Dr. Fox and guest Dr. Shari Gelber discuss vaccines in pregnancy. Covid-19 brought vaccines to the forefront of conversations, but Dr. Fox and Dr. Gelber agree that vaccines of all sorts have long been studied and proven to be safe during pregnancy. They discuss considerations including clinical trials, different forms of vaccine technology, and more.
“Vaccines in Pregnancy: It’s Not Just COVID!” – with Dr. Shari Gelber
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Dr. Fox: Welcome to today’s episode of “Healthful Woman,” a podcast designed to explore topics in women’s health at all stages of life. I’m your host, Dr. Nathan Fox, an OB-GYN and maternal-fetal medicine specialist practicing in New York City. At “Healthful Woman,” I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness. All right, Dr. Gelber. Shari, welcome back to the podcast. How are you doing?
Dr. Gelber: I’m great. Thanks for having me.
Dr. Fox: So when I gave you some potential topics to talk about, you pounced all over vaccines and pregnancy. It was of great excitement to you to talk about this topic. So I’m curious why.
Dr. Gelber: Because vaccines are easy. There’s lots of safety data. They save lives, they save mothers’ lives, they save babies’ lives, they save our neighbors’ lives, and we have lots of safety data and we don’t really have any concerns about any of the recommended vaccines in pregnancy.
Dr. Fox: Yeah. I think that vaccines have gotten a lot of attention recently, obviously, because of COVID and the COVID vaccine. Unfortunately, with the COVID vaccine, it’s become quite contentious, which is really odd, I would say, because prior to this, there was some level of it with other vaccines but it was really, really, I don’t know, beneath the surface. It was kind of a small amount and it was like a very, you know, small minority people who had a hard time with vaccines and were opposed to it. And okay, like whatever, you’re not getting 100% of people on board. But I think that, unfortunately, because of 100 reasons, the COVID vaccine is made the conversation about vaccines much more difficult. But on the other hand, I think it’s also raised a lot of people’s awareness about vaccines in general, which I would say is good news.
Dr. Gelber: Yes. I mean, I think with COVID at the beginning, people were saying, “I don’t know anything about this. We don’t have any data in pregnant women and how can we know it’s safe?” And that was all true. We didn’t have any data. Pregnant women were excluded from the original trials, which, you know, you can argue both ways. Like, if it hadn’t worked, then you would’ve been putting women and their fetuses at risk of something that wasn’t helpful. So it makes sense to exclude them, but then when it was rolled out, we couldn’t give patients the reassurance that it was safe. Interestingly, because I think they really wanted protection, some of the first people to jump at the chance to get COVID vaccines were pregnant healthcare workers, and a lot of the safety data came from them at the beginning. But now these vaccines have been around for a year and we really do have data, like we have information on people who are vaccinated in the first trimester, the second trimester, the third trimester, and pregnancy outcomes.
Dr. Fox: Yeah. It’s true that at the very beginning…Again, we were discussing this at the time when they were doing this, there’s always this debate with something that’s new, whether it’s a medication, a vaccine, a treatment, do you enroll pregnant women, do you enroll children, or do you not? And the argument in favor of doing it is, well, we need answers in this group. Like, you know, we need to know about pregnant women and we need to know about children and the argument against it is, well, if there’s risk, now we’re not just exposing these adult volunteers who understand there might be risk when they enroll for the study. We’re also now, you know, putting risk potentially on their, you know, fetuses, their children, or if you’re enrolling children on these, you know, they’re not really consenting for themselves, it’s their parents. It becomes, you know, ethically complex and it becomes logistically complex and just a lot of arguments.
So sort of the cleaner thing when you’re running this study is just exclude all those people, but then you don’t get the answers you want and that’s why there’s this argument back and forth. But like what you said, it was so fascinating, they didn’t include pregnant women but the healthcare workers were like, “I want this because, you know, I’m exposed all the time to COVID.” And sort of conceptually since the vaccine wasn’t a live vaccine, and we’ll talk about what that means, the thought was, “Well, we don’t expect it to be harmful, right? Just because from prior vaccines, it should behave similarly to that.” And they’re like, “All right. We’re willing to take that risk because I don’t wanna get COVID when I’m pregnant either.”
