Just got my #COVID19 vaccine @Baystate_Health
Despite the promising safety & efficacy data ( https://bit.ly/3oNu9Tb ),this was an incredibly HARD decision.After months of fertility treatment,I was finally pregnant...a about that decision #ThisIsOurShot #MyBandaidOurFuture (1/)

For a quick summary of the decision, our group (led by @emschoenfeld ) created a decision aid to help pregnant folks make a decision regarding the mRNA vaccines (updated version out soon) https://bit.ly/34iupS7 
@MySMFM also has a helpful publication https://s3.amazonaws.com/cdn.smfm.org/media/2641/Provider_Considerations_for_Engaging_in_COVID_Vaccination_Considerations_12-15-20_(final).pdf (2/)

First, it would have been easy had any of these companies conducted DART studies and/or included pregnant participants...but they didn't & often this perfunctory exclusion isn't well justified. We must do better for pregnant and lactating individuals https://s3.amazonaws.com/cdn.smfm.org/media/2591/SMFM_Vaccine_Statement_12-1-20_(final).pdf (3/)

So, I had to consider the risks
The theoretical risk (the mechanism of the mRNA vaccines) is very very low & the other ingredients in the vaccine are fine in pregnancy
The Moderna DART trial found no significant issues w/ fertility or congenital malformations (4/)

But it's so very early, an obvious worry is pregnancy loss / spontaneous abortion (i.e. miscarriage, but let's stop calling it that - it's almost never due to miscarrying anything)
the numbers in the placebo group mirrored baseline rates (~10-20% of pregnancies) (5/)

my partner and I had to confront these numbers and recognized that at age ≥35, my risk of natural pregnancy loss, regardless of a vaccine or therapeutic was not 0% - if something happened, it would be easy to blame the vaccine, but not necessarily accurate (6/)

We also had to weigh the benefits. If #COVID19 weren't so wildly uncontrolled and our communities could control it better , if I weren't an emergency physician treating sick covid-19 patients day after day....the benefits might not be so strong (7/)

Another benefit-the likelihood of transmission. I was reminded, yet again, that, by the very nature of my job and #COVID19 surges, I bring increased risk to this pregnancy AND my family (including elderly mother in law who lives with us) AND my kids' daycares (8/)

Also, speaking with trusted OB/GYNs and my reproductive medicine physician - they unilaterally encouraged me, in my high-risk occupation, to receive the #COVID19 vaccine. They have seen badness from COVID-19 in pregnancy and didn't want that for me (9/)

Lastly, and least importantly (the only time you'll ever hear me say this), SCIENCE. If people don't get vaccinated,we don't get http://data.As  a very risk averse person in , this wouldn't compel me alone, but it is a benefit (10/)

This decision was ours - right for us, but maybe not for others. I wanted to share this because so many friends & colleagues have reached out, asking what to do. We are lost, stressed, anxious, excited, and hopeful. And you are not alone (11/)