‘For many, the benefits outweigh the risks’: How ETHP is supporting pregnant individuals with their COVID-19 vaccinations

Pregnant people getting their COVID-19 vaccine

One hundred pregnant clients from East Toronto’s priority neighbourhoods were scheduled to receive their COVID-19 vaccine at a dedicated pop-up clinic for pregnant individuals at Thorncliffe Park Community Hub on April 23.

Since the beginning of Ontario’s COVID-19 vaccination efforts, obstetrics care providers like Dr. Jennifer Cram, chief of obstetrics and gynecology at Michael Garron Hospital (MGH), have advocated for their pregnant clients’ access to the COVID-19 vaccine.

“We felt very strongly that everybody, including pregnant clients, deserved to be empowered to make an informed decision about the vaccine,” says Dr. Cram.

The urgency to have pregnant clients vaccinated was felt early on, as Dr. Cram notes that individuals in reproductive age groups work in many frontline jobs, putting them at increased risk of contracting COVID-19. Now with variants of concern impacting younger age groups than what was seen during the first and second waves of the pandemic, more pregnant clients are getting COVID-19, and they are getting sicker than their non-pregnant counterparts.

“What we’re seeing is that pregnant patients with COVID-19 have a higher risk of being admitted to hospital and the intensive care unit (ICU), and are at higher risk of requiring invasive ventilation,” says Dr. Cram.

Improving access to the COVID-19 vaccine

That’s why on April 23, before pregnancy was added to the list of highest risk conditions eligible to book an appointment for the COVID-19 vaccine in Ontario, MGH in partnership with obstetrics care providers in East Toronto, piloted a dedicated pop-up COVID-19 Immunization Clinic for pregnant clients 18 years of age and older who live in East Toronto priority neighbourhoods.

The idea for this dedicated pop-up clinic came from Dr. Meera Shah, family physician and primary care digital health lead at Health Access Thorncliffe Park (HATP), who saw a need to provide this population with a way to access the COVID-19 vaccine that did not involve standing in a line-up.

At the time, adults 18 years of age and older who live in a priority neighbourhood, including those who are pregnant, could only access the COVID-19 vaccine through mobile pop-up clinics, which are typically higher volume and operate on a drop-in basis.

The dedicated pop-up clinic for pregnant clients who live in priority neighbourhoods, on the other hand, would be by appointment, with specialists on-site to help them make an informed decision about the COVID-19 vaccine.

“I have many patients that are young and pregnant and live in Thorncliffe Park, and I’ve been worried for months that they would end up in the ICU or possibly lose their baby due to COVID-19 complications,” says Dr. Shah. “This by-appointment clinic gave these individuals the opportunity to receive the vaccine in a way that was safe and suited to their needs.”

Dr. Shah contacted Dr. Cram with her idea, and together with their obstetrician, family physician and midwife colleagues in East Toronto, they personally contacted pregnant clients in priority postal codes to inform them of the dedicated clinic, answer questions and offer to book them an appointment.

“Many of our clients in priority neighbourhoods may face language and technological barriers, so contacting them directly to inform them of the opportunity to be vaccinated, answer their questions and help book them an appointment makes a big difference,” says Dr. Shah.

Within two days, 100 pregnant clients from East Toronto’s priority neighbourhoods were scheduled to get their COVID-19 vaccine at the dedicated pop-up clinic.

Why pregnant individuals should consider the COVID-19 vaccine

Dr. Shah acknowledges that the guidance around COVID-19 vaccines in pregnancy has been unclear. However, she says emerging evidence showing pregnant people are at an increased risk for severe illness from COVID-19, as well as adverse pregnancy outcomes, should encourage pregnant individuals to protect themselves by getting vaccinated.

“It’s important for pregnant individuals to discuss the risks and benefits of vaccination with their primary care provider, obstetrician or midwife,” she says. “With the high community transmission rates of COVID-19 we’ve been seeing in the GTA and other hotspot areas, for many, the benefits outweigh the risks right now.”

“I would recommend getting vaccinated to protect yourself and your newborn,” Dr. Shah adds. “Partners and members of a pregnant individual’s household — anyone in close contact with them — should also strongly consider being vaccinated for further protection against the virus.”

Pregnancy is now included in the list of highest risk conditions eligible to book an appointment for the COVID-19 vaccine. Book a vaccination appointment through the provincial booking system online or by calling 1-833-943-3900.

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