If only the medical advice were clearer, Anja W., a 35-year-old woman in the 25th week of pregnancy, would want to get vaccinated against COVID-19.
She’s a doctor, and she knows her way around all the issues.
“If the German Society for Gynecology and Obstetrics and the Standing Committee on Vaccination would clearly recommend vaccination for pregnant women, and if a COVID-19 vaccination was deemed a lower risk than an infection with the virus itself, I would get vaccinated. I’ve been watching the advice in other countries. In the US, they’ve been vaccinating pregnant people for months,” says Anja W.
In addition to the US, other countries, such as the United Kingdom, Israel and Belgium have recommended that pregnant people get vaccinated. In fact, they are to be treated as priority cases.
But the Standing Committee on Vaccination (STIKO) has yet to recommend it in Germany, either during pregnancy or for those people breastfeeding newborn babies.
In April 2021, STIKO recommended against vaccinating people during pregnancy.
It said that only those who had preexisting conditions resulting in a higher risk of a severe COVID-19 infection should be considered for vaccination, but only after a risk-benefit-analysis and after the person had been fully informed.
Basically, that’s vaccination only in individual, exceptional cases, and at the person’s own risk.
STIKO said it lacked sufficient data to make a general recommendation in favor of vaccinating pregnant people because they only rarely take part in clinical trials.
So, it’s not necessarily that the committee has spoken out against vaccinations for mothers-to-be, it just says it can’t recommend it for everyone who is pregnant.
It’s a case of not for and not against. But it’s precisely that stance that expectant mothers find confusing.
Intensive care professionals and gynecologists are stepping up the pressure. A group of 11 expert organizations in Germany have published a “position paper” (in German), arguing that pregnant women are at higher risk of severe COVID-19 and that there is now enough reliable data on the safety of mRNA vaccines.
Being pregnant in a pandemic is a special challenge
Stefan Kluge sees it the same way. Kluge heads the University Hospital at Hamburg-Eppendorf (UKE).
He says they are seeing a growing number of COVID cases among pregnant women in intensive care. He told the DPA news agency there were five such cases in the past two weeks alone.
“These cases are especially dramatic. We must start vaccinating pregnant women in Germany,” said Kluge.
We’ve known that pregnant women are a high-risk group since September 2020.
A meta-study, published in the British Medical Journal, had reviewed the data from 190 studies, involving 68,000 women.
The results were unambiguous: About five times as many cases among pregnant women were asymptomatic, but the risk that they would need intensive care or artificial respiration after an infection was twice as high.
The risk of death due to a COVID-19 infection was equally high at two in every 10,000 cases.
Pre-existing conditions such as diabetes or obesity, or indeed being over the age of 35, could increase the risk further.
On average, pregnant women are about as at risk as people aged 70 to 84 years.
Anja W. says that if pregnant women were now to be considered as risk patients, protecting them should be a top priority. As a working doctor, and pregnant at the same time, she feels especially vulnerable.
“I’m living through this pregnancy feeling more worried than I was during my first pregnancy,” she says. “I’m still working at the hospital and trying, as best as I can, to protect myself against a SARS-CoV-2 infection.”
“I would have welcomed better advice from the German Society for Gynecology and the Robert Koch Institute [Germany’s government agency responsible for disease control and prevention, the ed.] for pregnant people in the workplace,” she says.
Some countries recommend COVID-19 vaccines for pregnant women and treat them as priority cases
Expert organizations for gynecology in Germany, who want to see vaccinations for pregnant and breastfeeding women, cite the V-safe COVID-19 Vaccine Pregnancy Registry at the US Centers for Disease Control and Prevention (CDC).
The CDC says there are no indications that a COVID-19 vaccine would cause complications for pregnant women. It says there are also no concerns regarding the production of antibodies or people’s tolerance of a vaccine.
Pregnant women are advised, however, to preference mRNA vaccines. So, that’s the BioNTech/Pfizer and Moderna vaccines.
Pregnant doctor Anja W. would prefer a mRNA vaccine herself. “Pregnant women have a higher risk of thrombosis as it is, and I would want to reduce the risk of sinus thrombosis, so I would prefer a mRNA vaccine,” she says.
But many people — pregnant and willing to be vaccinated — are still not getting a jab, because doctors are said to be shying from the risks.
It’s left to pregnant women to decide whether the risks are greater of a COVID-19 infection or as a result of a vaccination.
Anja W. hopes there will soon be clearer advice in Germany for pregnant women. “Only by then,” she says, “my second child will already have arrived.”
Amid the coronavirus crisis, New York City’s Mount Sinai Hospital asked photographer Claudia Paul to portray the clinic staff as they fought to save the lives of COVID-19 patients. In the midst of the chaos, Paul captured intense moments showing healthcare workers from behind the scenes. Here, a doctor is getting ready for work.
Claudia Paul, a German photographer who lives in New York City, was “nervous about going to a clinic while this invisible threat was rampant,” she told “The Luupe.” But she knew that documenting the historic events in the clinic was important work. Here nurses discuss the condition of a patient in the COVID intensive care unit.
“There were many emotional moments that I will never forget,” says Paul, who has been living in the United States for 18 years. “It was often difficult, but there was also this fantastic spirit of resilience and teamwork. Everyone looked out for each other. My time in the clinic made me realize how important our health is.” Nurse Simone can be seen here seeking strength through prayer.
“I was very surprised at how humble the clinic staff are and how much they appreciated that we took their pictures and asked for their stories,” Paul said, adding: “They don’t see themselves as heroes. They just do what they have to do. It’s their calling.” This Mount Sinai Hospital worker was photographed at the end of his night shift.
This nurse is also praying for her patients in the COVID-19 intensive care unit. Documenting the hospital staff’s everyday work inspired Claudia Paul to also portray them more formally. The photos include a quote from the people portrayed on how they experienced the events. The series make up the photo exhibition “COVID-19 / Faces of Resilience,” now on show in Tübingen.
“In the midst of all the chaos, I had a moment where I realized that this was why I went into nursing,” reads the text in this photo. At the height of the first wave of the pandemic in 2020, thousands of people died of COVID-19 in NYC within days. Space in the morgues was becoming scarce, and it was hardly possible to treat the dead with dignity.
“My most memorable moment was seeing people realize that COVID-19 was not merely another virus,” recalls the Mount Sinai Hospital engineer. At the beginning of the pandemic, former US President Trump tried to downplay the threat of the coronavirus, which led the US to lose several crucial weeks in the fight against the virus.
At the peak of the crisis in New York City, healthcare workers were all overworked and strained: “Our staff banded together and became even stronger, despite being exhausted and stretched very thin at times,” says this emergency doctor.
The series “COVID-19 / Faces of Resilience'” by Claudia Paul is on show from May 5 through September 18, 2021 at the German-American Institute in Tübingen. A virtual tour of the exhibition is also accessible through the website, www.dai-tuebingen.de/covid.
This article was adapted from German.