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Initial Distribution Of COVID-19 Vaccine Won't Include Pregnant People

SCOTT SIMON, HOST:

Doses of coronavirus vaccines are being distributed to and stored in warehouses around the United States. First in line to receive it, pending FDA approval, are health care workers. But the most prominent of these vaccines have not been tested on pregnant people. And the CDC estimates there are over 300,000 pregnant health care workers in the U.S. right now.

Dr. Ruth Faden joins us. She's founder of Johns Hopkins University's bioethics institute. Dr. Faden, thanks so much for being with us.

RUTH FADEN: My pleasure.

SIMON: Does this concern you, the lack of testing on pregnant people?

FADEN: It does concern me. But we're in a situation right now where we have to go forward with the information that we absolutely do not have. It's understandable that we don't have data from pregnant women yet, but it would be nicer if we did.

SIMON: I mean, I have to ask - and I apologize for the fact I didn't know until today that three-quarters of health care workers are, in fact, women. Are pregnant people commonly not included in trials? Why would this happen?

FADEN: Yes. They're not included in initial trials of brand-new investigational interventions, especially for brand new pathogens. So they're actually good reasons why pregnant women were not the very first included in even the Phase 3 trials for the Moderna and the Pfizer vaccines. But it is - has been long time the case that there has been an evidence gap for pregnant women relative to other adults in terms of what we know when new medicines and new vaccines become available. Now is the time that pregnant women should be involved in the evaluation of these vaccines.

SIMON: What would you tell someone who is a health care worker and pregnant at the moment?

FADEN: So there are two different pieces to the risk that all of us face, pregnant women included. The first kind of risk is the risk of becoming infected in the first place. And pregnant people vary on that score. Separately, there's the risk of becoming seriously ill from the virus if you're infected. So disproportionate amount of burden of disease in pregnancy seems to be hitting women who are low-income, women who are from communities of color, women who are otherwise disadvantaged. There's nothing about pregnancy that is protective.

The FDA could make the determination that the pregnant woman should not take this vaccine. I don't think that's going to happen, but it could. Assuming the FDA doesn't say no and the CDC doesn't say no, then for women who are pregnant and who are working in health roles, they will face a decision, right? And there, pregnant women are going to need to think about their individual circumstances because not all pregnant women are equally at risk.

SIMON: This is a lot that could be confronted, right? I mean, and it could substantially increase the number of health care workers who are available to work with the vaccine and on the pandemic.

FADEN: We've had this issue for a while now. So lest anyone misunderstand, we've had pregnant people since March. And health systems around the country have had to figure out how ethically to respond to pregnant workers all the way through, especially as we get - got more and more evidence about risk in pregnancy. But yes, and especially if people were to be extremely precautionary and even throw in women who are breastfeeding. That would really be concerning. But people who are pregnant have a lot to worry about, and we don't need to add to people's stress. Unfortunately, this is a stressful circumstance. And take a deep breath, and if you're given the choice, it may make good sense to have this vaccine. It may not.

SIMON: Dr. Ruth Faden, a bioethicist at the Johns Hopkins University in Baltimore, thank you so much for being with us.

FADEN: My pleasure. Transcript provided by NPR, Copyright NPR.

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