Dr. Gelber: Right. And at the beginning, you know, for every individual, before you do anything, you’re sort of making a mental calculus, what’s the risk of this thing? What’s the benefit of this thing? You know, and how do I weigh those things? So right at the beginning, the benefit was it was gonna protect you from COVID. The risk was we didn’t know if there could be effects. Like, based on the science, we didn’t think there would be fetal effects, but we didn’t know. And so it became a matter of, well, how likely am I to get exposed to COVID? And for healthcare workers, they were out there every day. For people who worked in supermarkets, you know, for all the essential employees, we felt like the benefit of the vaccine outweighed the risk because the risk of the disease was so bad. For people who were staying at home right at the beginning, you know, they weren’t getting exposed to anything, they might not have needed vaccine, but now almost everyone is out and about. Things have really opened up because of the vaccine, but it makes it much harder for people to remain unvaccinated and stay safe from COVID.
Dr. Fox: Yeah. I remember when this was all first starting with the vaccines and I was having conversations, I would say the majority people, at least in my life personally and also professionally, were sort of in favor of getting vaccinated and they were looking for a reason to get vaccinated. You know, “Is it safe? Is it safe? I really wanna do it. I just wanna make sure it’s safe.” And then there was a subset of people who were really just, “I want nothing to do with this vaccine either ever or at least let’s wait a year or two or let’s wait, whatever.” And for them, I was like, “Well, you really have two choices. Are you comfortable, like, staying hunkered down in your basement with a mask on for the next six months to a year? And if so, then yeah, like you probably don’t need a vaccine because you’re not gonna get exposed to COVID.” And that’s what we found at the beginning, the people who were really, you know, not around other people didn’t get the virus.
However, if you are gonna be out and about or let’s say your work is making you come back or you, you know, have family members you have to see or whatever it is, it’s really unlikely you’re gonna be able to avoid getting this virus. And so then you have to sort of weigh those against each other. And like you said, nowadays, there’s so few people who are still able or willing to completely isolate from everybody else, and so they’re weighing this very minuscule risk of a vaccine versus, “Yeah, I’m gonna get COVID.”
Dr. Gelber: Yes. And, you know, it’s hard in pregnancy because pregnant women oftentimes don’t wanna put anything in their body like even if we know it’s safe. Like, you know, I’ve argued with patients about Tylenol. Like, they have a fever because they have the flu, I’m like, “Take some Tylenol.” “I don’t wanna take medication.” So if someone’s not gonna take Tylenol, it makes sense that they don’t wanna take a vaccine, but this idea that you have to be hypervigilant in pregnancy and that you shouldn’t put anything into your body may be not the most helpful thing in the setting of a pandemic.
Dr. Fox: Yeah. So I wanna take a step back since, again, COVID brought this all to the forefront, but we’ve been talking about vaccines in pregnancy for many years well before COVID, not regarding COVID specifically. And I wanted to talk about vaccination in general, you know, how they work, what’s the difference between a live virus and an inactivated virus and then sort of the principles in pregnancy and then go through each of the individual vaccines that we do and don’t recommend in pregnancy just sort of as an overview. We will put COVID in that conversation, but this is meant to be more broader discussion. So how do you explain to people who maybe just don’t understand vaccines or never learned about them? How do they work?
Dr. Gelber: So vaccines work to some extent the same way that disease works to prevent you from getting the same things over and over again. So back in the day when people got chickenpox or people got measles, typically they would only get it once. Like, you got it and then you wouldn’t get it again in your life because your body would make antibodies. And then if you got exposed to it, they would sort of…these cells would have memory that they had seen that and then when they got exposed to the virus again, your immune system would pump out these antibodies and kill the virus. Vaccines work by exposing the body to things to make it think there’s disease. So in a live vaccine, it takes whatever the virus is but inactivates it. So it looks like the disease virus, like measles, but it can’t replicate. It can’t make people sick, but it confuses the immune system so it can make antibodies. You can have recombinant viruses like hepatitis B where we’ve just made some protein that looks like hepatitis B and the body makes antibodies so that. It gets exposed to it. Your immune system says, “There’s a foreign thing. I’m gonna make antibodies to get rid of it.” And then it retains what we call immune memory.
Dr. Fox: And then the COVID vaccine was a little bit new because it wasn’t the virus that was going in. It was this RNA that was getting our own bodies to create the protein, one of the proteins, and then our body would create antibodies against it. It was more similar to this recombinant vaccine where it’s just a protein but the interesting part was instead of producing the recombinant, you know, protein or vaccine in a lab, it was produced in our own bodies. We sort of, you know, outsourced the production of this vaccine to our own bodies, which is really an interesting way and a very efficient way to do it actually, which is part of the reason the vaccine seemed to be useful, seemed to really work.
