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COVID-19

Pregnancy May Make Some People Eligible For COVID-19 Vaccine Under Phase 1B

A medical professional administers a COVID-19 vaccine on Feb 13, 2021.
Phil Roeder/FLICKR (CC-by-2.0)
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A medical professional administers a COVID-19 vaccine on Feb 13, 2021.

While not explicitly stated in Montana’s COVID-19 vaccine distribution plan, the state health department says pregnancy is a major medical condition that may qualify someone for a shot under the current phase.

Elle Ruis, a seventh grade math teacher at Kalispell Middle School, says she has wanted to get a COVID-19 vaccine as they’ve become more available.

“I just feel like in my job, I’m really exposed constantly to tons and tons of people and at a high risk of catching COVID,” Ruis says.

Ruis says she’s excited to get her first shot in the arm this week through the Federal Retail Pharmacy Program, which offers vaccines to school and child care workers regardless of state distribution plans.

But Ruis may have been able to get a vaccine a lot sooner due to a major medical condition.

“I’m just entering my second trimester. We’re expecting a boy,” Ruis says.

The Centers for Disease Control and Prevention list pregnancy as a condition that puts people at increased risk of severe illness from the virus that causes COVID-19. Pregnancy falls into a category that includes cancer, chronic kidney disease and Down Syndrome.

“Practically speaking, what we know about COVID-19 and pregnancy is that pregnancy increases the risk of COVID. So pregnant people have an increased risk for severe illness,” says OB/GYN and researcher Anne Lyerly on a recent webinar about bioethics for pregnant people.

She says COVID risk multiplies for someone who has a certain medical condition and is also pregnant, and pregnant people --

“They have increased risk for ICU admission, mechanical ventilation, preterm birth and death, and Black and Hispanic individuals bear a disproportionate burden of infection, morbidity and death, including in the context of pregnancy,” Lylery says.

Montana’s Chief Medical Officer Greg Holzman says around 250 of the more than 100,000 known COVID-19 cases in the state were people who were pregnant. He says 11 were hospitalized and that they all had pre-existing conditions. Holzman says there have been no recorded deaths of pregnant people with COVID-19 in Montana.

“I think one point that’s really important to make in this is that the risk overall for pregnant women is low but when you compare a pregnant woman of the same age and health background, pre-existing and everything, with someone who is not pregnant, they would show a higher risk,” Holzman says.

Under Phase 1B and 1B+ of Montana’s vaccination plan, pregnancy is not specifically listed as one of the high risk medical conditions that qualify someone older than 15 for a vaccine.

But Holzman points to the text at the end of the list that says “on a case by case basis, medical providers may include individuals with other conditions that place them at elevated risk for COVID-19 related complications.”

“If your provider feels that you should get vaccinated, you can within that 1B group, and that was specifically to look at the issue of pregnancy,” Holzman says.

The American College of Obstetricians and Gynecologists says pregnancy specific data on the COVID-19 vaccines is lacking but vaccines should not be withheld from pregnant people. The CDC says getting vaccinated is a personal choice for people who are pregnant and recommends they talk to their doctor.

“They can kind of go through that discussion with them about what we know about the vaccines and what we don’t know and risk and benefits and then make an informed decision together,” Holzman says.

Teacher Elle Ruis says that’s what she did last month. She talked to her doctor about getting the vaccine and then reached out to the Flathead Public Health Department. Ruis says she was told she did not qualify. She says maybe she could have gotten a vaccine if there had been better communication between state and local health departments and with the public.

“The way things have been dealt with so far just kind of seem kind of slap dash, and it makes sense because everyone is just trying to keep up with what’s going on, and I know people are understaffed and everything, but it’s just difficult with the lack of communication and difference in communication. That’s frustrating,” Ruis says.

“Do you feel like there’s a lack of communication or maybe not all health departments know that, that could qualify somebody?” Rachel Cramer asks.

“Yeah, there could be continued conversation on that,” Holzman says.

“The bottom line on all of this is we only have so much vaccine, and the supply is still less than the demand, and we’re trying to get it out to some of the most vulnerable people first, and trying to figure out how to do that at the population level with some assistance for individuals through their providers."

Holzman says he recommends pregnant people who have consulted with their medical provider to take a doctor’s note to the health department to get a vaccine. He says if there are problems, contact the state health department, which can work with the local health department.