Important COVID-19 Vaccination Information

December 2020

We hope that the fresh fallen snow brought a moment of calm in our otherwise busy lives, especially during the holiday season.

We are getting many questions about the COVID vaccine, primarily from our gynecology patients who are thinking about getting pregnant and those who are currently breastfeeding. The arrival of the first COVID vaccines is an exciting and hopeful new chapter in turning a corner in this global pandemic. Along with the American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine, we applaud the FDA’s decision to include pregnant and lactating women in the Emergency Use Authorization. While pregnant women were not included in the clinical trials investigating the safety and efficacy of the vaccination series, pregnant women who are at high risk of contracting COVID-19, including many of our pregnant healthcare and front-line workers, are encouraged to consider vaccination. Here is a link to ACOG’s official statement: Vaccinating Pregnant and Lactating Women Against COVID-19.

The currently available COVID vaccines are mRNA vaccines. mRNA is a genetic code for proteins, in this case the SARS-CoV-2 spike protein. This allows the body to produce antibodies to this protein. The COVID vaccines are not live vaccines; no active infectious particles are injected. The mRNA in the vaccine has been shown to rapidly degrade by the body’s usual mechanism. In addition, the mRNA does not enter the cell’s nucleus, which means that there is no risk that the mRNA will cause genetic modification to the person receiving the vaccine.

In addition, the currently available COVID vaccines appear to be highly effective. Even patients who have had COVID-19 are encouraged to consider vaccination.

These facts are highly encouraging.

Of course, the lack of data in pregnant women is frustrating – but we hope that ongoing studies will give us increasing confidence in the safety of the vaccine in pregnant women. At this time, consistent with the recommendations put forth by ACOG and SMFM, we recommend that pregnant women at high risk of contracting COVID-19 (including health care and front-line workers, especially those with high-risk underlying medical conditions) consider vaccination.

Non-pregnant women, women who are trying to conceive and women who are currently breastfeeding are strongly encouraged to vaccinate. It is clear that there is no evidence that vaccination leads to issues with fertility and our top reproductive scientists at Yale have refuted any scientific plausibility. Thus, women without contraindications who are considering getting pregnant or who are breastfeeding should receive the vaccination without reservation.

It is important to understand that vaccination does not alleviate the need to continue to use the now well-established precautions to prevent the spread of infection: wear masks, wash hands frequently and maintain social distance. We are seeing an increase in cases in our community. Please maintain vigilance in your infection prevention efforts. SARS-CoV-2 seems to spread primarily through respiratory droplets produced when an infected person coughs, sneezes or talks, and therefore basic but consistent precautions can be taken to reduce the risk of contracting COVID-19. As mentioned above, these measures include

• frequent handwashing: wash your hands (well) for at least 20 seconds, making sure to scrub all surfaces up to your wrist: your hand, fingers, between fingers and under fingernails. If soap is not available, use hand sanitizer containing at least 60% alcohol, rubbing your hands until they are dry.

• wearing facemasks: wearing a mask that covers your mouth and nose can prevent those who have the virus (including asymptomatic carriers) from spreading it to others and can protect the wearer from contracting infections. Cloth masks should be made of two or more layers of washable, breathable fabric and fit snug to the face. Wear your facemask in public settings and when around people who don’t live in your household, especially when social distancing measures are difficult to maintain.

• avoiding close (<6 feet) contact with people: SARS-CoV-2 spreads primarily among people who are within 6 feet of each other for at least 15 minutes over a 24 hour period. Virus transmission can occur when an infected person coughs, sneezes or talks. People can have no symptoms and still spread the virus. This is particularly important indoors where poor ventilation has been linked to increased rates of transmission.

• disinfection of frequently touched surfaces: the virus can live on some surfaces for a period of time, though just how long is not entirely known. Make sure to wash your hands after touching anything that may have been contaminated – door handles, outdoor railings, computer keyboards, etc. Disinfect frequently touched surfaces.

