Much like what we are experiencing today with COVID-19, the first Mother’s Day revolved around infectious disease and public health. The idea of Mother’s Day originated as an effort to improve health conditions contributing to childhood infectious illness like measles, diphtheria, and typhoid, for which we now have effective child vaccines. In 1914, Mother’s Day became an official U.S. holiday.
Mother’s Day has always been a day to support women and children. In 1968, Coretta Scott King hosted a march in support of underprivileged families as the launch for the Poor People’s Campaign, with thousands of demonstrators. Women’s groups have also used the date to highlight equal rights and childcare access.
In 2021, there are significant parallels between the original version of Mothers’ Day and our current involvement in the COVID pandemic, with efforts to improve public health and to become involved in the social justice campaigns that address original efforts to help support mothers, children and families.
Compared to men, women are more concerned about COVID exposure, and have experienced larger impacts on employment, caregiving, and mental health. According to the Kellogg Foundation, while women were already taking on more caregiving responsibilities than men prior to the pandemic (14% vs 9%), COVID resulted in more women than men (12% vs 8%) taking on additional caregiving. Women were also more likely to take time off work, with more mothers than fathers taking off work due to childcare needs (30% of mothers; 20% of fathers), and half (51%) of mothers who had to quit jobs due to COVID reported that it was due to childcare closures. A similar number of mothers compared to fathers reported having to quit a job (11% mothers vs. 8% fathers).
Over the course of the pandemic, mental health symptoms related to anxiety and depression have increased. Among mothers with children under 18, a majority (54%) report that COVID has impacted their mental health, but only 16% sought mental health treatment.
Children have also been impacted; even though emergency room visits have decreased during the pandemic, there was a higher percentage of pediatric visits related to mental health. Parents should consider family-based risks for depression and anxiety that contribute to increased child risk.
Support for family mental health services is of particular importance during the pandemic. One way to help children is through open conversations with parents, which can reduce depression and anxiety symptoms.
COVID’s disproportionate impact on mothers and families further illustrates the need to support women caring for their families. In Illinois, the Mamas Caucus, a bipartisan caucus made up of elected officials who are all mothers, formed to make the state more mom-friendly and support working families and maternal health. At a national level, the current administration has proposed additional attention devoted to improving black maternal health outcomes during pregnancy and childbirth.
Beginning in February 2021, pregnant women who were initially excluded from vaccine clinical trials were finally allowed to participate. Now, new reports show the safety of the vaccine during pregnancy. CDC Director Rochelle Walensky noted that "no safety concerns were observed for people vaccinated in the third trimester, or safety concerns for their babies," referring to a new study with the Moderna and Pfizer-BioNTech vaccines. Pregnant women were more likely to report pain at the injection site, but less side effects like headache and fever compared to non-pregnant women. Rates of preterm birth and miscarriage were the same for vaccinated and non-vaccinated women. Additionally, vaccines have been shown as protective for pregnant and breastfeeding women and their babies, creating antibodies in breastmilk and placentas, and providing passive immunity for babies. Pregnant women are at higher risk of COVID complications, so vaccination is especially important for them.
Most side effects reported following vaccines are minor, with commonly reported symptoms being headache (22%), fatigue (16%), dizziness (16%), chills (15%), and nausea (15%). While women represent 61% of vaccinated people, of those reporting side effects, 79% were women following Pfizer dose 1, 73% after Pfizer dose 2, and 77% following Moderna dose 1. All side effects should be reported through V-safe and the Vaccine Adverse Event Reporting System (VAERS). Safety monitoring is ongoing, and the current COVID vaccine monitoring is the largest ever implemented.
Women reporting more side effects does not necessarily mean that women are experiencing more, but that women are reporting more using the VAERS; however, an earlier study did find that nearly all people experiencing anaphylaxis (a rare and serious allergic reaction) after vaccination were women. Another study of health care workers found the same, and earlier studies, including those with influenza vaccines, also found more women affected. Emerging literature points to differences in COVID responses between sexes, suggesting that women may have a stronger immune response, or (based on influenza vaccines) responses may differ due to hormones.
Special considerations for women with vaccinations include timing of mammograms and possible temporary menstrual cycle irregularities, with no evidence for influences on fertility. Research on how having COVID may impact reproductive health is also ongoing.
Lurie Children’s Hospital is at the forefront of pediatric clinical trials for COVID vaccination. Dr. Bill Muller is guiding these trials. He recently told FCHIP about the unique role that Lurie Children’s Hospital will play in the vaccine trials. “Lurie will be a site for at least one of the ongoing or planned COVID vaccine studies in children. We are close to opening the Moderna study, which aims to demonstrate safety and effectiveness of their mRNA-based vaccine in children as young as 6 months of age. This study is expected to take months to reach complete enrollment. There are additional studies planned in children which involve other vaccines that have been shown to work for adults. We are working to participate in those trials as well.”
"Ultimately the goal is to choose a vaccine dose in children which minimizes side effects while providing similar or better protection from disease and infection.”
To enroll a child in the pool for a vaccine trial, click here.
As of May 2021, experts remain uncertain about a number of COVID issues that concern families and children, but FCHIP will follow and track all new health information in future reports. During COVID vaccine trials for children, parents should work to balance and minimize risks, and also continue to follow the recommended immunization schedule for all other vaccinations. How the new COVID vaccine may fit in with existing vaccine schedules is still being discussed.