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There's a lot of talk about whether COVID vaccines are safe for pregnant women and their fetuses. Current guidelines, while mentioning that there's little data, suggest that they are safe. However, I'm curious about what basis there is to suspect that they might not be safe. Is there a historical precedent of a vaccine which, say, harmed the fetus? If so, what was the mechanism of action? Is there a concern about inflammation, fever, etc? The articles I find in the popular media never address what the underlying concern is.

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    The question I would ask is why are people raising concerns without providing the basis for those concerns, leaving the rest of us to explain their apparently irrational concerns?
    – Carey Gregory
    May 4 at 3:50
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    @CareyGregory I think it's a simpler failure-of-communication issue. Those who depend on data ("group A") to determine safety are only willing to declare safety when they have evidence of safety. Those who run trials don't run trials on pregnant women. Those who ask group A "is this safe in pregnant women?" hear "we don't have evidence of safety in pregnant women" and repeat it as either "There isn't evidence of safety in pregnant women" (correct but scary) or "Isn't safe in pregnant women" (even scarier even if technically correct if your standard is "having evidence of safety"). May 4 at 4:41
  • Thank you for adding a productive comment, @BryanKrause. My question might be related to how this is communicated, but I'm unclear if that's the case so that's why I came here to ask. I'm trying to understand if group A is saying "we don't have evidence of safety in pregnant women [WDHESPM] (but we have no historical/scientific reason to expect anything based on anything similar)" or if it's "WDHESPM (and we want to make sure it's not like vaccine X from year Y which wasn't safe for pregnant women and their fetuses)".
    – gammapoint
    May 4 at 13:18
  • Normally this type of contextual information would be present in a journal article on the topic, either in the introduction for motivation or in the discussion section. However, the articles I've looked at thus far have not provided any clarification on the nature of the concern (nejm.org/doi/full/10.1056/NEJMoa2104983). Since it seems these questions get interpreted poorly, maybe I should add that I am a fully vaccinated PhD physicist who is trying to understand the context of a rare pregnancy situation and not researching this to do a segment on Good Morning America.
    – gammapoint
    May 4 at 13:21

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