Dr. Gelber: Yeah. It’s an amazing way to do things. And I think a lot of people felt that, you know, because this was new technology, they were more frightened about it, but a lot of people have been working on mRNA vaccines for a long time and working mRNA for other things. And one of the really nice things about mRNA is that it degrades, it falls apart. So you put that virus in but you’re never gonna find it like weeks, or months, or years later because your body needs to have ways of getting rid of mRNA because your body’s making mRNA all the time so that it makes proteins for all the things your cells need to do to function. And if it couldn’t get rid of the old mRNA, you would always be making…anytime you made a protein, you would keep making it. So the body is very efficient at breaking down mRNA. So like I think people worry we’re gonna inject this thing and it’s gonna be there forever, but you’re not gonna be able to find any vaccine particles in your body after a short period of time.
Dr. Fox: Right. And when you said before that we put the virus in the body, you meant the mRNA from the virus, meaning no one got the virus injected.
Dr. Gelber: Yes. Correct.
Dr. Fox: Yeah. It’s just a little piece of mRNA, meaning there was no virus that was going into anybody for this vaccine.
Dr. Gelber: Nobody is getting virus injected.
Dr. Fox: The way we always looked at vaccines in pregnancy was basically we divided them into two groups. There was the kind that you mentioned before, which was this live attenuated virus, which is basically, it is virus. It’s alive, so to speak, but it’s changed so that it wouldn’t make someone sick. Like the measles is one of those. So we inject the measles vaccine. It is something that’s live, but it’s not gonna make them sick with the measles versus the other kind, which was, you can either think of it as not the virus at all, whether it’s just a protein from the virus, sort of like we said with the hepatitis B, sometimes something called a toxoid which is something that the virus produces, but basically that other kind where there’s nothing alive going in. And in pregnancy, we generally would only give the second kind versus the first kind. I mean, we would not give the live attenuated viruses. So that would be like measles, rubella, chickenpox, or varicella. And why is it that we wouldn’t give the live ones in pregnancy?
Dr. Gelber: So it’s really about theoretical risk. Those vaccines are live. They are supposed to be designed so they can’t cause disease, but there’s always concern like what if theoretically they got to the fetus and caused the problems that those diseases cause? So rubella, German measles, causes a very specific syndrome, which is very, very bad for a fetus and can cause stillbirth, but also can cause children to be born with multiple birth defects. So when you’re putting something in and you’re like, “Well, it’s not gonna make someone really sick, but maybe it’ll make a little something happen,” there’s this theoretic concern that if it gets to the fetus at just the right time, maybe there’ll be a little bit of congenital rubella syndrome. So, you know, that’s the concern.
Practically, there has never been a case of congenital infection from a vaccine and people have inadvertently been vaccinated in the first trimester of pregnancy maybe before they knew they were pregnant, and we don’t recommend that people terminate pregnancies in that situation. There are vaccine registries for when that happens and it’s actually pretty safe, but just because of the theoretic risk, we don’t recommend live vaccines in pregnancy.
Dr. Fox: Right. So I mean, we don’t do it because the thought is it’s not a situation where you sort of need to do it. And so we avoid it because of the, like you said, theoretical, very minuscule risk. But again, it’s never actually been shown to be a problem. And there’s so many cases of people who have been vaccinated with these when they’re pregnant that, in fact, you could make the opposite conclusion. There’s very good data that it is safe, but since, like, it’s not common that you would need to do it, we don’t give those vaccines in pregnancy. But again, it’s really important to realize that they’re not known to be problematic. In fact, all the data shows they’re safe. We just do it to be like, as we’ve been saying in the past couple of years, abundance of caution. We’re just doing abundance of caution here with those.
Dr. Gelber: Before I said risk and benefits because your risk of getting exposed to rubella in this country is very low or practically zero. There’s really not a benefit to target pregnancy as a time to get vaccinated.
Dr. Fox: Right. Exactly. The other vaccines, which again, there isn’t live virus going in, the safety is both assumed, but then there’s also data, you know, sort of empiric data supporting it. And what would be the principles? Like, what would be the reasons you would specifically vaccinate someone in pregnancy? Like, why would someone be recommended you should get vaccine A, or B, or C while you’re pregnant specifically as opposed to before or after?
