Infectious Diseases | Mount Sinai Today

Vaccine Facts: COVID-19 Vaccines Are Safe—and Essential—for Pregnant Women

Sep 23, 2021 | COVID-19, Featured, OB/GYN, Vaccines, Women's Health, Your Health

For those who are pregnant or considering getting pregnant, there are so many health questions, from “Is caffeine okay?” to “Can I still exercise?” But during the COVID-19 pandemic, some are also wondering if the COVID-19 vaccines are safe to take.

In this Q&A, Joanne Stone, MD, MS, Director of Maternal Fetal Medicine at the Mount Sinai Health System, explains the dangerous risks of COVID-19 during pregnancy, shares the facts on why you should get the vaccine, and offers reassurance for those who may be worried.

New Guidance on COVID-19 Vaccines: In April 2023, the Food and Drug Administration and the Centers for Disease Control and Prevention announced some major changes for COVID-19 vaccines. Click here to read more about what you need to know.

Update: The Centers for Disease Control and Prevention on September 29, 2021, strongly recommended COVID-19 vaccination either before or during pregnancy because the benefits of vaccination outweigh known or potential risks. Read more from the CDC

If someone is pregnant, or trying to get pregnant, should they get vaccinated?

Yes, if you’re pregnant, or thinking of getting pregnant, or even if you’re breastfeeding, this is absolutely the time to get the vaccine. I would not wait one extra day. I would get it today because there’s a lot of data that shows the vaccine is very safe and it’s not associated with miscarriage or infertility. Also, it’s the most important way to prevent COVID-19 infection.

Joanne Stone, MD, MS

Are pregnant people especially at risk for COVID-19?

Pregnant women who get COVID-19 infection are at a much higher risk for adverse outcomes, such as severe disease and even maternal death. There’s also higher risk for complications, including preeclampsia, which is high blood pressure in pregnancy, as well as increased risk for the baby, including preterm delivery. For all these reasons, the risks of COVID-19 infection are much higher for both mom and baby. So it’s extremely important to prevent this disease during pregnancy through vaccination plus other measures like mask wearing and social distancing.

What else should patients know about the vaccines and pregnancy?

Patients should understand there are a lot of myths out there that have not proven to be true. For example, there’s no increased risk of infertility if you get the vaccine prior to getting pregnant. Pregnant people should also know that there are complications associated with COVID-19 in pregnancy, and these complications that can be prevented by getting the vaccine. Also, the vaccine has been studied extensively. All the major organizations involved with women’s health care—including the Society for Maternal-Fetal Medicine and the Centers for Disease Control and Prevention—are strongly advocating that people who are pregnant get the vaccine.

Face Masks Are Still a Fact of Life, Here’s What You Need to Know About Safe Use

Sep 20, 2021 | COVID-19, Your Health

Woman who is alone on street, takes mask off while outside

Now, almost two years into the fight against COVID-19, face coverings have become a necessary addition to our everyday wardrobe. Along with proper hand washing and social distancing, their use has helped to prevent the spread of COVID-19. As the pandemic goes on and the effort to get people vaccinated continues, the U.S. Centers for Disease Control and Prevention (CDC) has issued additional guidance about face coverings. Importantly, the CDC now clarifies that while some outdoor, unmasked activity is relatively safe, both unvaccinated and vaccinated individuals should continue masking when indoors to protect themselves and others from the highly contagious Delta variant.

Krystina Woods, MD, Hospital Epidemiologist, Medical Director of Infection Prevention, and Deputy Chief Medical Officer at Mount Sinai West, explains the care and use of masks over the long haul and why those vaccinated against COVID-19 still need to mask up.

Why is it important that vaccinated people continue to wear face coverings?

We now know that vaccinated people can both become infected with COVID-19 and pass it on to others. And because of that, in certain settings, it is extremely important for even vaccinated people to wear masks.

Is it still less risky to be unmasked while outdoors? If so, why?

When you’re outdoors, there’s better ventilation. So, for example, if there is someone nearby who has been infected with COVID-19, the amount of virus can be diluted by all the freely moving air, making it less likely that others will be infected.

It is also important to remember that part of the thinking about being unmasked outdoors is that you’re unmasked while still being socially distant. If you are in a really, really large crowd; the protection is not going to be as good. You are much safer choosing to take your mask off outdoors if you have the ability to have a little bit of distancing.

