Dr Gillian Paulsen

29/11/2024

Don't forget your whooping cough vaccination after 20 weeks gestation and for partners and close family contacts who are not up to date with their vaccinations.

26/06/2022

30/05/2022

I cannot recommend these classes with Bronwyn enough. The more information you have about life after the delivery of your baby, the better prepared you will be. And Bronwyn is fantastic!

13/12/2021

A reminder to those planning or who are already pregnant that covid vaccination will protect both you and your baby.

“At least 66 pregnant Australians with COVID-19 have needed intensive care in the Delta wave of the pandemic, compared with just one in earlier waves. More than 93 per cent of those patients had not received any COVID-19 vaccine, according to available data.”

Senior doctors at major Melbourne hospitals caring for COVID-19 positive pregnant women, including the Royal Women’s Hospital, Royal Melbourne Hospital and Monash Health, say none of the mothers transferred from the COVID-19 maternity ward to intensive care in recent months were fully vaccinated.

21/11/2021

Back in October I shared some data from the UK Obstetrics Surveillance System (UKOSS) which looked at the increased risks of severe COVID disease in women who were pregnant, and increased risk of adverse perinatal outcomes. That post can be found here 👇🏼

https://www.facebook.com/100044147934160/posts/440302597451334/?d=n

On Friday, the CDC in the USA published a new Mortality and Morbidity Report looking into the risk of stillbirth amongst women with and without COVID-19 at delivery.

The study looked at data from 1,249,634 delivery hospitalisations spanning March 2020-September 2021. They then determined the risk of stillbirth in pregnant women with COVID-19, both in the pre-delta and post-delta periods. Stillbirths were defined as foetal death >20 weeks gestation.

During this period, a total of 8,154 stillbirths were tragically documented. Amongst these:

💥 The rate of stillbirth amongst deliveries without COVID-19 was 0.64%, whereas the rate amongst deliveries with COVID-19 was 1.29%.

Translation: the risk of stillbirth increased 90% when a diagnosis of COVID-19 was involved.

💥 During the pre-delta period (March 2020–June 2021), 6,983 stillbirths were documented, involving 0.64% of deliveries without COVID-19 and 0.98% of deliveries with COVID-19.

Translation: in the pre-Delta period, the risk of stillbirth increased by 47% when a diagnosis of COVID-19 was involved.

💥 During the Delta period (July–September 2021), 1,171 stillbirths were documented, involving 0.63% of deliveries without COVID-19 and 2.70% of deliveries with COVID-19.

Translation: during the Delta period, the risk of stillbirth increased by 400% when a diagnosis of COVID-19 was involved.

We know from previous studies of pregnancies complicated by SARS-CoV-2 infection that placental histopathologic abnormalities have been identified, suggesting that placental hypoperfusion (reduced blood flow) and inflammation might occur with maternal COVID-19 infection https://pubmed.ncbi.nlm.nih.gov/34425296/

It is clear that further investigation from prospective studies is needed to confirm these findings and to help identify the biologic mechanism for the observed increased risk for stillbirth with maternal COVID-19. The timing and severity of infection, and the contribution of maternal risk factors also needs to be considered.

But with the risk of stillbirth 400% higher in COVID-positive women in the Delta period, these findings do underscore what obstetricians have been championing all year: the absolute importance of COVID-19 prevention strategies, including vaccination before or during pregnancy.

If you are pregnant and you have concerns, please speak to your obstetrician and GP today.

- Sara

CDC Report 👉🏽 https://www.cdc.gov/mmwr/volumes/70/wr/mm7047e1.htm

21/10/2021

Victoria:

Today we reached the following targets for the eligible population aged > 16+

70% double doses ✅
90% single doses ✅

And when we consider the population aged > 12+

68.2% are double dosed
88.8% are single dosed

And when we consider the entire population > 0+

58.25% are double dosed
75.8% are single dosed

For reference, we have gone ahead of Israel in terms of the number of citizens who have had single doses given. We will shortly pull ahead in terms of double doses too.

But we don’t want to be like Israel. We want to be like Portugal, Malta and UAE. Countries which have vaccinated at much higher rates than Israel and have had much better case figures, hospitalisation rates and ICU admission.

High vaccinations rates not only protect the individual from worse outcomes, they also protect the vulnerable non-immune member of our society who live amongst us.

A recent peer-reviewed study from Sweden has shown that people without immunity against COVID-19 were at considerably lower risk of infection and hospitalisation as the number of family members with immunity from a previous infection or full vaccination increased.

Specifically, the study looked at 1.8 million people spanning 800,000 families, and found that non-immune family members had a 45 to 97 per cent lower risk of infection and hospitalisation, as the number of immune family members increased.

This study really demonstrates exactly why your vaccination matters, and gives hope that in families where members may be too young for vaccination that they will still be afforded some level of protection.

That study can be found here 👇🏼

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785141

Thank you to every Victorian who has rolled up their sleeves and contributed to our vaccination figures.

And to those who haven’t: it’s never too late to change your mind.

- Sara

19/10/2021

https://vimeo.com/606222671?fbclid=IwAR272oB_410FNq9MV9Nh2TPnJ7Laz16ZQ5ooxGpLJ885J5arwZ6tGSDG8fc

Experts discuss COVID vaccination in pregnancy, breastfeeding, and those planning to be pregnant, dispelling myths and highlighting the global evidence, which has…

18/10/2021

We are so lucky to have a safe and effective vaccine to get us through this pandemic. Look at how well it has been proven to work in the US. Amazing.

For anyone still on the fence about the benefits of vaccination, despite the overwhelming amount of data that shows how vaccines have protected recipients and turned this pandemic into a pandemic of the unvaccinated, the CDC had released important data on its COVID-19 Data Tracker, which tracks COVID-19 hospitalisation and deaths by vaccination status.

The data looks at 16 Health Departments that regularly link their case surveillance to immunisation status, and represent 30% of the total US population. These include Alabama, Arizona, Arkansas, Colorado, Connecticut, Florida, Georgia, Idaho, