April 2021 Moms
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Pregnant Healthcare Worker - COVID

Hi All, 

I would love to hear from other pregnant healthcare workers and what they are doing the to protect themselves, how they're managing stress/anxiety related to COVID risk, and if you're still working or not!

I am a physical therapist working at large outpatient clinic in CA and I am continuing to work, but my OB and boss have agreed that I should wear an N95 mask, procedure mask, and face shield at all times given that I have to get within inches of my patients and they're not reliable at keeping their masks on (either it keeps sliding off or they're working out and cannot breath well and need to drink water, or other emergent situations). This has been really hard on me, I'm not even that big yet but I already notice that I can easily get short of breath and my heartburn/acid reflux is making me nauseous all over again like it's my first trimester. Wearing double masks and face shield on top of this makes it even harder, and it can be a struggle for me to find time to drink water or step away to get even a second break. The only time that I can take it off is when I'm eating lunch outside otherwise I have 4+ hours before and after lunch where I am wearing it at all times.

I honestly dread going to work now because of this and am a bit paranoid every time I am working with a patient who tells me they just flew somewhere or had a party last night or think this is all a hoax. I am strongly considering taking leave earlier because I am uncomfortable and tired, am I being over-dramatic? If I take leave early I won't get paid which is obviously not ideal.

Would love to hear anyone's thoughts.

Michelle
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Re: Pregnant Healthcare Worker - COVID

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    rexnierexnie member
    edited December 2020
    Hi! I'm an SLP in an acute care hospital in southern CA. We're surging and it's stressful. I only work part time (per diem) now, on weekends, so my husband can watch our toddler son. I used to work more regularly and he was enrolled in part time daycare before all of this. 

    I got a written accommodation for an N95 for all patients (+ face shield) since my work is aerosolizing. 99% of my job is swallow evaluations, so patients are unmasked and coughing. 

    Honestly I'm taking it one week at a time right now. I am motivated to stay employed, even through this surge, to get early access to the vaccine - our hospital is expecting first shipment in 2 weeks. I expect to hit my allocation maybe in January. I'm currently communicating with all my providers - MFM, OB, GI, and baby's pedi, to make sure everyone is in agreement that the benefits of the vaccine outweighs the risks. 

    The Society of MFM just released a statement yesterday in support of pregnant healthcare workers being provided with the vaccine if you're curious. https://s3.amazonaws.com/cdn.smfm.org/media/2591/SMFM_Vaccine_Statement_12-1-20_(final).pdf
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    Thank you so much for your response! This was so helpful, I had no idea about this letter from MFM and I honestly ruled out the idea of getting a vaccine completely, until now, given our population was not given the vaccine in their trials. 

    I am currently in between OBs and don’t have a pediatrician yet (first pregnancy) but will definitely make sure to bring this up at my next appointment. 
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    Hi! I am a pathologist at an academic center. I plan on working right up until delivery, if possible. My situation is a bit difference, since I mostly don't have direct patient interactions, however I do have to work with patient tissues, including COVID patient tissues. I have talked to colleagues and have been coming up with strategies to limit my interaction with other workers and infected tissues as much as possible. I am unsure about the vaccine, but plan to ask my OB at my next appointment in 2 weeks. It is stressful, but I am trying to just do as much as I can to prevent myself from getting sick and trying not to get overly anxious (which is way easier in theory). Its hard, because I really cant take off for the entire pregnancy either. 
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    Thank you so much for your response! This was so helpful, I had no idea about this letter from MFM and I honestly ruled out the idea of getting a vaccine completely, until now, given our population was not given the vaccine in their trials. 

