Here’s What We Know: New COVID-19 Vaccine Guidance For Healthy Pregnant Adults and Children

The Centers for Disease Control and Prevention (CDC) recently issued new guidelines regarding who should receive the COVID-19 vaccine and who shouldn’t. Healthy children and pregnant women are no longer on the list of vaccine-eligible Americans. 

While the COVID-19 pandemic ended roughly two years ago, the disease is still very much with us. It’s one of several respiratory infections, including the flu, RSV (respiratory syncytial virus) and community-acquired pneumonia, that can lay us low, especially during the fall and winter months.  

COVID can still cause severe illness and even death. In the past few months alone, more than a million Americans have died as a result of a COVID-19 infection. 

Leading medical experts have pointed to potential problems with the new guidance—Weill Cornell Medicine’s Dr. Sallie Permar among them. Dr. Permar serves as Chair of the Department of Pediatrics, Nancy C. Paduano Professor in Pediatrics and Pediatrician-in-Chief at Weill Cornell Medicine. She subspecializes in the treatment and prevention of neonatal viral infections.  

Dr. Permar was recently quoted in New York magazine, Medscape and on NPR’s “All Things Considered,” expressing support for administering the COVID-19 vaccine to healthy children and pregnant individuals.  

The mRNA vaccines that protect against severe COVID-19 are extremely safe, she said, especially in the smaller doses used to immunize children. In fact, they’re “among the safest we know of,” she told one reporter.  

She also commented on the vaccine’s side effects. In general, she said, these include redness at the injection site, soreness and fever. These aren’t very different from the side effects associated with other widely used vaccines. 

Myocarditis—a very rare side effect of the COVID vaccine that affects adolescent boys and young men—hasn’t been reported in children aged 6 months to 5 years old, Dr. Permar said, strengthening the case for its safety when given to young children. 

Pregnancy and the immune system 

Dr. Permar had even more to say about the dangers of contracting COVID-19 during pregnancy. But first, here’s a little background. 

Being pregnant changes a woman’s immune system, with two main consequences. One of these is positive: The pregnant woman’s weaker immune response protects the fetus from rejection. But one is negative: Immune system changes make expectant mothers more susceptible to infections, including COVID-19. 

Pregnancy also makes a woman five times more likely to develop blood clots, Dr. Permar said, a risk that increases if she gets COVID. These clots can be dangerous for mother and baby alike. Clots in the placenta associated with certain COVID variants may lead to an increased risk of stillbirth. 

Moreover, a pregnant woman is more susceptible to infections than members of other groups, with the exception of those taking immunosuppressant medication and people over 65. She is also likelier to develop blood clots, especially if she gets COVID. Given these heightened risks, why would the Department of Health and Human Services remove pregnant women from the list of vaccine-eligible populations? 

So far, there are no answers to that question—but we’ll stay on top of the government’s new guidance and look out for any welcome changes to the list of Americans who are advised to get the shot. 

The government’s call for clinical trials 

The Department of Health and Human Services has also called for additional clinical trials of the COVID-19 vaccine—especially the mRNA vaccines that have saved countless lives during the pandemic and beyond. 

Our hope is that funding for these trials will be available, Dr.Permar said. 

Decisions, decisions 

In the meantime, if parents wish to have their child vaccinated, or if an expectant mother wants to receive the shot, they may need to pay for it out of pocket. Check with your insurance plan to see whether the COVID-19 vaccine is still covered.