Dr. Gelber: So we specifically recommend influenza vaccine in pregnancy in any trimester. Like, whenever the vaccine comes out, we recommend vaccinating pregnant women. There’s been a lot of safety data. We don’t know of harm from the influenza vaccine and there’s tremendous benefit. It’s a little bit like coronavirus. Pregnant women are more likely to be sick from influenza than their age-matched peers who aren’t pregnant. They’re more likely to end up in an intensive care unit. They’re more likely to need to be intubated and they’re more likely to die. Like, pregnant women sometimes die of influenza.
So we recommend influenza vaccine to protect the woman herself, but we also recommend it to protect the baby because when we vaccinate someone, they make an immune response and those antibodies cross the placenta, they get to the fetus and when the baby is born, the baby gets passive immunization. The baby still has the maternal antibodies for the first few months of life and those can protect the baby if the baby is exposed. And there have been pretty significant studies done showing that women who get vaccinated against influenza in pregnancy, their children are less likely to be hospitalized for respiratory illnesses in the first six months of life.
Dr. Fox: Yeah. And I think that that’s a real important point that when we recommend vaccination in pregnancy, it’s either for both or one of these two reasons. One is the mother’s health herself and the other one is the baby’s health. And so influenza or flu happens to be for both of them. And I think with, you know, COVID, a lot of people got very interested in the idea of getting vaccinated to protect their babies. And it’s true that women who are vaccinated for COVID or women who get COVID when they’re pregnant, their babies are born with some antibodies to COVID. And so I think the principle’s true, but the difference is COVID does not seem to be so dangerous for newborns whereas flu can be dangerous for newborns. Like, you do not want your newborn getting the flu. And so if you look at influenza vaccine, on the baby’s side, it’s much more “valuable” than potentially the COVID vaccine for the baby. So the COVID vaccine is mostly recommended for the mother’s health, not so much for the baby’s health just because it doesn’t seem to make a huge difference for the baby.
Dr. Gelber: Right. I mean, there have been a handful of cases of newborns, you know, getting hospitalized with COVID, you know, getting symptoms, getting sick, but that is more rare. And some of it is probably that nobody’s really taking their babies out anymore and everyone is wearing masks. And so fewer kids are getting coronavirus than other viral illnesses. But also, there seems to be a difference in the way children respond to coronavirus than adults.
Dr. Fox: Right. So we spoke a little bit specifically about the influenza vaccine, and there are two types of influenza vaccine. And so we’re talking about the one that’s injected like the one people think about as a vaccine, the one that’s put in your arm or whatever it is because that’s the one that’s not live. But there is a form of the vaccine that we don’t give to pregnant women that is the live one, and that’s the nasal spray, correct?
Dr. Gelber: Correct. So we give inactivated influenza vaccine. The nasal spray, the idea is it works, in theory, the same way that influenza works. Like, it goes up your nose and then you’re making this mucosal immune response. But because that does depend on virus reproducing, replicating, we don’t use that in pregnancy. It’s also unpleasant. Like, you think you don’t like needles, that flu [inaudible 00:20:16]. It’s like at the beginning when you were doing the COVID test, sticking that thing into your brain.
Dr. Fox: Yeah. And the other you mentioned very specifically is that it could be given in any trimester, meaning it’s well-known that the influenza vaccine does not cause birth defects. That would be the only reason to avoid something in the first trimester as opposed to the second or third that it would cause either birth defects, because that’s when the baby’s being formed, or a miscarriage, and it does not cause either. So like you said, it’s not good to get the flu no matter what trimester you’re in. And so if flu season’s around and it’s available, it’s recommended no matter where you are in pregnancy, definitely benefits the mother and it benefits the baby as well. So that’s influenza vaccine and that’s recommended. The next one that I think is pretty much universally recommended in pregnancy is the Tdap vaccine. So what’s the Tdap vaccine.
So the Tdap vaccine protects you against tetanus, diphtheria, and the reason we’re recommending it in pregnancy is really pertussis. So pertussis is whooping cough. If you were to get pertussis, you would be very unhappy. Pertussis makes people cough, and cough, and cough. It makes people miserable. But this is a vaccine we’re not giving for the mother. Like, we don’t want anyone to cough, and cough, and cough, but we’re really giving it for the baby. When you get pertussis itself, you cough, you’re unhappy, you can’t sleep. It lasts forever. It can last for weeks and you’re unhappy. But if a newborn gets pertussis…It causes inflammation in the airways and that’s why people cough. But a newborn, their airways are so small, they can actually die of whooping cough or they could have to get hospitalized from whooping cough. And so the recommendation to vaccinate pregnant women was really to prevent morbidity of pertussis in the first few months of life. Babies get their first pertussis vaccine at 2 months and until then, they are susceptible. And so the idea of vaccinating pregnant women in the third trimester is really to provide passive immunity to the baby.