    I am currently in between OBs and don’t have a pediatrician yet (first pregnancy) but will definitely make sure to bring this up at my next appointment. 
    It's so unfortunate our population was excluded from trials. It makes me want to rip my hair out! The vaccine won't be for everyone, but hopefully your providers can help you weigh the risks of the vaccine against the risks of the virus, keeping in mind your overall exposure to the virus. That math will be different for everyone. Hang in there - this has been a crazy year and it looks like we're in for quite the ride this winter.
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    @rexnie yes!! It is so frustrating because we are completely without concrete data! I have been reading everything I can find to try to make an informed decision, but I still don't know what to do.
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    rexnierexnie member
    edited December 2020
    @rexnie yes!! It is so frustrating because we are completely without concrete data! I have been reading everything I can find to try to make an informed decision, but I still don't know what to do.
    Totally understand. By excluding all pregnant women from participating in trials, we've effectively been forced into choosing to participate in clinical research as an entire group. It is a bit of an easier decision for me personally, since I'm on immunosuppressants, and the baby is exposed to immunosuppressants which will place him at higher risk for COVID complications after birth. 

    If I can get some antibodies to him before he's exposed to everyone on the outside, I'll feel more peace of mind - I know it won't be total protection; but perhaps maternal vaccination will lower the risk of severe disease like it does with the flu, TDAP, etc. The risk of fetal harm with the mRNA virus should be theoretically low (but will remain unknown for some period of time). If I didn't work in healthcare and could have a home birth (I'm risked out), I would likely choose differently. I also feel more at peace getting the vaccine in the late second or early third trimester than I would during the first tri - this isn't based on any actual data, though, obviously.

    So far I've gotten an immediate "yes" twice (GI, MFM), my son's pediatrician asked for more time to research before answering the question, and I see my regular OB later today and plan to discuss with her.

    These decisions suck. If you find anything worth reading or listening to, please share! 

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    I'm glad we are talking about this. I am not a healthcare worker and generally low risk so I'm sure I will be last to receive the vaccination. That's fine, but I do have a lot of questions/anxiety about when I will be able to get it safely and when it will be recommended for newborns (as well as my older kids, 4 & 2). 
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    rexnierexnie member
    edited December 2020
    @juliebird6 unfortunately trials in kids under 12 have not started for any of the vaccines undergoing trials in the US, so it will likely be many months for the 4 and 2 year olds. I expect it will be even longer before we have an infant vaccination schedule for COVID; but if we can vaccinate enough of the population, we will protect the infants through herd immunity - like we do for other infectious diseases they can't be directly vaccinated from early on. Here's an article that vaguely discusses timelines and the frustrations with not including at least older children in trials earlier, when initial safety data began looking very promising: https://www.washingtonpost.com/health/2020/12/02/kids-vaccine-delay/


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    @rexnie hey hey! Fellow SLP here-- working in the schools but I went into this field to be all medical. Was obsessed with my work in hospitals and just didn't find a good placement acute enough when I moved and settled in Northern CA. I've been so much happier than I thought I would be in the schools but I really miss the hospitals!
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    @eahayes how are things operating at your school/s with COVID? are you in person or remote? I'm sorry you couldn't find the position you had hoped for, but I'm glad you're happy where you landed. :) 
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    nope, all remote for now. Our teacher's are killing it even though we are all getting really burnt out. We were going to go back this month but our numbers went to "double purple if double purple was a thing"- quote from principal. I have a feeling we will be back soon though.. I work in an affluent community and parents have a lot of pull...
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    Has anyone had their OB recommend for or against getting the vaccine? I asked my OB and she said she didn't have enough solid information to advise one way or the other and she was still waiting for guidance (from ACOG, I presume). I'm just curious to see what other OBs are recommending. 
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    Has anyone had their OB recommend for or against getting the vaccine? I asked my OB and she said she didn't have enough solid information to advise one way or the other and she was still waiting for guidance (from ACOG, I presume). I'm just curious to see what other OBs are recommending. 
    My OB and MFM docs recommended to get vaccinated as soon as the (Pfizer or Moderna) vaccines are available to me. But this was based on a conversation about my risk of exposure and risk of severe disease. 

    If you're looking for more information, I'd recommend reading the ACOG and Society of Maternal Fetal medicine links above.

