Update time: November 11, 2021 / 1:57 PM / CBS News

Maria del Carmen Garcia does not need to seek medical advice when considering whether to get the COVID-19 vaccine. The 39-year-old teacher from Fort Hood, Texas, was trying to have another child. She consulted with her sisters who work in the health care department and her former pharmacist husband. 

"We did a lot of research in this house," she said. "Sometimes people look at us and they say,'You read too much'-but we would rather be over-understood than not be told." 

Her decision to receive the injection was not for her own safety, but to protect her child as much as possible. Despite concerns about potential side effects, she believes that vaccination is the safest decision for her future children. 

Garcia was confident in her choice, but others begged her to reconsider, just like her former boss. 

"I was one of the first people to be vaccinated in my previous company," she said. "Even on the day I accepted it, [she] still tried to persuade me not to do it." She warned Garcia that if she was vaccinated, her child might be "deformed"-this statement has been debunked by the CDC. The data shows that there is no difference in the rate of birth defects among babies vaccinated by mothers. 

Garcia was not deterred and kept following up. She later learned that her decision to vaccinate — and the subsequent safe pregnancy — inspired another colleague who was pregnant to also get the vaccine. 

Garcia’s experience illustrates the challenges faced by millions of women across the country who are pregnant or considering giving birth when deciding whether to get the COVID-19 vaccine. 

Studies have shown that these vaccines are safe and effective before and during pregnancy, and studies have not found any increase in miscarriage or fertility problems after vaccination. Health officials emphasize the importance of vaccinations because pregnant women who are not vaccinated face a higher risk of severe illness or death from COVID-19. 

But it is difficult for health officials to build confidence in vaccines among pregnant women, especially people of color.  

According to data from the Centers for Disease Control and Prevention, so far, only 35.3% of Americans have been vaccinated before or during pregnancy, which is half of the national adult population. 

The speed of vaccination shocked health officials and prompted the CDC to issue a health alert in September, calling for "urgent action" to address the problem. In late October, the agency’s Dana Meaney-Delman, responsible for maternal immunization, said in a webinar that “we still have a long way to go” and that the vaccination rate is “not what we want”. 

Vaccination rates for women of color are even more lagging. Less than one-third of Hispanics/Latinos and only one-fifth of African Americans were vaccinated before or during pregnancy. Doctors attribute this gap in part to worse medical care, worse results, and deep-seated mistrust caused by systemic racism that has largely gone unresolved. 

Dr. Manisha Gandhi, director of the Maternal and Fetal Medicine Clinic at the Women's Museum of Texas Children's Hospital, said that although health officials have tried to address racial disparities in care, historical mistrust has been difficult to overcome. 

"I think again this may be related to mistrust and racism issues, prejudice issues, which cause women not to receive this vaccination and distrust how it might affect pregnancy," she said. 

Dr. Javaka Moore, who runs a network of prenatal and maternal health clinics in Washington, DC, said that these historical inequalities are "embarrassing" and that there is little effort to reduce them. 

"We are trying to tell people that we as a society are not really making any effort to help," he said. "Suddenly, we were concerned about pregnant women and the incidence of COVID, but before that?" 

According to the CDC, before the pandemic, pregnancy-related death rates for black women were more than three times that of white women, and this trend has continued for many years. Federal data also shows that the infant mortality rate of black children is more than twice that of white children. 

"I think COVID has just ripped the band-aids from all of this, or ripped multiple band-aids from these differences. It is the front and center, and you can see it in real time, face to face, in real time," Moore said "It will be a little difficult to regain trust in the medical field."

In a statement to CBS News, Meaney-Delman stated that the agency is “deeply concerned” about the low vaccination rates for black and Hispanic pregnant women, adding that the number of unvaccinated people is too high and many people face serious illnesses and unhealthy pregnancies. The risk of ending. . 

"We will continue to work hard to increase the vaccination rate and fairness of this population," she said. "We need to work together nationwide to educate pregnant women through local outreach work and cooperation with many organizations."

But Garcia believes that the benefits of vaccination have not yet been fully communicated to people in her community. She said that her mother-in-law was a church secretary and it was difficult for a trusted messenger to talk to the community. 

"They will bring in someone who looks like an outsider instead of letting in from the community," she said. "So they think someone told them something that has nothing to do with them, so they brag a little bit." 

The massive amount of misinformation that permeated communities across the country compounded the problem. According to a summer study conducted by the COVID National Project (a network of multiple universities made up of policy experts and academics), one in five Americans believes there is at least one false statement about the vaccine epidemic. Of the four false claims covered by the survey, vaccination can cause infertility and make it more difficult to conceive is the most widely considered. A new survey by the Kaiser Family Foundation found that 17% of adults believe that pregnant women should not be vaccinated. 

In the early days of the vaccine’s launch, confusion and misinformation existed, partly because of the lack of clear, official guidance for pregnant women. The initial clinical trials of the three vaccines currently in use in the United States exclude pregnant and breastfeeding individuals, which has led health officials to provide cautious and ambiguous recommendations. Other studies have confirmed the safety of the vaccine, but it was not until August that the CDC officially recommended vaccination for pregnant women. 

In an interview with CBS News at the time, Sasha Ellington, then head of the agency’s emergency preparedness and response team for the agency’s reproductive health department, said that vaccine manufacturers “really missed” access to this group of people earlier. Data and acknowledged the agency’s “not too enthusiastic” guidance before the update. 

Dr. Valerie Montgomery Rice, president and CEO of Morehouse School of Medicine and founder of the Women’s Health Research Center at Meharry School of Medicine, said that due to concerns about the health of pregnant women, it has historically been difficult to include pregnant women in clinical trials. Mother or child, but in this case, more work can be done to release data on women who became pregnant after being vaccinated in the trial.

"We could have considered more on the front end," she said. 

Recent studies have shown that these vaccines are not only safe for pregnant women, but also beneficial for their children. 

A study by New York University Langone (NYU Langone) examined 36 women who were vaccinated after birth and their children, and found that 100% of newborns had antibodies that might help protect them from coronavirus infections . Another study by the University of California, San Francisco found that breastfeeding vaccinated women or their babies had no serious adverse events. The study also found that COVID-19 antibodies were increased in the milk of lactating individuals, although they were not passed to the baby through breastfeeding as the study showed. 

Now, with more encouraging data—and more and more evidence that pregnant women are more likely to have severe COVID results—medical professionals across the country can advocate vaccination with greater confidence. 

Montgomery Rice added that health agencies across the country must provide "multiple ways of participation." This includes not only doctors, but also Doula, midwives or family and friends.

She also mentioned her university’s work on teenage pregnancy participation, in which the researchers conducted some prenatal meetings in groups. This allows women’s questions to be answered not only by the professionals present, but also by other people who may have similar concerns. Others added that proper advocacy requires empathy, personalization and respect for autonomy. 

"When we talk to patients, we talk to them as individuals, community members, and family members, and really try to solve or clarify all their possible worries," said Dr. Camille A. Claire, a woman from SUNY Downstate, New York. Dean of the Department of Obstetrics. "We continue the conversation." 

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First published on November 11, 2021 / 1:34 PM

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