APHA Signs On Open Letter Urging COVID-19 Vaccination Coverage in Pregnancy

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Contact: Media Relations

Open Letter Urging COVID-19 Vaccination Coverage in Pregnancy

The American Public Health Association joins the American College of Obstetricians and Gynecologists and dozens of organizations in an open letter urging COVID-19 vaccination coverage in pregnancy. We call upon payers and insurers to continue making the COVID-19 vaccine available to pregnant people without undue utilization management or cost-sharing requirements. As organizations dedicated to public health and evidence-based health care for pregnant patients, we are particularly passionate about ensuring equitable and free access to these critical vaccines. We are deeply concerned about the recently adopted HHS policy to no longer recommend COVID-19 vaccination during pregnancy. Given the historic gaps in research, investment, and support for women’s health, it is essential that all aspects of obstetric and gynecologic care—including COVID-19 vaccination—be grounded in the best available scientific evidence.

Research has shown that pregnant women who have COVID-19 are more likely to need care in an intensive care unit or with a ventilator, or to die from the illness. They are also more likely to have cesarean birth, preeclampsia or eclampsia, and blood clots. COVID-19-related complications are worse in pregnant women with particular comorbidities (eg, hypertension and obesity) and socioeconomic risk factors. These pregnant patients may face greater obstacles to optimal health due to social, economic, or environmental disparities.

We also understand that the severe effects of COVID-19 infection are not limited to those who are pregnant. Studies demonstrate that infants who are born following a COVID-19 infection during pregnancy are at an increased risk of low birth weight, stillbirth, respiratory distress, and rarely, vertical transmission. Data also continue to demonstrate that COVID-19 vaccination during pregnancy is safe and effective, and that it protects pregnant patients and their infants after birth. In fact, the vast majority of infants under six months who were hospitalized due to COVID-19 infection had not received the protective benefit of vaccination during pregnancy. It is vital that we ensure that pregnant women continue to have access to this prevention tool so that they can protect themselves and their young infants, a vulnerable group who is not yet eligible for vaccination.

Our organizations assert that we must continue to prioritize high levels of COVID-19 vaccine coverage in pregnant patients to protect them and their infants after birth from undue morbidity and mortality. The science around the benefits of COVID-19 vaccination in pregnancy has not changed; therefore, we maintain our position and strong recommendation that all pregnant patients should continue to receive the COVID-19 vaccine. As such, payers should be fully reimbursing for the cost of providing immunization counseling and administration services for all evidence-based vaccinations without utilization management practices or cost-sharing requirements for all patients, including pregnant patients. Payers have the authority to go above and beyond the baseline federal recommendations for vaccinations and can provide equitable and free access to this critical tool to increase availability for all patients.

In this unprecedented time of uncertainty, all health care professionals and insurers must continue to rely on science and evidence to provide the most effective and quality care to patients. We urge payers and insurers to embrace the opportunity to join us in working toward improved health outcomes for women and infants and to continue coverage of vaccines that is based on evidence and saves lives.

See the full list of organizations joining ACOG here.

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The American Public Health Association serves as a convenor, catalyst and advocate to build capacity in the public health community. We speak out for public health issues and policies backed by science. With our broad-based member community and 150-year perspective, we influence federal policy to improve the public’s health. We lead public awareness campaigns such as Get Ready and National Public Health Week. Together, we are creating optimal, equitable health and well-being for all. Learn more at www.apha.org.