peace of mind pediatrics :: Article CreatorCOVID Vaccination During Pregnancy Protects Newborn Babies
COVID Vaccination during Pregnancy Protects Newborn Babies
Studies show that vaccination against COVID during pregnancy provides a powerful safeguard for vulnerable infants too young to receive the vaccine on their own
By Shannon Hall
Stock photo. For illustrative purposes only.
ArtistGNDphotography/Getty Images
Vaccines
When Emily Kara was 34 weeks pregnant, she received an additional COVID vaccine. She did not technically qualify for one. She had received her latest dose merely five months earlier, and her midwife even advised against another shot. But Kara (who asked to go by her middle name out of concern for her privacy) was determined. She had read multiple studies that strongly suggested a maternal COVID vaccine would pass along antibodies to her baby girl and protect her after she was born, when she was vulnerable to SARS-CoV-2 (the virus that causes COVID) and too young to receive the vaccine herself.
So Kara received an extra shot. And she is incredibly thankful that she did. "It gives me peace of mind," says Kara, whose baby is now nine months old and has not tested positive for COVID.
The first wave of COVID vaccine trials that began in 2020 excluded pregnant people—leaving expectant parents in the dark as to the vaccine's safety for themselves and their child. But now that millions of pregnant people have received the vaccines, the data are solid. Not only do they show that the vaccines are safe and effective during pregnancy, but a growing consensus is also emerging that vaccinating a pregnant person against COVID can protect their newborn at a time when their little one's immune system is not mature enough to mount its own defense. Some studies even suggest that the protection lasts until roughly six months of age, when infants are old enough to receive their own vaccine.
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The science is relatively simple: when a COVID vaccine is given during pregnancy, the parent's immune system develops antibodies against a protein in SARS-CoV-2 that then cross the placenta to the fetus and thus protect the newborn. This is why pregnant people have long been advised to receive the flu shot and the Tdap (tetanus, diphtheria and pertussis) vaccine. And one vaccine—the respiratory syncytial virus (RSV) vaccine approved last year—was even developed specifically to be given during pregnancy to protect the baby after birth. "That is something that we really ought to be leveraging for COVID as well," says David Kimberlin, a pediatric infectious disease specialist at the University of Alabama at Birmingham. "I think the data are clear."
A study published in March in Pediatrics from the National Institute of Allergy and Infectious Diseases (NIAID) found that mothers who received an mRNA-based COVID vaccine during pregnancy protected their infant against symptomatic COVID infection for at least six months after birth. Last fall the U.S. Centers for Disease Control and Prevention similarly noted that infants born to women who had received a COVID vaccine—be it the primary series or a booster—at any point during pregnancy had a decreased risk of COVID hospitalization compared with infants who were born to women who had never received a COVID vaccine. And a study published in Nature Medicine in March 2023 found that newborns born to mothers who were vaccinated with a third (booster) dose were half as likely to be hospitalized for COVID as newborns born to mothers who had received the primary series and were eligible for a third dose during pregnancy but had not received it.
This protection is great news given COVID's risk to newborn babies. "One of the facts that gets lost in the general public is that in the pediatric population, COVID is most severe among young infants, resulting in the highest rates of hospitalization and death in this young age group," says Cristina Cardemil of the NIAID, who led the Pediatrics investigation. The hospitalization rate in babies under six months increased during the Omicron period and rivals that of adults aged 65-74. Not only have these infants never encountered these infectious diseases but they also have small airways and become dehydrated easily. "They're doubly at risk for being vulnerable to a number of infectious diseases," Cardemil says.
Now expectant parents have a tool to shield their baby. Multiple studies show similar findings, and many suggest that a COVID booster during the second or third trimester confers the best protection. The Nature Medicine study authors write: "We anticipate that future guidelines will adopt recommendations for routine COVID booster vaccination during the third trimester, aiming to reduce early infant morbidity, similar to recommendations for pertussis and influenza prevention."
And yet that is not the case. The CDC currently recommends that everyone, pregnant people included, receive the most recent version of the COVID vaccine, but it does not recommend an additional booster to ensure vaccination during pregnancy or point toward a specific administration time. For example, a pregnant person could receive a COVID vaccine in the fall before conceiving and deliver a baby before the next fall vaccine is released—thus missing out on the benefits that an extra vaccine dose confers. The World Health Organization does recommend a single additional dose of the COVID vaccine during pregnancy, but this guideline seems to be the exception. In January, for example, Canada's National Advisory Committee on Immunization provided guidance on who should get an additional spring booster, and pregnant people were not mentioned. The same was true for the U.K.'s spring booster campaign. (Guidelines from both countries note that the vaccine is safe and effective during pregnancy.)
