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Doctors across Canada are imploring people who are pregnant, planning to get pregnant or breastfeeding to get vaccinated against COVID-19.

Dr. Eliana Castillo, MD, who co-leads a national team studying COVID-19 in pregnant women (the CANCOVID-Preg study), says scientific evidence and international data show vaccination prevents severe illness and hospitalization. With the fourth wave of COVID-19 walloping Alberta, Castillo is seeing climbing numbers of pregnant people needing care in emergency rooms and/or the ICU.

Castillo also adds that the Delta variant has shown unvaccinated pregnant individuals experience higher rates of pre-term birth, leading to their priority vaccination in many provinces.

Not wanting to cause undue alarm, Castillo, a clinical associate professor with the departments of Obstetrics and Gynecology and Medicine at ��ݮ����Ƶ����, refers to Alberta's chief medical officer of health, Dr. Deena Hinshaw, who recently reported that during the first year of the pandemic seven unvaccinated pregnant women were admitted into Alberta ICUs due to COVID-19. In August 2021 alone, six unvaccinated pregnant women were admitted into ICUs with COVID-19, resulting in five pre-term births. In one month, the number of hospital admissions was nearly the same figure as the first and second waves combined.

And as the fourth wave hits Albertans, the doctor says the outcomes could be more dire.

As a result, Castillo worries that some of these women who are fighting COVID-19 won’t be able to properly support their pregnancy. Data from the CANCOVID-Preg study, says Castillo, indicates that chances of admission to intensive care unit, hospitalization, or having a premature birth are several times higher in pregnant individuals with COVID-19. She adds the risk of preterm babies is nearly double that of the baseline population which means some babies can be left struggling with developmental issues.

Between confusing public-health messages, inflammatory social media posts, and the natural desire for a mother to want to protect their baby, Castillo understands the vaccine hesitancy she’s witnessing. “But we know so much more now than we did in December when the vaccines were first approved. Now that we are in a second year of pandemic learning we know what variants can do to moms and babies. Plus, we now have North American data on 150,000 pregnant patients who took a leap of faith and got vaccinated.”

One of the hurdles facing Castillo and her message — “get vaccinated” — is the misconception behind how the mRNA vaccine (made by Pfizer-BioNTech and Moderna) actually works. To begin: The vaccine does not go straight into your bloodstream.

“We have not been clear on that," explains Castillo. “Once the shot goes into your arm, the vaccine enters your lymph nodes which act as a factory that produces protection in the form of antibodies. The vaccine will not get to the baby . . . but the protection you gain, in the form of antibodies, will (usually after two weeks).” She also adds that it is crucial to get two doses to gain full protection.

Evidence also confirms that the antibodies a mom makes after the vaccine are of higher quantity and quality than the antibodies that are made should they have contracted the real COVID infection. In a separate study of breast milk, continues Castillo, “They were also able to see the difference in the type of neutralizing antibodies that a mother who was vaccinated produced compared to those who weren’t and that, too, was superior. Vaccination of pregnant people and lactating people actually leads to the transfer of some immunity to their newborns and lactating infants.”

Although everyone’s reaction to COVID-19 is different, Castillo describes the most dire of circumstances: Some mothers experience a shortness of breath. Others get fevers. Many get so dehydrated that their heart rate is forced to pump in overdrive. And some “may reach a point where they are so short of breath that they just don’t have enough oxygen for themselves and their baby and so that they have to get hospitalized to be intubated and then wind up in ICU,” adds Castillo. “And some just cannot sustain the pregnancy any further and so they end up having emergency caesarean sections and premature babies.”

Of course, most pregnant women who contract COVID-19 exhibit mild to moderate flu-like symptoms, but the fourth wave is threatening to alter that as an increasing number of unvaccinated mothers-to-be are becoming seriously ill with the virus.

“What’s heartbreaking,” adds Castillo,” is that it’s preventable. Get vaccinated. Today.”

To help make an informed decision, here are some helpful resources: