feels less frightening, she said. Even still, as cases surge in the community, she’s grateful for her vaccine.

Ashlee George is pictured with her oldest daughter, Ella, as Ella meets baby Avery for the first time because she wasn't allowed inside the hospital where her sister was born.   (Courtesy photo/Andrew George )
Ashlee George is pictured with her oldest daughter, Ella, as Ella meets baby Avery for the first time because she wasn’t allowed inside the hospital where her sister was born.  (Courtesy photo/Andrew George )

“My personal belief is trust your doctor, and trust your gut,” George said. “I want to do what’s best for myself and everybody around me and that’s the vaccine. And I think we got to watch out for each other in order for us to get out of this.”

Arielle Dreher's reporting for The Spokesman-Review is primarily funded by the Smith-Barbieri Progressive Fund, with additional support from Report for America and members of the Spokane community. These stories can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.