The issue, experts say, is COVID fatigue. Governing agencies must make recommendations based on what is actually feasible, and an extra booster might be a hard sell when so few pregnant people are up to date on their COVID vaccine in the first place. In the U.S., for example, a mere 13 percent of pregnant people aged 18 to 49 have received the updated 2023–2024 COVID booster. "People are very lackadaisical about it," says Laura Riley, chair of obstetrics and gynecology at Weill Cornell Medicine in New York City. "And I'm in a place where people get vaccinated." So the CDC has streamlined the most important message: vaccination protects against disease.
In response to a request for comment, a spokesperson from the CDC said: "Available data show the vaccines for all eligible people—including pregnant people—continue to be strongly protective against severe illness and death." For that reason, the agency recommends that pregnant people stay up to date on their vaccines, but it will continue to review available evidence on whether additional or differently timed doses might be needed.
Yet many experts argue that the recommendation does a disservice to pregnant people, who are at heightened risk from the disease, and their newborn. "The politicization of vaccines has led to this vaccine not being utilized as much as it should be," says Sallie Permar, chair of pediatrics at Weill Cornell Medicine and pediatrician in chief at NewYork-Presbyterian Komansky Children's Hospital. She argues that the COVID vaccine clearly falls into the same category as the flu and Tdap vaccines, whose "safety records and the benefits to both mom and baby have just been universally awesome."
Kimberlin agrees and is hopeful that the tides will soon shift toward stronger recommendations and a higher vaccine uptake during pregnancy. "This is a very easy way to keep your baby safe," he says. "And it absolutely should be recommended vigorously."
What Does Your Peace Of Mind Look Like? Finding Financial Tranquility In A Volatile World
If you did a scan of financial advisory websites, you'd find a lot of similarities. Lots of photos of happy people in the active phase of their emerging retirement, most of whom have the same three hobbies: golf, sailing, and long walks on the beach. As for the words and phrases, I'd bet that some version of "sleep at night" or "peace of mind" is ever-present on these websites, too.
Indeed, peace of mind is one of (if not) the greatest benefits to be derived from wise wealth management. Yet, much in the same way that there are a lot more than three hobbies in the recently retired affluent set, peace of mind is not a singular state of being. Peace of mind looks different from one person to the next, and we must not presume what will bring it—and what will take from it—in financial planning.
So, what does your peace of mind look like?
What does YOUR peace of mind look like?
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If it's endless golf, sailing, or long walks on the beach, that's great! But I think we could agree that peace of mind is less something we do, and more a state of being. While some may find their happy place on a par four in Augusta, others (myself included) may reach the height of their agitation at the tee box, or in the rough rough, or fishing a tiny dimpled ball out of the bottom of a pond.
Let's consider for a moment a fourfold framework that can help us identify what brings us peace of mind at any phase of life and with any level of net worth, and the associated dangers with each of these individual orientations:
Grow
Growth-oriented people may find comfort, however ironically, in pursuing higher highs, believing that growth solves all. If you're a Grow person, you likely spend more resources than most today in recognition that you can make more tomorrow. Yet, you may also have a future orientation—always thinking about the next success, sometimes even before your current project is complete. You likely prefer taking on the greater risks often required for higher gains, and you may be a minimalist when it comes to insurance. Yes, peace of mind to a Grow person may look more like activity than tranquility.
One of the dangers of those with a growth orientation is that they tend to connect their self-worth to their net worth, viewing their "number" as in competition with, well, everyone else. And because there is always someone who has experienced more success, this can lead to perpetual dissatisfaction for the growth-minded.
Protect
The most risk-averse will find greater comfort in life when they feel optimally protected from financial discomfort. If you're a Protect person, you will typically desire a higher level of cash on hand to fend off emergencies and fund surprises. You likely lean toward a less volatile portfolio structure and focus intently on ensuring insurable risks are well covered. You may even prefer a more predictable career with a steady paycheck from a stable company or institution. Simply put, Protect people find peace of mind in the size of the moat, to steal Warren Buffet's analogy, around their castle.
The danger protectors face is that they may live in fear of the unknown and, worse yet, the unknowable, spending too much of their money and mind space on protective measures.