Dr. Fox: Right. And I think there’s a lot of interesting points there in that Tdap, T-D-A-P…it’s an acronym. T is tetanus, D is diphtheria, A is and, and P is pertussis or whooping cough. The reason we give Tdap as opposed to P is they’re just made together, right? They’re just linked. I don’t even know if you can get pertussis vaccine alone. Can you? I don’t know of it.
Dr. Gelber: That’s not a thing. And the truth is like, you know, many of us, you know, pediatricians are very good at vaccinating people. Adult doctors are traditionally less good at vaccinating people. So you’re supposed to get a tetanus vaccine every 10 years and that’s the vaccine that protects you if you step on the rusty nail. I think your mother, you know, always told you to wear shoes so nothing bad would happen. You get the tetanus vaccine to protect you from organisms that live in the dirt. And you’re supposed to get that every 10 years. Most of us stop getting vaccinated when we stop seeing a pediatrician. And so, you know, for many women, getting that tetanus booster is just updating their vaccines.
Dr. Fox: Right. In terms of that, two interesting points. Number one is, yes, a lot of people, especially in their first pregnancy, when they get that Tdap vaccine, they were due for it anyway, so it’s perfectly fine. And also let’s say their partner, they’re like, “Well, should I get the Tdap vaccine?” I’ll say, “Well, you’re not gonna be pregnant. So you’re not gonna give any passive immune to the baby. But if you’re due for one, you should get one.” But what happens is if they have a second kid, so it’s a year-and-a-half, two years, three years later, she’s like, “Why am I getting vaccinated again? I just got this two years ago.” And I’m saying, “Right. Because we’re not giving it for you. Like, you don’t need another Tdap vaccine for your own health, but this is a new baby, and that baby’s not gonna get any passive immunity unless we vaccinate you while you’re pregnant. You need that boost of antibodies, not just the fact that there’s some level swirling around.”
And so we revaccinate her in the next pregnancy, but the partner definitely does not need it. And the same is true. Like, “Well, should I get my family members vaccinated?” Usually, I tell them, “Well, if they’re due for one, they should get one anyways.” But it’s not that likely that someone’s gonna be walking around your baby with whooping cough and not know about it, right? It doesn’t get passed like that because they’ll be pretty ill. So if they’re due for one, they should get it, but it’s not typically worth fighting with them over it as opposed to maybe something like flu, or COVID, which is a lot more contagious and people can have it and not know they have it and things like that.
Dr. Gelber: Pertussis is interesting. So for one thing, the Tdap, the A is actually acellular.
Dr. Fox: I like and, it’s easier. It’s just easier. Acellular, without cells. Yeah.
Dr. Gelber: So you can edit this. The interesting thing about the pertussis…
Dr. Fox: No. We’re not editing it. I’m happy to be wrong.
Dr. Gelber: Okay. The interesting thing about the pertussis vaccine is there used to be a vaccine that worked better, but the problem was it caused a lot of side effects and it could really make people sick. And so there’s been this trade-off where now we use a vaccine that’s less good but because it’s less good, we’re recommending it more. Because I think people feel like vaccines happen. Like, they get approved and then nobody thinks about it. But, in fact, people are constantly looking at the efficacy data of vaccines and they’re constantly looking at safety data. And so, you know, at some point they were like…When they had this old pertussis vaccine, they were like, “Yeah, works great, but not worth the risk because there’s now pertussis.” So now we’ve gone the other way where we have this trade-off, you might still get pertussis. It’s less likely. It’s really that it doesn’t as long and that’s why we need these boosters, but it’s much safer.
Dr. Fox: Right. And less side effects is also nice.
Dr. Gelber: Yes.