So, being unmasked when on an early morning walk through a sparsely populated Prospect Park is okay, but if you’re window shopping on the weekend on a packed street in SoHo, throw on a face covering.

If my risk of severe illness is low, why should I continue to take precautions once I am fully vaccinated?

We need to continue to be careful. You don’t always know what the health problems are of those around you and, there’s a certain amount of civic responsibility that we have to each other.

None of us live completely isolated and, over the last 18 months, we’ve all felt what it is like to have to isolate ourselves from those we care about. So, we need to be careful about the fact that there are still people who have not gotten vaccinated, those who are not eligible for vaccination—like children—, and those who are otherwise vulnerable—like the elderly and immunocompromised. We have a duty to protect those amongst us who do not have the protection of vaccination.

Should I upgrade to a better face mask?

I wouldn’t see this as a necessity. The most important thing is that the face mask is multi-layered and fits well. If you are using a cloth mask, it is a good idea to double mask by using a surgical mask underneath the cloth mask. In place of that, a regular surgical mask is sufficient. However, if someone feels more comfortable wearing an N95 or its international equivalent (the KN95 or KF94), they certainly can—just make sure the masks are legitimate. The CDC has advice on how to identify counterfeit masks.

How do I know if my face mask has a proper fit?

Your mask should not fall off of your nose as you’re talking and it should fully cover your nose and the mouth. Additionally, it should not have large gaps around the perimeter of the mask—around the sides or the top and bottom. And, you should be able to tolerate wearing the mask for an extended period of time without feeling uncomfortable.

How should I take care of my cloth face masks?

Reusable masks should be washed at least daily, by hand or in your regular washing machine. And you can put them in the dryer, or hang them up to dry. If you have a disposable face mask, throw it away after wearing it once. And always wash your hands after handling or touching a used mask. The CDC has a lot more information about masking here.

Get more COVID-19 information from Mount Sinai

Vaccine Facts: Immunocompromised People Should Get a Third Dose

Sep 9, 2021 | COVID-19, Featured, Vaccines, Your Health

Immunocompromised people have a reduced ability to fight infections and are more vulnerable to severe COVID-19. That is why the U.S. Centers for Disease Control and Prevention (CDC) is recommending that people with moderately to severely compromised immune systems receive an additional dose of the Pfizer-BioNTech or Moderna vaccine.

In this Q&A, Meenakshi Rana, MD, Associate Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai, and the Director of Transplant Infectious Disease, explains why immunocompromised people, who make up almost three percent of the U.S. population, should get this third vaccine dose and why it is important to take other protective measures.

What did the CDC recommend?

The CDC and the Advisory Committee on Immunization Practices took an important action to prevent COVID-19 infection in our immunocompromised population and among transplant recipients. They now recommend that people who are moderately to severely immunocompromised receive an additional dose of an mRNA COVID-19 vaccine, either Pfizer or Moderna, at least 28 days after the completion of the initial series. The Food and Drug Administration (FDA) now allows for the additional dose for these people as well.

To be clear, this is not considered a booster dose. A booster dose is given to a patient whose immunity to the vaccine may have waned over time. This is considered an additional dose, given to immunocompromised patients to improve their initial response to the vaccine series. These patients are essentially receiving a three-dose mRNA vaccine series instead of a two-dose series.

Who is considered immunocompromised and should get the third dose?

Meenakshi Rana, MD

Immunocompromised patients are a very large and heterogeneous group. For the purposes of an additional COVID-19 vaccine, the CDC has defined a specific moderately to severely immunocompromised group, which includes:

Patients who have been receiving active cancer treatment for tumors or cancers of the blood
Patients who had a solid organ transplant, such as a heart, lung, liver or a kidney, and currently take immunosuppressive medications
Patients who had a bone marrow transplant within two years or had a bone marrow transplant and are currently taking immunosuppressive therapy, or patients who receive CAR T-cell therapy.
Patients who have advanced or untreated HIV
Patients who have another medical condition that require high-dose steroids or immunosuppressive therapy for that medical condition

If you think you fall within this category, it’s important that you speak to your physician to determine if you are eligible for an additional dose of mRNA COVID-19 vaccine.

Why is the CDC taking this action?

