There is new confusion and uncertainty about who will get the shot after federal health officials suddenly changed their Covid-19 vaccine recommendations for pregnant women last month. Currently, 30 health and healthcare institutions are seeking ongoing access to vaccines and insurance coverage.
The organization, which includes key experts in obstetricians, primary care providers, pediatricians, pharmacists and nurses, wrote, “We are deeply concerned that the recently adopted HHS policy will not recommend Covid-19 vaccination during pregnancy.” “It is important that pregnant women continue to have access to this preventative tool, so they can protect themselves and their younger infants.
The letter is called “to payers and insurers to make Covid-19 vaccines available to pregnant people without excessive use management or cost sharing requirements.”
Pregnant women with Covid-19 are more likely to require care in an ICU or ventilator, or when they die, they are at increased risk for complications such as caesarean section, pre-lamps or acupuncture, blood clots and other complications. Infants born after Covid-19 infection are also facing an increased risk.
The letter comes two weeks after US Health and Human Services Director Robert F. Kennedy Jr. suddenly announced that the Covid-19 vaccine, which has been shown to be safe and effective during pregnancy, will no longer be recommended for pregnant people. The U.S. Food and Drug Administration leader recently outlined a new framework for the Covid-19 vaccine approval process.
Experts quickly warned that these changes could create new barriers to vaccines for those who want them, including confusion about eligible patients and higher costs, if insurance no longer covers them.
The American Association of Pharmacists, signing the open letter, said it had already received reports that patients had been denied the Covid-19 vaccine.
Lehi Haldeman, 33, a pregnant nurse at Harborview Medical Center in Seattle, told CNN she had tried twice to get vaccinated last week, telling CNN she turned her back.
“It’s definitely important to me to get the vaccine right now and boost that extra immunity due to some complications during my first pregnancy,” said Haldeman, who won his last shot in the fall of 2024.
At two different pharmacies, she was told that it is not recommended for pregnant women to receive the Covid-19 vaccine based on the new guidelines.
She still couldn’t get a shot.
Many doctors still strongly recommend getting a Covid-19 vaccine during pregnancy.
“Despite the changes in recommendations from the HHS, science has not changed,” the American College of Obstetricians said in a statement. “It is very clear that Covid-19 infection during pregnancy can lead to devastating and major disability, and can have devastating consequences for families. During pregnancy, Covid-19 vaccines are safe and can protect postnatal patients and infants.”
After last week’s appointment, Haldeman agreed to the obstetrician’s advice to get additional Covid-19 shots during pregnancy. Her first attempt was at the Walgreens store where she had an appointment to get the vaccine.
“I went through the entire check-in process, and as soon as the pharmacist saw I was pregnant they said, ‘We can’t give you this,'” she said. “We’re just giving it to people who are immunocompromised right now.”
She said she asked if she was considered an immunocompromised patient because she was pregnant. Haldeman said the pharmacist responded that guidelines had been changed and that it was not recommended and that they would not give it to her.
She then called her primary care provider and obstetrician, but neither of them had the vaccine in stock. For the past few years, pharmacies have managed most of their Covid-19 shots.
A Walgreens spokesperson told CNN: “We will continue to closely monitor and review all federal and state guidance related to vaccines. As regulations and recommendations evolve, our pharmacy teams continue to be committed to ensuring that they are up to date to support patient care.”
Haldeman said her obstetrician suggested that she try another pharmacy. She called Safeway and said, “I’ve been pregnant for 25 weeks. My provider recommends getting this covid booster. Can you give me that?”
The immediate answer was no.
“I’m under the impression I need to get this from a provider,” she recalls saying. “The pharmacy is the only people who seem to have it now. What do you need to do to get this vaccine?”
She said the pharmacist told her, “As of last Friday, the guidelines have changed. We can’t give you that.”
The pharmacist suggested that Haldemann try to get a prescription for the vaccine from the provider so that the pharmacy can administer it. Her obstetrician wrote a prescription for the vaccine and sent it to Safeway Pharmacy, but when Haldeman visited the location at 7pm the same day, she was told the pharmacy had not received the prescription.
In a statement from a company spokesman, Albertsons, the parent company of Safeway, told CNN: “We have adjusted our Covid-19 vaccination policy in accordance with the recently updated CDC guidance. Pregnant individuals with certain medical conditions that increase the risk of severe symptoms remain suitable for vaccination.
The lack of clarity made Haldemann unsure about what to do next.
“I spent half of this. …Most people are probably not going to go to those lengths to get the vaccine. The more hoops you have to jump people, the fewer people will get the vaccine,” Haldeman said. “And you know that having covid during pregnancy will do something terrible for your placenta, and certainly reducing that risk is worth it. So it’s very frustrating.”
The American Association of Pharmacists said in a news release that updates to its Covid-19 recommendations “doesn’t believe they are based on scientific evidence provided over the past few years.
However, pharmacists “can face consequences if they fail to follow the Advisory Committee on Vaccination Practices or CDC Recommendations,” said Allison Hill, the association’s Director of Professional Affairs.
“Recent changes to the HHS and CDC’s Covid-19 recommendations create barriers and confusion,” Hill said.
Following an unusual update to HHS’s Covid-19 vaccine schedule, there was a drastic change to the CDC’s advisory committee on vaccination practices this week. Kennedy said it bypassed ACIP when making changes to Covid-19 and rejected an entire panel of 17 members this week. On Wednesday, Kennedy announced eight new members to ACIP.
The removal of vaccine advisors has led to a rapid backlash from healthcare providers and professional organizations.
Dr. Tinatan, president of the American Infectious Diseases Association, another organisation that signed the open letter, said that eroding the integrity of ACIP was “completely unfounded” and “has a major negative impact on Americans of all ages.”
The Pharmacists Association said Tuesday: “We are extremely concerned about removing 17 scientists overnight to eliminate the historical knowledge, scientific training and clinical expertise needed for pharmacists and the public to make the right choice for their health based on risk.”
Kennedy said doctors are worried about the future of patients and vaccinations since announcing a change in schedule for the Covid-19 vaccine.
“We are concerned about future patients. Patients may be less likely to choose to vaccinate during pregnancy despite clear and conclusive evidence demonstrating their benefits,” Dr. Stephen J. Freshman, president of the American College of Obstetrics and Gynecology, said in a statement. “We are concerned about the impact on access and what this recommendation means for the insurance policy for the Covid-19 vaccine for those who choose to get vaccinated during their pregnancy.
Studies have shown that infants born after Covid-19 infection during pregnancy are at increased risk for stillbirth, difficulty breathing and low birth weight.
“There is a risk of premature birth due to impaired maternal health and the risk of potential loss of a very small baby, or fetal loss,” said Dr. Frol Munoz Rivas, associate professor of pediatrics and infectious diseases at Baylor School of Medicine.
Dr. John Lynch, associate medical director at Harbourview Medical Center and a colleague at Haldeman, said Covid-19 vaccinations during pregnancy also benefit newborns.
“Vaccinating a mother will help protect the baby when there is no immune response,” Lynch said.
Covid vaccines are not available to babies under six months old, so vaccinating mothers may be the safest way for young children to gain some kind of immunity.
“The first year of life is the highest risk, and this is a vaccine-preventable disease,” Munoz said. “We can change the outcomes for these babies through maternal vaccinations and infant vaccinations.”