Vaccine Hesitancy and Pregnancy: How the Medical Humanities Can Help

Dr. Sam Allen Wright // Four days before I saw a faint second line on a pregnancy test, I got my first COVID vaccine. I knew that I could be pregnant when I got the shot. In fact, that’s why I wanted the vaccine so badly; I knew that COVID caused increased risks for pregnant women. When I got the shot and then almost immediately found out I was pregnant, I was elated. Not only was I pregnant, something my husband and I have wanted for years, but the baby and I would both be protected from COVID. In the middle of a pandemic and becoming a first-time mother, the vaccine meant there was one less thing to worry about. It was my first good decision as a mother (and hopefully counteracted some of my less good mothering decisions, like my first trimester diet). 

Imagine my surprise when my obstetrician told me that I was one of the few vaccinated patients in her practice. Despite the pandemic and her constant discussions with patients, most refused to be vaccinated. From discussions I’ve had with pregnant friends, some thought the vaccine was too new or unnecessary; others worried that it hadn’t been studied in pregnant women enough. Since vaccine hesitancy is so common the US, none of this should be a surprise. As of early November 2021, 67.8% of adults in the US has had at least one COVID vaccine dose (U.S. COVID-19 Vaccine Tracker). Although this number undoubtedly needs to be higher to combat the pandemic, the numbers are far worse among pregnant people. As of the end of September, only about 30% of pregnant people in the US were vaccinated and only 18% were vaccinated while pregnant (Crist).  These low numbers mean a lot of pregnant people are at serious risk for COVID, which can be catastrophic during pregnancy. 

My interest in vaccine rates among pregnant people stems from more than my own pregnancy. My Ph.D. is in American literature, and I specialize in the medical humanities, focusing on illness narratives. I want to know how patients tell their illness stories, how this can affect health care, and the role these illness stories play in American literature, history, and culture. I’m also interested in science writing and public health. From what I’ve noticed, the narratives around the COVID vaccine, especially in pregnancy, are filled with fear and misinformation. Claims that the vaccine causes miscarriages, death, or even that the vaccine is simply ineffective are all over the internet. From my experience talking to family and friends who are unvaccinated, most claim that a friend of theirs knows someone who either died or had a serious reaction the vaccine. 

For many of us, the misinformation about vaccinations is infuriating. According to copious amounts of research, the COVID vaccine is simple, safe, and effective. In particularly vulnerable populations, like pregnant people, the vaccine literally can be the difference between life and death. To me, the vaccine was an easy choice, and I’m happy to share my story to anyone who’ll listen. Although many of us are frustrated by the low vaccine rates, at the same time, we must acknowledge that research on vaccines and pregnancy is limited. For example, research on pregnancy and female reproductive health is not where it should be. Anecdotally, I can tell you I’ve googled many pregnancy health concerns or asked my doctor, only to learn that we often don’t have the answers. For example, something as simple as whether or not pregnant people can safely sleep on their backs is debated; the available information is scant and conflicting.

In a New York Times’ Op Ed, M.D.-Ph.D. student Alice Lu-Culligan and Dr.Randi Hutter Epstein argue that the research surrounding the COVID vaccine and women’s menstrual cycles isn’t conclusive enough to gather any real data. They write, “If so many things can affect periods, why don’t we know more about how these vaccines — or any others — affect menstruation? It’s part of a long history of medicine not taking women’s bodies seriously” (Lu-Culligan and Hutter Epstein).  If we don’t know how the vaccine—or any other vaccine—can affect women’s reproductive health, then we also must acknowledge that vaccine-hesitant women are not responding only to misinformation campaigns or ignorance, but rather are responding to a long history of poor information about women’s health. In order to have an honest discussion with women who are vaccine-hesitant, we must acknowledge the ways research about women’s health has failed in the past and emphasize why the information we have about the vaccine is trustworthy. Sweeping these concerns under the rug or dismissing women’s concerns as misinformation is counterproductive. 

The good news is that all the studies we have on the COVID vaccine and pregnancy are overwhelmingly positive. The Center for Disease Control reports that the vaccine is not linked to miscarriage, the vaccine reduces the chance of COVID infection, and antibodies from the vaccine may be passed on to the baby (“Covid-19 Vaccines”). As someone with a background in science writing and the medical humanities, I can—more or less—understand the research and read it for myself. I also have the ability to do the research as a university employee with the ability to access medical journals. That’s why I’m sharing my story; personal stories grab people’s attention. Being able to take complex medical data and translate the information into a compelling narrative, a piece of art, or some other form of creative expression is a talent—a talent that must be utilized to combat misinformation and vaccine hesitancy.

In order to combat misinformation, those in the medical humanities need to do two things. First, we need to share our stories as medical practitioners, patients, researchers, and/or scholars. For every person who has heard that their cousin’s neighbor’s friend died of the vaccine, there needs to be a story of someone whose life was saved by the vaccine. Anecdotes alone aren’t enough, but vaccine-positive stories are easily backed up by facts and data, whereas misinformation is not. I call on everyone in the medical humanities to take their unique expertise and use it to share stories and information to help end this pandemic.

However, storytelling alone won’t solve vaccine hesitancy. We also as a field need to acknowledge where medicine has failed and work to end basic inequalities in medical care. Women’s health has far too often been ignored or under-studied. The critical medical humanities, as defined by Anne Whitehead and Angela Woods in the Edinburgh Companion to the Critical Medical Humanities, argues going beyond simply examining the medical humanities in terms of how it can improve medical education or provider practice. Instead, they argue: “critical medical humanities also aims to reach and interact with medical research, be that in the context of genetics or of psychiatry, and to influence questions of policy and diagnosis” (Whitehead and Woods 25). We need to raise questions about why there are so many inequalities in medicine, bring these issues to light, and use the humanities to show the devastating consequences of healthcare disparities. Understanding the root causes behind things like vaccine hesitancy are vital in ending the pandemic. Although the temptation to dismiss vaccine hesitancy as ignorance or political posturing can be strong, a little understanding can go a long way—and may result in important conversations that are desperately needed in medicine. 

Works Cited

“Covid-19 Vaccines While Pregnant or Breastfeeding.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html.

Crist, Carolyn. “Covid Vaccination Rates among Pregnant Women Remain Low.” WebMD, WebMD, 29 Sept. 2021, https://www.webmd.com/vaccines/covid-19-vaccine/news/20210929/covid-vaccination-rates-pregnant-people-remain-low.

Lu-Culligan, Alice, and Randi Hutter Epstein. “Opinion | No, We Don’t Know If Vaccines Change Your Period.” The New York Times, 21 April. 2021, https://www.nytimes.com/2021/04/20/opinion/coronavirus-vaccines-menstruation-periods.html.

“U.S. COVID-19 Vaccine Tracker: See Your State’s Progress.” Mayo Clinic, Mayo Foundation for Medical Education and Research, https://www.mayoclinic.org/coronavirus-covid-19/vaccine-tracker.

Whitehead, Anne, and Angela Woods. The Edinburgh Companion to the Critical Medical Humanities. Edinburgh, Edinburgh University Press, 2016.

Image: Section of Vaccination anti-variolique vers 1820, by Constant-Joseph Desbordes. // Wikimedia Commons.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s