Patients who are considered moderately to severely immunocompromised are more vulnerable to COVID-19. They are more likely to have severe disease, and more likely to be hospitalized with COVID-19. In addition, there has been data suggesting that moderately to severely immunocompromised patients may not have as strong an immune response to the initial COVID-19 vaccine series, and we have seen breakthrough infections in vaccinated immunocompromised patients, occasionally requiring hospitalization. The CDC also now has data suggesting that a third vaccine would be safe.

What should I do if I think I am affected by this action by the CDC?

If you think you are considered moderately to severely immunocompromised, talk to your doctor to see if you are eligible for an additional dose of COVID-19 vaccine. The CDC recommends that you receive a third dose with the same mRNA vaccine. For example, if you received an initial Moderna vaccine series, then you should complete your series with an additional third dose of the Moderna vaccine.

What if I am immunocompromised and I received the Johnson & Johnson vaccine?

When the CDC made this recommendation, they did not have enough data on whether immunocompromised patients who received the J&J vaccine would have an improved response after receiving an additional dose of the same vaccine. For this reason, we are currently awaiting more guidance from the CDC on what to recommend for these patients.

If I am immunocompromised, what else should I do to protect myself?

In addition to receiving an additional dose of an mRNA vaccine, you should continue to practice all those protective precautions that we’ve been discussing: social distancing, hand hygiene, and masking. It’s also very important that all of those around you, your family and your friends, are all vaccinated.

The FDA has also authorized the use of a medication, known as a monoclonal antibody, for what is termed “post- exposure prophylaxis.” That means, if you are exposed to a loved one or family member with COVID-19, this medication can be given to you to prevent COVID-19 and progression to severe disease or hospitalization with COVID-19. You should call your physician to see if you are eligible.

Should I get an antibody test to see if I am eligible for the third dose?

We are not recommending that you get an antibody test for this purpose, because we don’t know what level of antibodies is considered protective. We recommend that if you are considered immunocompromised, you should receive an additional vaccine dose, regardless of antibody response.

How Do I Keep My Kids Safe When They Return to School In Person?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

As the Delta variant surges, and the timeline for vaccinating children under 12 remains uncertain, concerned parents are wondering how to keep students safe. But there are smart strategies for school children of all ages that can help protect them in the classroom.

In this Q&A, Roberto Posada, MD, a pediatric infectious disease specialist in the Jack and Lucy Clark Department of Pediatrics at Mount Sinai Kravis Children’s Hospital and Professor of Infectious Diseases and Medical Education at the Icahn School of Medicine at Mount Sinai, shares the best ways to help keep kids safe from COVID-19.

Given the current concerns about COVID-19, should parents be worried about sending their kids back to school?

I think it’s important for kids to go back to school not only for their education, but also for socialization and healthy development. But it’s also important to take precautions to make sure they return to the classroom in a safe way. If in-person learning is done safely, the benefits will outweigh the risk. According to the Centers for Disease Control and Prevention, children have been less affected by COVID-19 compared with adults. But kids can develop serious illness, especially those with underlying medical conditions, such as obesity, diabetes, and asthma; those with certain genetic, neurologic, or metabolic conditions; or those with congenital heart disease. In general, the best way to protect children is to make sure adults in the household are vaccinated.

What advice can you give to worried parents about keeping their kids safe at school?

It’s important to continue the things we’ve been practicing for the last year and a half: The main thing is that children over the age of two should wear a mask when they go to school. Children should also be encouraged to wash their hands, either with soap and water or with alcohol-based sanitizer frequently. Children should be encouraged to practice respiratory etiquette, which means coughing or sneezing into their elbow and washing their hands after coughing or sneezing. And they should be taught to maintain a safe distance at all times.

In addition, parents shouldn’t send their kids to school if they have a fever, cough, abdominal pain, or any symptom whatsoever of an illness, including COVID-19.

How worried should people be right now about the increasing cases of COVID-19?

The number of COVID-19 cases has been going up for the last several weeks in the United States, mostly due to the Delta variant. Vaccination is very important. Every child aged 12 and older should be vaccinated. The vaccine is safe, and in some cases it fully protects against COVID-19; in some cases people who are vaccinated may still get COVID-19, but usually it’s a much milder disease.

Is there any guidance for older vaccinated kids that you would recommend to parents?