    Here is the info directly from Pfizer so far, but more follow up will come: 

    (TW for outcome discussion)
    Pregnancies 

    Female study participants of childbearing potential were screened for pregnancy prior to each vaccination, with a positive test resulting in exclusion or discontinuation from study vaccination. The study is collecting outcomes for all reported pregnancies that occur after vaccination, or before vaccination and not detected by pre-vaccination screening tests. Twenty-three pregnancies were reported through the data cut-off date of November 14, 2020 (12 vaccine, 11 placebo). Study vaccination occurred prior to the last menstrual period (LMP) in 5 participants (4 vaccine, 2 placebo), within 30 days after LMP in 8 participants (4 vaccine, 6 placebo), >30 days after LMP in 1 participant (0 vaccine, 2 placebo), and date of LMP not known in 5 participants (4 vaccine, 1 placebo). Unsolicited AEs related to pregnancy include spontaneous abortion and retained products of conception, both in the placebo group. Pregnancy outcomes are otherwise unknown at this time. 

    (end TW)

    Additionally, Pfizer should be releasing DART study results (looking at toxicity to pregnant rats) in the coming days. This is usually a prerequisite to enrolling pregnant women in clinical trials. Clinical trials for pregnant women should begin in Jan but we will have some time before that data is available.

    As part of the EUA, the FDA is requiring Pfizer to submit interim data on pregnant people who receive the vaccine. I believe this will be released on a monthly basis, beginning in Feb.

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    @rexnie thank you! That info is super interesting. I had read some of the facts and know that ACOG and SMF made statements, but hadn't seen the details on the 23 who ended up being pregnant in the trail. 
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    @rexnie yay! And thank you for taking the leap of faith.
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    bbrahmbhattbbrahmbhatt member
    edited January 2021
    @rexnie yay! How was your second dose? I am supposed to get my second dose in 2 weeks. I'm nervous because I hear so many people saying they had horrible side effects. I only had a sore arm with my first one. 

    ETA: I'm curious, for those of us who have taken it, did you OB recommend it? At first I was not planning to get it, and my OB said she didn't have enough information to guide me one way or the other. Then, at my last appointment she said ACOG had put out an updated statement and she recommneded I get vaccinated. She said she had several pregnant physician friends who had gotten vaccinated, and when I asked her if she would get it if she were pregnant she said yes. She said that the benefits for me far outweigh the potential risks. 
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    @forevertired @bbrahmbhatt thank you! Second dose was fine - arm is actually less sore than the first dose. I totally expected to be out of commission today, so I had meal prepped and rearranged my schedule. But so far, so good almost 24 hours out.

    My OB did recommend it. She was on the fence when I first inquired (prior to FDA emergency use authorization) and then actually reached out to me after ACOG released their statement (the week after our appt/discussion) and recommended I receive the vaccine. I had already pretty much made up my mind to receive it at that point (and had been recommended to receive it by MFM) but it did give me peace of mind. 


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    @bbrahmbhatt my OB encouraged it this morning. He told me to call my general practitioner and let them know I am pregnant and take immunosuppressive medication to see how high I can move myself on the list as a precaution. 
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    @bbrahmbhatt my OB told me it was my decision, but she wasn't against it before I got the shot, then on Monday I went in and told her I got it, and she said "good, I would have gotten it too if I was pregnant" haha My MFM told me "it was completely reasonable for me to get it". 

    I get my second shot on the 25th, so it's nice to hear that @rexnie didn't have the flu like symptoms! My daughter has been home this week after potential exposure from day care late last week, and today I feel exhausted and like I could be coming down with something. She hasn't had any symptoms all week. So i'm just sitting here praying and hoping that it is nothing, and I just need more sleep! 
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    @cagncoo12 fingers crossed you just need more sleep. I'm sorry about the exposure.
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    @cagncoo12 fingers crossed you're just exhausted! Those possible exposures are so scary, hopefully its nothing
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    edited January 2021
    Since ACOG changed their stance on pregnant women, I'm going to call my OB Monday and see what she recommends. I qualify as 1B due to hypertension, so it might be worth looking into. I was going to wait until delivery, but if she okays it, then... Here we goooooo

    Edit - Texas made pregnancy a 1B classification. 
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    @aisukurimsarang good luck with whatever choice you make! Hope the conversation is productive. 

