A16 EZ RE K THEWASHINGTONPOST.FRIDAY,APRIL 1 , 2022
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VectorGroupLtd 12.04 13.
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IBM 130.02 -1.6 -2.
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extravaccinedosesforAmericans
who are 50 or older.
Hughes predicted thatfederal
health officials eventually will
addpregnancytothe listoffac-
tors thatare groundsfor extra
booster shots.
Thestudyfoundthatseveral
conditions poseonly aslightly
greater risk of vaccinated people
experiencing infections com-
paredwith peoplewithoutthose
conditions.They includekidney,
liver and blood disorders.Pa-
tientswithlungdiseaseshad a
slightlyhigherrisk —30percent
greater than patients without
thosediseases.Ontheotherhand,
cardiovascular diseasesappearto
create no addedrisk, and patients
withcancershad slightlylower
oddsof breakthroughcasesthan
thosewho are cancer-free.
Thefindingsdo not explainthe
reasonbehindthe risk levels. De-
nise Jamieson,aspecialistinin-
fectious diseasesduringpregnan-
cy,calledthehighriskofinfection
amongvaccinated pregnantpeo-
ple an “interesting and intriguing
finding.”
Jamieson,chairof gynecology
and obstetrics at EmoryUniver-
sitySchoolofMedicineinAtlanta,
said the findingcouldreflectthat
such peopleare morelikely to get
tested, becausetheyare receiving
prenatal care, putting themin
unusuallyfrequentcontactwitha
health-careprovider.
AndHughesnotedthatcorona-
virustesting has becomeroutine
whenpregnantpatientsare ad-
mitted to laborand deliverycen-
ters.As aresult,she said,it is
possiblethatmore positivetests
maybedetected amongsuch pa-
tients,even whentheylack symp-
toms, compared with people
whosemedicalconditionsdo not
lead to routinetests.
Jamiesonsaid the findingalso
couldsuggestthatpeopleofchild-
bearingagetend to be in jobs,
such as teachingor nursing,that
putthemat uncommonlyhigh
risk of exposureto the virus.At
the sametime,she said,the ap-
parentlyhigh risk of abreak-
throughcaseduringpregnancy
couldbe aresultof the waythe
study matchedits pairsof pa-
tients.
Or,Jamiesonsaid,the study
couldactuallyreveal thatpreg-
nantindividualsaremoresuscep-
tibleto becominginfected with
the coronavirus,even whenvacci-
nated.
“It’sdefinitelyinteresting,” Ja-
miesonsaid. “This study asks this
question but doesn’tanswerit.”tive directorofthe American
Public HealthAssociation, said
theEpic findingspointtoaneed
to understandwhetheritismost
helpful to be vaccinated before
becomingpregnantorsoonafter-
ward, themostuseful time inter-
valbetweenshots and whatdos-
ageisbest. Thosequestions ap-
ply,hesaid,tothe well-beingof
pregnantpatients and their ba-
bies.
“There’s lots of good scienceto
be had here,”Benjaminsaid. But
for now,headded, “people
shouldn’t panic.Youare not get-
ting sick becauseof the vaccine.It
arguesthatyou probablyneeda
little moreof the vaccine.”
Theanalysiswas basedon Epic
medicalrecordsfrom 13.8 million
patientsbetween January2021,
whenthe firstpeoplein the Unit-
ed States werefullyvaccinated
and had enoughtime to develop
immunity, and late Januarythis
year.Littleand colleaguesana-
lyzedthe risk from12 comorbidi-
ties throughoutthatperiod.The
study includedthe deltaand omi-
cronvariantsurges but did not
differentiate the rateofbreak-
throughinfectionsduringthose
waves or othertimes.
Theresearchersmeasuredthe
risk by analyzingthe recordsof
pairsof fully vaccinated patients
fromthesamepartofthecountry.
In each pair,one patienthad the
conditionthatwas beingmea-
sured,and the otherdid not. The
patientswerenotmatchedbyage,
and the pregnantpeoplecould
havebeenmatchedintheanalysis
with aman or awoman.
Theanalysisfoundthatthe
110,000pregnantindividualsin-
cludedin the study were90 per-
centmorelikely to have been
infected withcoronavirus than
the samenumberof peoplewho
were not pregnant. Thenext-
highestrisk —80percentgreater
—was amongorgantransplant
recipients. Theelevated risk
amongthose twogroupswas
higher than amongpatientswith
compromisedimmunesystems,
who had 60 percentgreater odds
of coronavirusinfection.
Thefactpregnancyappearsto
pose agreater risk than having a
weakened immune system is
striking,because public health
officials have warnedthatbeing
immunocompromised can ren-
dercoronavirus vaccinessignifi-
cantlyless effective. Federal regu-
lators allowedpeoplewith immu-
nitytroublesto getafourth shot
substantiallybefore guidance
shifted this weekto permitthepercentof peoplewho werepreg-
nanthad beenvaccinated before
or during their pregnancy, ac-
cordingto federal data, though
disparitiespersistamongracial
and ethnic groups.
Thenew study goes beyond
whathas previouslybeenunder-
stood, suggesting thateven preg-
nantpeoplewho are fully vacci-
nated tend to have less protection
fromthe virusthanmanyother
patientswith significantmedical
problems.
“If you are fully vaccinated,
that’smagnificent,”said alead
authorof the study,David R. Lit-
tle, aphysicianwho is aresearch-
er at Epic,aWisconsincompany
thatmaintainselectronicpatient
recordsfor nearly1,000hospitals
and more than 20,000 clinics
across thecountry. “But if you are
fullyvaccinatedandbecomepreg-
nant,you remainat higherrisk of
acquiringcovid.”
Little said the findingsbuttress
CDC recommendations thataddi-
tionalprecautionsagainstthe vi-
rus shouldbe taken duringpreg-
nancy, suchaswearingmasksand
maintainingsafe distances.He
said the study also suggeststhat
health-careworkers should“be
onthelookout”forsymptomsand
encouragetesting to detectthe
virusearly,when it is easierto
treat.
Thedataalso raises scientific
questionsthatwarrant further
researchinto how besttoprotect
pregnantindividualsand their
babiesfrominfection,according
to publichealthleadersand spe-
cialists in pregnancy.
“Tome, the mostimportant
questionthenewstudyraisesis,is
therean increasedrateofsevere
illness and death in pregnantpa-
tientsafter acertain period of
time”followingvaccination, said
BrennaL. Hughes,vice chairfor
obstetrics and qualityatthe Duke
UniversitySchoolofMedicineDe-
partmentof Obstetrics and Gyne-
cology.
“I have not admitted asingle
vaccinated patient to the ICU.Ev-
eryone hasbeen unvaccinated,”
Hughessaid.“Ofcourse,weworry
as boosters wane.”Thereis no
researchevidenceon whether the
protection conferredby coronavi-
rus shotslasts as long for preg-
nant peopleas it does for others.
Thestudydid not assesshow
sick the patientsbecamewhen
theywere infected with covidaf-
ter having been vaccinated.
GeorgesC.Benjamin, execu-VIRUSFROMA
Pregnancy, breakthrough covid studied
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