When she found out she was pregnant in late 2020, Erin Zanza of Hattiesburg thought she’d wait until after she gave birth to be vaccinated against COVID-19. The vaccines weren’t widely available yet, and the clinical trials that resulted in their emergency use authorization had not included pregnant women.
Waiting until her son was born would prevent any risks to him in utero, and she could still pass on antibodies through her breast milk after she was vaccinated, she thought.
Zanza’s attitude changed as the delta variant swept across Mississippi last summer. Hospitals and their intensive care units were overflowing with patients, some of whom were pregnant and died, lost their babies or both. One of those mothers was a close friend of Zanza’s.
“It was just really eye opening that this perfectly healthy mom and baby were gone because of it,” Zanza said.
So Zanza went to her doctor, who walked her through the science of how the vaccine works. She explained that only the antibodies Zanza was producing would reach her baby through the placenta, not any vaccine material. She also consulted her brother, a doctor and father of small children, who wholeheartedly encouraged Zanza to get vaccinated.
So, 37 weeks into her pregnancy, she received her first dose. For the first 24 hours after getting the shot, Zanza’s hand stayed glued to her stomach.
“I was so scared that maybe I’d made the wrong decision and something was going to happen,” Zanza said.
Ultimately, Zanza’s baby boy, Drew, was born happy and healthy, just a few weeks later. Recently, Zanza and Drew, now five months old, were infected with the omicron variant. Thankfully, they both had mild cases and recovered quickly.
“I truly believe it’s because I had the vaccine and had given him some immunity,” Zanza said.
Zanza also recalled how things went differently for a close friend of hers who is against vaccines. It’s one of those areas of disagreement they avoided discussing, and Zanza didn’t tell her that she’d been vaccinated until a few weeks after Drew was born. That friend also recently caught COVID-19 and was bedridden for weeks.
Zanza’s position is one thousands of Mississippi women have found themselves in over the past year. On top of the normal stressors of pregnancy, they had to decide whether to risk contracting the coronavirus and potentially becoming seriously ill while pregnant or taking a new vaccine that they knew nothing about.
While no demographic was exempt from the spread of vaccine misinformation, perhaps no group was targeted as ferociously as pregnant women. “The vaccine causes infertility.” “The vaccine will make you miscarry.” “The vaccine will give your child autism.”
These false claims spread like wildfire online and among friend groups as the vaccine was rolled out across the United States.
Lauren Rhoades of Jackson, who was vaccinated in March 2021 and gave birth in July, credits getting off Facebook before the pandemic began with helping her avoid most of the misinformation being circulated about the vaccine.
While home on maternity leave, Rhoades watched in horror as the delta variant swept across Mississippi and the subsequent surge in pregnant women and infants being hospitalized. Since the virus reached Mississippi in March 2020, it has caused at least 73 fetal deaths, or miscarriages before 20 weeks, and killed 13 pregnant women.
“I imagined that they just wanted to do what was best for them and their child, and they had just received so much misinformation that made them fearful of getting vaccinated,” Rhoades said. “It just made me feel so sad to see such preventable loss.”
The Centers for Disease Control and Prevention didn’t recommend vaccination for pregnant women specifically until late April, and that message then had to compete with the doubt and mistrust that had built up and calcified over those early months that the vaccine was available.
“I think over the time that they delayed, that just gave a lot of fodder for people to be worried about it,” Katie Poor, who gave birth to her second child in December 2021, said.
Poor struggled to navigate unclear guidance and the uncertainty that came with it.
“There’s so many things that you are supposed to be cautious about because of the impacts that it could have on your unborn child,” Poor, who lives in Jackson, said. “If I’m limiting things like caffeine, then I obviously want to be really sure about what medications I’m putting in my body as well.”
After consulting with her doctor and seeing that the vaccine wasn’t causing complications for pregnant women, Poor was vaccinated in the spring. Now, she’s thankful to be in a position to pass on her antibodies to her two-month-old daughter, offering what protection she can until she can be vaccinated herself.
“Breastfeeding my newborn is one of the things that gives me a feeling like I’m doing something to protect her when there’s a lot of ways that I feel like I can’t protect her as well as I should have,” Poor said.
Following a year of widespread sickness, death and research, the risks COVID-19 poses to pregnant women and infants are clearer than ever.
One recent study, co-authored by Dr. Charlotte Hobbs, a pediatrician and professor at the University of Mississippi Medical Center, found that babies make up a disproportionate amount of the minors hospitalized due to COVID-19.
The study identified 630 patients aged 0 to 18 with severe COVID-19 across 50 of their hospital sites, including Children’s of Mississippi, between March to December 2020. Of those, 128 were under a year old, and half of those were under two months old.
Another area of concern is that two-thirds of these infants had no serious health conditions prior to their COVID-19 diagnosis, but still struggled to overcome their infections. Seventy-seven percent had respiratory complications, and 13 percent needed a ventilator during their treatment.
“It’s been well established that vaccination of mom protects baby, and as infant COVID-19 can be severe, this underscores the importance of maternal immunization,” Hobbs said.
Even with the vast amount of data proving the vaccine’s efficacy and safety, Hobbs says misinformation is still rampant, even in the medical community.
“Millions of people at this point had been vaccinated, and I still hear providers say that there’s not enough data,” Hobbs said. “And I think that we need to educate our providers, so we can educate our population. I think people trust their doctors, but if the doctors don’t have the right information, then the patients won’t either.”
Dr. Anita Henderson, President of the Mississippi Chapter of the American Academy of Pediatrics and a pediatrician at The Pediatric Clinic in Hattiesburg, has seen more infants hospitalized during the omicron wave than during any other stage of the pandemic. One theory is that omicron affects the upper airways more so than other variants.
“When you have a baby that has a very small airway, it makes for a more significant illness,” Henderson said.
She has also seen other disturbing trends like one and two-month-olds suffering from COVID-induced sleep apnea and an increase in babies being born with intrauterine growth retardation, or IUGR. The condition, in which a baby doesn’t grow to normal weight during pregnancy, can be caused by a mother’s blood vessels being damaged as the result of a COVID-19 infection. This can cause clotting in the placenta, restricting the fetus’ access to nutrition and stunting its growth.
Having the vaccine conversation with patients can be difficult, Henderson said, but it’s also gotten a lot easier over time as mothers have seen the protection vaccination has given to others in their lives, and come to understand the danger that its absence poses to them and their children.
“They’re just conversations we have to keep having every time we have the opportunity to educate moms and explain why vaccination is the best thing for them and for their babies,” Henderson said.
Editor’s note: The final quote in this story from Dr. Anita Henderson was updated for clarity.