    Just a clarification but ACOG hasn't changed their stance - they've released official comments and letters about including pregnant women in the COVID vaccine trials since March (then later argued for including pregnant women in vaccine prioritization schedules and finally FDA EUA inclusion). https://www.acog.org/advocacy/advocacy-and-covid-19/covid-19-vaccines-and-pregnancy


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    @rexnie, what I'm hearing from several health care professionals I know is most feel the risks of COVID-19 for a pregnant woman are known and far worse than the theoretical unknown risks of the vaccine. They've said since I'm nearly in the third Tri, that any risks would be minimal and to get it as soon as I can. 
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    @aisukurimsarang for sure!

    I just wanted to point out that I don't think that represents any recent change. Rather, ACOG has consistently advocated that the benefits (to pregnant women and their babies) of including our group in trials, FDA EUA, and vaccination schedules outweigh the potential risks. This is an important distinction IMO because some people get uncomfortable with decision making when they feel guidelines are rapidly changing -- even if that's exactly how the scientific process works.
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    Made it through the week with no symptoms, and just about zero patience haha. DD goes back to daycare tomorrow, turns out one teacher ended up with symptoms and will continue quarantining and is waiting on test results, but she was not near other teachers or the kids for at least the last 10 days at this point. 

    One week and a day till vaccine shot number two! 
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    It’s nice to read that people here are getting it.  

    I work in healthcare but not with covid patients but my OB said I could get it if I felt like I was at high risk of getting covid.  I have to get my tdap soon and I will ask how long I have to wait to get the covid vaccine after that.
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    Just found out I’m eligible now too. I work in healthcare but don’t have direct patient contact. Still have to discuss with my doctors. My biggest fear right now is COVID combining with severe preeclampsia (had it with my first). I also have a cardiac conduction abnormality and we have a lot of cases in my area so my guess is they will recommend to get it. Relieved and a little scared at the same time! 
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    @slord33 i delayed my tdap to 31 weeks which will be exactly two weeks after my second shot. My ob said two weeks is good, but that she wanted to make sure I got tdap at least two weeks before baby comes out to make sure I can pass protection on (i delivered at 35+3 with my first).

    @jenn622-2 the fear of severe pre-e mixed with covid was one of my biggest deciding factors in getting the shot! Really what covid could do to my bp in general terrifies me. 
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    PA just moved pregnancy to a 1A priority so I guess I am now eligible as well. Will be discussing with my MFM doc next week but keep going back and forth... 
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    @runsoncoffee I checked on VA priorty for pregnancy because of your comment and pregnancy is listed as 1B here.  My husband is a teacher and is in 1B, and he just got his first dose two days ago.  I messaged my OB and am talking to some dr family/friends about if I should take it.  It's hard.

    Pregnancy Ticker
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    wow, interesting @runsoncoffee! I’m in PA too and I didn’t know this. I have an appointment on 1/26 so going to discuss again with my OB then. 
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    By sheer tenacity and dumb luck, I was able to get into the vaccine pool for 2/12. My parents are still trying to get appointments as are my aunt and uncle
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    @theblondebump I just happened to see when I was looking for a news article. I'm definitely curious what they will say. My appt is also the 26th... you'll have to report back what your doc says.
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    Yes, I will! @runsoncoffee Likewise for you - we can compare notes after haha. 
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    So I pre-registered with my city to be notified when it’s my turn to make an appointment.  With the rate of distribution I may no longer be pregnant by that time, so I’d no longer be in the 1b phase.  We shall see.

    Pregnancy Ticker
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    Good luck @bbrahmbhatt

    So FWIW, I discussed with my kids pediatrician at an appt today getting it and if it would impact baby at all and she did not hesitate to say yes, please get it if you can. She thinks based on the science of the vaccine there would be very little (if any) risk to baby. So I am leaning towards getting it once confirming with my mfm and pending its actually available anywhere.
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