Dr. Fox: I mean, usually with these vaccines…I mean, COVID probably, the corona vaccine had more side effects than the other ones did. You know, flu vaccine and Tdap, you know, most people have no side effects followed by maybe a sore arm for a day or two and a few people will sort of feel a little flu-like for a day or two. It’s not the virus itself. It’s just a response. I think COVID was more higher percentage of people had symptoms and they tended to be a little more severe. I mean, some people got really sick from the COVID vaccine or had really bad arm pain. That’s pretty unusual for the flu and for Tdap, I would say. Really, really, really unusual to have severe side effects for one of those. So we covered flu, which is recommended. We covered Tdap, which is recommended. Again, that’s the third trimester because we’re really giving for the baby. So you could give it in the first trimester if someone needed it. It’s safe, but we don’t strategically give it until the third trimester because again, it’s specifically for the baby.COVID vaccine, we mentioned. We mentioned not to get the live vaccine. So that’s your MMR, which is measles, mumps, rubella, and also varicella, which is chickenpox. So we don’t give those in pregnancy. Those are the more common vaccines. What are the other vaccines some people might be recommended or might think about getting and whether we can or can’t do those in pregnancy?
Dr. Gelber: So there’s hepatitis B vaccine. So certainly for people my age, I’m really old, I didn’t get hepatitis B vaccine as a child. At some point, they started recommending it as part of routine childhood vaccines. So most pregnant patients at this point should have gotten hepatitis B vaccine as children. So if they got their whole vaccine series, they shouldn’t need it in pregnancy. If someone didn’t get it as a child and we think they’re at high risk to be exposed to hepatitis B, then they should be vaccinated. And so the risk factors are if you have a family member who has hepatitis B or there’s a high likelihood of you needing a blood transfusion or being exposed to people’s blood, like I don’t know, if you’re having dialysis or if you’re going to get a tattoo, people who have a history of recent sexually transmitted diseases, or people who are IV drug abusers, those are all risk factors for hepatitis B. And so if there’s a chance you might get hepatitis B in pregnancy, you should be vaccinated because hepatitis B is transmissible to a newborn usually at the time of birth and that can cause long-term health problems. Like, children who get hepatitis B at birth or at increased risk for things like liver cancer in life. And so that is not the gift we wanna give our children, so…
Dr. Fox: Right. But, again, most people are gonna be vaccinated for hepatitis B already because they got it as children.
Dr. Gelber: Yes.
Dr. Fox: And what about some other vaccines? Like, there’s one for pneumonia, for meningitis.
Dr. Gelber: I think those vaccines, it’s really a matter of risk. Like, if we think you’re at high risk to be exposed to meningitis and you haven’t gotten a meningococcal vaccine, then that’s something you might want to get. The meningitis, the pneumococcal vaccines, the recommendations are really to talk to your healthcare provider about the likelihood you’re gonna get the disease. There’s no…Or get exposed to the disease. There’s no known risk for those vaccines, but there’s limited safety data because usually we don’t have reasons to be giving those vaccines in pregnancy. There are certain things like rabies vaccine where it’s certainly a good idea to give it if you were bit by a dog or a cat and there’s a risk, but we don’t generally give it prophylactically. So sometimes people come in, they’re veterinary students and they’re like, “Should I get my rabies vaccine?” And it’s like, you know, depends what they’re likely to be doing.
Dr. Fox: Yeah. My wife was attacked ironically by a fox last year, which is…It’s a good thing my last name isn’t, you know, rhinoceros or something, hippopotamus, but she was attacked by a fox and she got bit and she actually had to get a rabies vaccine. It was crazy. So it happens. People are bit by wild down animals periodically. And, you know, during the, I guess, pandemic, the foxes were going wild.
Gelber: And rabies is lethal. So, you know, it’s worth getting the vaccine.
Dr. Fox: Yeah. I think sometimes…
Dr. Gelber: But that’s a whole conversation.
Dr. Fox: Yeah. Yeah. I think sometimes these things come up if people, either for leisure or for their work, they have to travel to places where there’s certain diseases that are endemic. There’s, you know, sort of the whole concept of travel medicine and what vaccines they’re supposed to get that you wouldn’t…you know, that you’re not gonna be exposed to if you’re living in Cleveland, but you might be exposed to if you’re going, you know, on safari or something like that. And, you know, those are unique and it’s important to talk with your OB or with, you know, travel medicine doctor about, A, should I be taking this trip in general, but B, if let’s say you have to, or you’re gonna be moving to, you know, one of these places let’s say that has an endemic disease, should I get this vaccine, should I not? And those are more unique. But typically, if you’re at risk for getting the disease, it’s usually better to have the vaccine than the disease. That’s usually the principle in this situation.
Dr. Gelber: Yes.
