WHO doesn’t recommend Moderna vaccine for pregnant women, unless at risk of high exposure

The World Health Organization released recommendations Tuesday for the Moderna vaccine, saying it is "currently not recommended" for pregnant women unless they are at high risk of exposure. 

The recommendation comes from WHO’s Strategic Advisory Group of Experts.

"While pregnancy puts women at a higher risk of severe COVID-19, the use of this vaccine in pregnant women is currently not recommended, unless they are at risk of high exposure (e.g. health workers)," the organization said in a news release.

The American College of Obstetricians and Gynecologists has previously said neither COVID-19 vaccine should be withheld from pregnant women, and that women should discuss individual risks and benefits with their health care providers.

The U.S. government’s emergency authorization for the Pfizer and Moderna vaccines being rolled out for priority groups doesn’t list pregnancy as a reason to withhold the shots.

But the OB-GYN group says women should consult their doctors since COVID-19 vaccines have not yet been tested in pregnant women. Evidence about safety and effectiveness is reassuring from studies that inadvertently included some women who didn't know they were pregnant when they enrolled.

Experts say there’s no reason to think the two authorized vaccines would harm fetuses. They might even protect them from developing COVID-19, although that hasn't yet been proven, said Dr. Denise Jamieson, chair of gynecology and obstetrics at Emory University School of Medicine.

That thinking comes in part from experience with vaccines for influenza and whooping cough, which are approved for use in pregnancy and protect newborns and their mothers from developing those diseases.

On Tuesday, WHO also recommended the following others not take the Moderna vaccine: 

  • Individuals with a history of severe allergic reaction to any component of the vaccine
  • Very frail older persons with an anticipated life expectancy of less than 3 months should be individually assessed
  • Anyone younger than 18 pending results of further studies

WHO also recommended those who are immunocompromised or living with HIV should talk to their doctor first. 

WHO said people who have had COVID-19 in the past can get the Moderna vaccine but may wish to defer their vaccination for up to six months from the time of infection. 

"Immunity persists for several months, but the full duration is not yet known," WHO said.

Both the Moderna and Pfizer vaccine require two doses. WHO says Moderna’s second dose should be scheduled 28 days after the first dose, though if necessary can be extended to 42 days.

WHO also said, based on the evidence so far, the Moderna vaccine still proves to be effective against new COVID-19 variants.

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Officials say a new Brazilian variant of the coronavirus has made its first known appearance in the United States in a person who recently traveled from Brazil to Minnesota. State health officials said Monday that the Brazil P.1 variant was found in a specimen from a Minnesota resident who had recently been to Brazil. 

Viruses are constantly mutating, and new variants often emerge. Health officials are also worried about variants that were first reported in the U.K. and South Africa.

"I think we were on track to have a good — or a better, at least — spring and summer, and I’m worried that the variants might be throwing us a curveball." — Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security Rivers, on concerns that the more contagious variants of the virus could lead to a deadly resurgence this year.

An increasing number of COVID-19 vaccination sites around the U.S. are canceling appointments because of vaccine shortages in a rollout so rife with confusion that even the new CDC director admitted over the weekend that she doesn’t know exactly how many shots are in the pipeline. 

States are waiting to find out their latest weekly allocation of vaccines. 

For days now, governors and top health officials have been complaining about inadequate supplies and the need for earlier and more reliable estimates of how much is on the way so that they can plan accordingly.

According to data through Jan. 25 from Johns Hopkins University, the seven-day rolling average for daily new cases in the U.S. did not increase over the past two weeks, going from 249,234.9 on Jan. 11 to 170,720 on Jan. 25.

This story was reported from Detroit. The Associated Press contributed

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