What I want to stress is that even people who are fully vaccinated should be wearing a mask whenever they’re inside, whether they’re in school, on public transportation, in a store, or anywhere indoors. That applies to adults, as well. The reason is that even people who are fully vaccinated may have breakthrough infections, and they can still pass on the infection to other people. So by wearing a mask—in addition to getting the vaccine—you’re helping decrease cases in your area, which is what we all want.

When do you think the vaccine will be available for children 11 and under?

The original timeline was for this to be available in the fall. So let’s hope that’s going to be the case.

Is there anything else people should know about keeping their kids safe from COVID-19?

Any parent who has a particular concern about their child due to a chronic medical condition medical condition should talk with their pediatrician to come up with an individualized plan.

My Child Is Anxious About Returning to School In Person. How Can I Help Them?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Mental Health, Psychiatry, Your Health

With the start of the new school year, many kids may be relieved to return to in-person learning. But others may feel more anxious.

In fact, experts at the Mount Sinai Adolescent Health Center anticipate that this transition may be especially challenging and anxiety-provoking.

Rachel Colon, LCSW, a social worker at the Center who treats young people ages 10-26, says that her case load has nearly doubled as adolescents seek help for anxiety and depression.

Rachel Colon, LCSW

“Young people are feeling a great deal of anxiety about returning to school,” she says. “They don’t know what they’re stepping into, who their friends are, and they’re nervous about the lack of predictability in an environment that has always been safe and provided routine.”

Ms. Colon offers some steps you can use to help your kids with the transition to in-person learning this school year:

Have lots of conversations with your kids; keep the lines of communication open.
Empathize with your children; let them know they are not alone if they feel anxious.
Reach out to your child’s school to ask what steps are being taken to familiarize students with their surroundings.
Look for signs of withdrawal, isolation, stomach aches, headaches, irritability. These can be signs of depression and/or anxiety.
If your child is headed to a new campus, or stepping up from middle school to high school, offer to take a walk to school before the first day of school.

Heading back to school can be stressful even in normal times. Over the years, the Mount Sinai Adolescent Heath Center has compiled a list of seven things for kids and adults to do to start the year off right. Click here to see them on the Center’s kid friendly blog.

One potential new issue this year is that kids may feel they have lost touch with their group of friends, or that they don’t belong, and masks, while a critical safety tool, may make things more difficult.

“Many kids are telling me they don’t have a friend group anymore. They don’t know how their classmates will look,” she says. “With the potential requirement of masks, this will likely compound social anxiety because it’s hard to read expressions when a person is masked. Are they happy or sad? Are they smiling at me? Though masks are a crucial safety tool right now, kids really need simple cues—like a broad smile—to maintain social relationships.”

The Mount Sinai Adolescent Health Center is a comprehensive, integrated health center that provides nonjudgmental and confidential care to young people ages 10-26 in New York City—all at no cost to patients, regardless of insurance or immigration status.

Learn more about the Mount Sinai Adolescent Health Center

Check out seven back-to-school tips from the Mount Sinai Adolescent Health Center

Vaccine Facts: No, the COVID-19 Vaccines Were Not Made Too Quickly

Aug 12, 2021 | COVID-19, Vaccines, Your Health

One of the many misconceptions that some have about the COVID-19 vaccines is that they were developed too quickly. In fact, all of the normal safety steps were followed in developing the vaccines, and they are helping to bring the pandemic to an end. In a roundtable talk, experts from Mount Sinai answer some frequently asked questions.

Did scientists and the government take short cuts and develop the vaccines too quickly?

Scientists followed all of the normal safety steps that are taken when we create new vaccines. No safety steps were skipped. The Pfizer-BioNTech and Moderna vaccines were made with technology that has been studied for many years, and the Johnson & Johnson vaccine was made using traditional methods.

So how did we produce and test these vaccines as quickly as we did?

COVID-19 vaccines became the priority for everyone. Researchers around the world dedicated themselves at the same time to finding solutions. We quickly understood how well the vaccines worked because COVID-19 spread so rapidly. It became clear that people who were vaccinated weren’t getting hospitalized, weren’t in ICUs, and weren’t dying of COVID-19.

How do we know the vaccines are safe?

In the United States alone, nearly 200 million people have safely received the COVID-19 vaccines—twice as many as the flu vaccine. If you haven’t yet, we encourage you to get vaccinated.

Get more information from Mount Sinai about COVID-19 vaccines

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