Dr. Fox: So, you know, there’s a couple of resources I wanted to go over that our listeners can use. One of them that you sent to me was just from the CDC, the Centers for Disease Control and Prevention. You know, you can Google, you know, “CDC guidelines for vaccinating pregnant women.” And they have a website and it’s updated and they sort of go through each of the vaccines and what’s recommended and what’s not. And there’s really good information on the CDC website. Like, they do a good job at updating things for people for both, you know, for regular folk, for doctors, nurses, whoever. So that’s a good one, but also, tell us about your daughter’s website.
Dr. Gelber: My daughter made a website. I didn’t even know she knew how to make a website. It is knowyourvaccines.org. I’m so excited about this, both because I think it’s an amazing resource for patients and for people in the community, and also because my daughter made it. The thing she wanted to provide was information about what’s in vaccines. So that’s what the website was designed. She has information about all of the childhood vaccines and some adult vaccines. She’s gonna move on to travel vaccines. And there’s a link for each one where you can look at the list of ingredients and then she explains why those ingredients are in that vaccine and then she provides some just general information about vaccination. And she tries to…She’s not a physician.
Dr. Fox: Tell us about her, where she is in life just so people understand that your daughter’s not like a Ph.D. in immunology right now. Who’s your daughter?
Dr. Gelber: My daughter, Samantha Ratner, is a senior at the University of Michigan.
Dr. Fox: Go blue.
Dr. Gelber: And she is really interested in public health. And you know, some of that has to do with being in college in the middle of the pandemic. And a lot of the things that I’m looking at guidelines for, like she and her roommates and the college, they’re sort of figuring things out for themselves. And she was a lot, you know, certainly heard a lot about people having question about things and she thought there was a real need for a website that was not the CDC, was not your doctor, like something that was put together by someone without a medical education. So she sort of put in there the things that she had needed to look up that she wanted explained in a basic way and that, you know, things her friends were asking about.
Dr. Fox: Yeah. It’s really terrific. Again, it’s knowyourvaccines.org. That’s one word and know with a K-N-O-W and it’s just really…It’s user-friendly. It’s easy to go through. It’s not convoluted. You know, the font is good, you know, the links are easy. Some websites are just a disaster to try to navigate, but this is really straightforward and interesting, and helpful. And go Sam, strong work. Really impressive. Look at you, your progeny are, you know, taking the mantle from you. I love it.
Dr. Gelber: That is what we want. We wanna be able to retire one day.
Dr. Fox: Yeah. And if there’s anyone out there who wants to, you know, buy her website and, you know, monetize this for her, you know, so she can pay for grad school, that’d be pretty cool. But it’s really…No, seriously, it’s a great website for people who are looking for more information on vaccines that’s not the CDC, just another resource to look at.
Dr. Gelber: Can I talk about one more thing?
Dr. Fox: Yeah.
Dr. Gelber: There is this horrible COVID thing called COVID placentitis, which is like inflammation in the placenta. And that has been associated with stillbirth. And, you know, it’s something that scares providers. It’s rare, but it happens. And someone did this really, really nice study where they looked at patients who had been vaccinated because we always worry that, you know, these vaccines are mimicking disease and, you know, what if the vaccines cause a problem? And someone took a cohort of patients who had not had the vaccine in pregnancy and a cohort of patients who had had the vaccine in pregnancy and they did not see any evidence of any differences in the placentas in women who had gotten vaccinated. And so in addition to the fact that we have data on newborns because there are registries that are collecting that, it’s nice to see that the placentas are doing fine when patients are vaccinated.
Dr. Fox: Love it. Thank you for that. Awesome. All right. Gelber, now we will say goodbye. Shari Gelber, thank you so much for coming on the podcast, talking about vaccines. Hopefully this will be really helpful for pregnant women and also just for everyone out there about vaccines in general and why they’re important, why they’re recommended, and the fact that we keep continuing to gather and to report all the safety data that people should be really reassured that these are not just being, like, led out into the public without any sort of oversight. There is a lot, a lot of data that goes into this. Thank you for coming on the podcast. I really appreciate it. We’ll have you again.
Dr. Gelber: Thank you.
Dr. Fox: Thank you for listening to the “Healthful Woman” podcast. To learn more about our podcast, please visit our website at www.healthfulwoman.com. That’s healthfulwoman.com. If you have any questions about this podcast or any other topic you would like us to address, please feel free to email us at email@example.com. Have a great day.
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