Give
Our preference for self-preservation is less evident in those who have a giving or serving orientation. Acts of service don't drain these folks, nor are they fearful that their generosity could put them at risk financially, personifying the Scriptural belief articulated by Jesus, "Give and it will be given to you…For with the measure you use, it will be measured to you." (Luke 6:38 NIV) Faithful givers, somewhat paradoxically, feel safer when they are sharing their financial resources with others. That's where they derive peace of mind.
The pothole I find givers stumbling over is that they may feel guilty about their own financial success with such evident unmet worldwide needs. In the most challenging cases, givers may even subconsciously sabotage themselves financially.
Live
If growers find peace of mind in pursuit of a future ideal, protectors feel safer knowing they are buffered from the unexpected, and givers find greater contentment in the service of others than themselves, those with a Live orientation are especially focused on the present moment. They find peace of mind in knowing that their income is secured sufficiently so that they can live today as they choose, prioritizing flexibility and spontaneity in their lives.
As you might guess, an over-correction with a present orientation can lead to an unwillingness to learn from the lessons of the past and willful blindness that, while not promised, the future is quite likely to come.
So, as you read these four peace-of-mind postures, where do you find yourself gravitating? Is there one of the four where you identify most closely?
Please recognize that I'm not suggesting we each fit neatly into one of these boxes. Most of us will exhibit traits from all four; therefore, it may be helpful to order from most likely to least to understand yourself better. For example, I'm likely a Grow-Live-Give-Protect-person, but I can identify with traits from each.
Personally, I find that adequately planning in each of these categories brings me, and the clients I've been privileged to work with, the most peace of mind. For further reading on how to do that, here is A Simple Framework For Activating Your Wealth. Because in the end, true wealth isn't a number. I believe true wealth is peace of mind, so that you can pursue the things in life that are most important to you.
Peace Of Mind: Offsetting Stress Is A Process Worth The Investment
Depression, anxiety, grief — these are some of the stress manifestations that can wreak havoc on older adults' mental health. If left unchecked, that stress can often show up in physical ways, according to a local expert on aging.
"I think it's important to know what stress means," Cristina Pritchett, a geriatric psychiatrist with the Emory Brain Health Center's Fuqua Center for Late-Life Depression, told The Atlanta Journal-Constitution. "It is a state of worry or mental tension that is caused by a difficult or challenging situation. We understand that low levels of stress are normal. In fact, stress has some survival values that prompt us to respond to threats. Higher levels of stress and negative ways to cope or respond can be pathologic and can lead to negative consequences."
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Addressing stress, whether it's from minor things or life's weightier pressures, has its challenges, but putting in the effort can offset more serious health challenges later.
Credit: contributed by the Marcus Jewish Community Center of Atlanta
Credit: contributed by the Marcus Jewish Community Center of Atlanta
Understanding stress
That process begins with understanding types of stress and how they arise.
"Minor things are challenges that are short-lived or transient, like maybe somebody runs out of gas, or they're stuck in traffic or in the middle of a crowd or running late to an appointment," Pritchett said.
Major stressors are the more persistent issues older adults must learn to navigate, like chronic illnesses.
"Dealing with these illnesses can be, per se, a stress-inducing factor," Pritchett said.
An inability to live independently, drive safely, or manage one's own routine and finances, she pointed out, can make a person's everyday life less recognizable. This loss of autonomy can also cause ongoing tension.
Other contributing factors, she said, can be loneliness, which is common among seniors, and caregiving responsibilities, which often increase as couples grow older together. Transition points like death of loved ones, divorce or moving into a new living situation can be overwhelming, too.
"Retirement can be a stressing factor as well for a lot of our patients," Pritchett said. "I think, especially, for those who don't really have a hobby where they can dispose time."
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Credit: Contributed by the Marcus Jewish Community Center of Atlanta
Credit: Contributed by the Marcus Jewish Community Center of Atlanta
Offsetting factors
Rapid heart rate, muscle tension, cortisol production, inflammation — these are all physical signs of stress in the moment, Pritchett said. But over time, according to the Mayo Clinic, the compound result of stress responses can be longer-lasting health risks like anxiety and depression, sleep problems, high blood pressure, heart attack and stroke.
So, what's the best way to head off these more serious issues?
Pritchett has some recommendations:
Talk therapy: Approaches like cognitive behavioral therapy can allow patients to better understand their own thoughts and use adaptive thinking to lower their own stress levels. This option depends on a person's cognitive status; memory problems will hamper engagement, she said.
Socializing: Keeping in touch with family and friends can reduce stress and increase resilience.