• keeping holiday gatherings small: getting together in person with family may be difficult as the weather becomes colder and we move indoors. In addition to stocking up on warm clothes so that you can stay outside as long as possible, start planning ahead for these types of gatherings. Consider quarantining for 14 days ahead of the event and/or having everyone get COVID testing. Limit the size of your gathering. Interact outdoors when possible. Avoid sharing food. Use disposable cups, plates and utensils. Consider spreading out eating areas so that people can remain distanced while eating without masks. Take special precautions to protect your elderly relatives who are particularly vulnerable to the virus.

• get your flu shot!: while the same measures we are using to prevent the spread of COVID-19 will also help prevent the spread of flu, influenza remains a risk – to pregnant women in particular. We have flu shots available. If you have an upcoming appointment we can give you the flu shot then; otherwise please call and we will bring you in for a shot prior to your next visit.

OFFICE UPDATES:
OFFICE HOURS: Our offices are open Monday through Friday from 8am to 5pm. We are busy trying to accommodate a backlog of patients from the spring, so please be patient with us as we work to schedule appointments for you. We continue to carefully space our patients to adhere to appropriate social distancing and infection control procedures, which limits our capacity. Please let us know if you have an urgent issue, and we will do our best to accommodate you in a timely fashion.

CORONAVIRUS SCREENING: All patients are pre-screened by phone and undergo additional screening at check-in for recent travel, symptoms of COVID-19 and recent contacts with confirmed or suspected COVID-19. In addition, we are conducting routine temperature checks for both our patients and our staff. Be assured that we are not allowing patients with symptoms or known infection to come into our offices. If you are sick with COVID-19, however, and need care, please reach out to us so that we can coordinate the best approach to provide you with the care that you need. All patients continue to come alone to all appointments, and appointments are spaced to optimize our ability to directly move patients to the exam room and minimize time in the waiting room.

INFECTION PREVENTION: We meticulously sanitize our exam rooms and all equipment used in the course of your care, as well as high-touch surfaces. We have clear physical barriers at check-in and check-out as an added layer of protection beyond the masks that you and we are already wearing.

FACEMASKS: Very good data supports the efficacy of facemasks in reducing the risk of transmission of COVID-19. As such, to protect both you and our staff, we will routinely wear facemasks while interacting with you. We also ask that you wear a facemask to your appointment. This added layer of protection is appropriate and will protect both you and us. A regular surgical mask or homemade fabric facemask is just fine. If you need a facemask, please let us know. We have a limited supply of extra masks that we can give to you.

VISITOR POLICY: We continue to request that all patients come to office appointments unaccompanied, including partners and children. This includes appointments in our office as well as for outpatient ultrasounds. We have started to allow a single support person to accompany our patients to their first pregnancy ultrasound, so you may see an occasional partner in the offices.

MENTAL HEALTH: Many people are experiencing anxiety, depression and other mental health issues during the pandemic, as it is a time of stress and uncertainty. Make sure you are taking care of yourself.

PERSONAL SAFETY: We know that some of our patients are suffering in silence, and we want to encourage you to speak up. Whether you reach out to us over the phone, through MyChart, or during an office appointment, we want to remind you that you can safely and confidentially share with us any concerns you might have about intimate partner violence, food insecurity, or other devastating impacts the coronavirus has caused to your life. We want to help. There is a statewide hotline that is open 24/7 at 888.774.2900 or online at www.CTSafeConnect.org. The Special Supplement Nutrition Program for Women, Infants and Children (better known as “WIC”) provides supplemental food, nutrition services, health care referrals and breastfeeding support to low income pregnant and postpartum women and to children up to age 5. If you have lost your job, you have 60 days to enroll in health care access through Access Health CT, Connecticut’s health insurance marketplace.

This unprecedented time brings unusual challenges, but as always we are all in this together. Please know that we continue to be here for you.

Warm Regards,

Thomas Hanson, MD, FACOG
Musa Speranza, MD, FACOG
Steven Fleischman, MD, FACOG
Michael Reel, MD, FACOG
Margaret Baumbusch, MD, FACOG
Meagan Haynes, MD, FACOG
Erin Moroni, FNP-BC