In the face of the ongoing COVID-19 pandemic, the development and distribution of vaccines has been imperative in combating the spread of the virus and minimizing its devastating impacts. While the ethical debate surrounding vaccination is challenging in and of itself, this essay focuses on the importance of COVID-19 vaccination for pregnant women. Women who are pregnant are at a higher risk of COVID-19 infection and severe illness versus non-pregnant women. By considering the principles of autonomy and beneficence, we can establish a strong ethical foundation for advocating vaccination among pregnant women, emphasizing the potential benefits and addressing potential concerns.
In this article, 27 pregnant Midwestern women were asked about the COVID-19 vaccine, what concerns they had about it, how effective they thought the vaccine was, how it would affect their unborn child, and many other questions. These women all have autonomy. They have the power to choose for themselves what they put into their bodies. So, the dilemma that arises from trying to administer the vaccine to these pregnant women is the principle of autonomy vs. beneficence. I believe vaccinating pregnant women against COVID-19 aligns with the principle of beneficence, which promotes actions aimed at maximizing overall well-being. By receiving the vaccine, pregnant women can significantly reduce the likelihood of severe illness, hospitalization, and potential complications, thus safeguarding both their own health and the well-being of their unborn child. As our core PA principles have shown us, PAs must hold as their primary responsibility the health, safety, welfare, and dignity of ALL human beings.
The principle of beneficence also extends to protecting the welfare of the unborn child. During pregnancy, a COVID-19 infection increases the risk of preterm birth, stillbirth, and other adverse neonatal outcomes. Vaccination of pregnant women not only lowers the risk of said infection but also provides the potential for transplacental transfer of protective antibodies to the growing fetus, providing passive immunity and mitigating the chances of infection after birth. By prioritizing maternal vaccination, we can safeguard the health and future well-being of both the mother and the child.
Alternatively, these women expressed valid concerns and reservations about the COVID-19 vaccine, which deserve careful consideration. Most of the surveyed cohort consisted of women from African American and Hispanic backgrounds, communities that have long experienced significant health disparities. These women not only bore the disproportionate burden of health inequities exacerbated by the pandemic but also endured mental health challenges and anxieties associated with being pregnant amidst a global crisis, with reported higher rates of depressive symptoms. In this context, the principle of autonomy came into full swing, as apprehensions about the vaccine were unsurprising given the history of systemic shortcomings within the healthcare system, undermining trust, and fostering understandable hesitancy.
Ultimately, the authors of the article asked the question, “What would most influence their [the woman’s] decision to get vaccinated for COVID-19?” and the answer was surprisingly simple. A healthcare provider who had taken the time to explain, recommend and administer the vaccine was the number one response. With respect to the principle of autonomy, it was essential that these pregnant women were provide them with accurate and comprehensive information about the COVID-19 vaccine to effectively empower them in making informed decisions. Healthcare providers should offer clear explanations of the vaccine’s safety, including available data on pregnant women who have already received the vaccine without adverse effects. By ensuring transparency, accessibility, and open dialogue, pregnant individuals in general can exercise their autonomy in making choices that align with their values and protect their health.
References
Adhikari, E. H., & Spong, C. Y. (2021). COVID-19 Vaccination in Pregnant and Lactating Women. JAMA, 325(11), 1039–1040. https://doi.org/10.1001/jama.2021.1658
Gray, K. J., Bordt, E. A., Atyeo, C., Deriso, E., Akinwunmi, B., Young, N., Baez, A. M., Shook, L. L., Cvrk, D., James, K., De Guzman, R. M., Brigida, S., Diouf, K., Goldfarb, I., Bebell, L. M., Yonker, L. M., Fasano, A., Rabi, S. A., Elovitz, M. A., Alter, G., … Edlow, A. G. (2021). COVID-19 vaccine response in pregnant and lactating women: a cohort study. medRxiv : the preprint server for health sciences, 2021.03.07.21253094. https://doi.org/10.1101/2021.03.07.21253094
Redmond, M. L., Mayes, P., Morris, K., Ramaswamy, M., Ault, K. A., & Smith, S. A. (2022). Learning from maternal voices on COVID-19 vaccine uptake: Perspectives from pregnant women living in the Midwest on the COVID-19 pandemic and vaccine. Journal of community psychology, 50(6), 2630–2643. https://doi.org/10.1002/jcop.22851