Exercise: Seniors need to tailor activities around any physical limitations, but moving around can stimulate production of endorphins, which Pritchett said have painkilling and mood-lifting properties.
"The American Heart Association recommends at least 150 minutes per week of moderate-intensity aerobic activity," Pritchett said. "Depending on the patient, they can add muscle strengthening activities at least two times per week."
Diet: Keeping food intake healthy and balanced is key. The Mediterranean diet — lean meats, whole grain cereals, and fruits and vegetables — is a helpful guide, Pritchett said, and it can reduce stress-inducing inflammation.
Sleep: Adequate rest can bring down hormones related to cortisol, Pritchett said, and it can reduce anxiety and stress.
Support groups: Participants can join others facing similar circumstances, like caregiving, grief, or physical and mental health conditions.
Meditation: Mindfulness meditation can reduce stress levels by teaching practitioners to calm racing thoughts, relax muscles and reduce negative feelings.
Credit: Courtesy of Jennifer Curry
Credit: Courtesy of Jennifer Curry
Finding local resources
Finding local resources can be the first step for older adults looking to offset stress. That support can look like social groups, health-related services or simply assistance with navigating everyday challenges. The search for fulfillment of basic needs can be distressing in and of itself, though. It's a circumstance AgeWell Atlanta manager Jennifer Curry understands well.
"The people who call us," she said, "99% of them are stressed."
AgeWell is a four-agency collaborative, which, via its 1-866-243-9355 telephone line, connects seniors with local resources from recreational activities to social services to long-term care options and caregiver support groups.
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"We provide what's called warm hand-offs. So, if we have an hourlong conversation with someone, and then, they are looking for assistance, we maybe identify three or four things that they could possibly take advantage of," Curry said. "If we can't fulfill their needs within our network, we have a lot of trusted community partners that we also refer them to."
Transportation resources can restore some degree of independence and a reduction in daily stress, she added.
And for a longer-term approach to calm and enrichment, there's the Agewell Atlanta Neighborhood Program administered through the Marcus Jewish Community Center of Atlanta in Dunwoody.
Neighborhood programs run the gamut of social outings, educational classes and physical activities, including local museum trips, support groups, nutrition counseling, pickleball and chair yoga. There's even Yiddish language instruction, with participants coming from all faiths and backgrounds, Curry said.
Neighborhoods classes, such as the language course, went virtual during the pandemic and have remained that way. Curry said it's a great option for older adults looking to meet people before moving to the area.
"What we've had people tell us is that these events are invaluable for them because of the social connection," she said.
Each year, AgeWell holds its annual Senior Day, a mini-conference that provides attendees with lunch and AgeWell resources. This year, the event will take place Thursday, April 11, at MJCCA, Curry said, and there will be a bus transportation option for those who need it.
Credit: Georgia Meditation Center
Credit: Georgia Meditation Center
Calming the mind
Coming to terms with aging and its inevitable transitions can affect a person's state of mind, but regular meditation can help with perspective, according to Bee Intakanok, president of the the Georgia Meditation Center in Dunwoody. She's seen firsthand the benefits of meditation, both at the center and while teaching the practice at Altria Senior Living in Milton.
Regular meditation, she explained, can allow practitioners to face life's hecticness with response instead of reaction.
"When you meditate, you're learning to calm and still your mind and be patient with yourself and listen to yourself and find out who you are by not doing anything," she said. "When you actually make an effort to quiet your mind and stay in place and breathe or close your eyes, you start to learn to allow yourself that space that you need."
The center holds nonreligious meditation sessions each week. A "community of spiritual friends" meditates, cultivates mindfulness and encourages one other in good deeds, Intakanok said.
Meditation participation later in life is sometimes the result of a more flexible mindset. Intakanok has seen a distinct receptiveness in the seniors she's taught.
"They're more open a lot of times because they've had more wisdom and more experience in life. They're just a lot more willing to try different things and look at things in a different perspective. I think younger people aren't always there yet," she said. "Seniors are looking for more substance and more depth and more peace of mind."
AgeWell Atlanta Senior Day
9:30 a.M.-2 p.M., Thursday, April 11 at Marcus Jewish Community Center of Atlanta, 5342 Tilly Mill Rd., Atlanta, $15. Atlantajcc.Org/seniorday. Call 678-812-4010 and mention you saw this story in the AJC for $10 AgeWell rate.
Georgia Meditation Center meditation sessions
7 p.M.-8:30 p.M., Wednesdays. Georgia Meditation Center, 4522 Tilly Mill Rd., Atlanta. 770-452-1111.
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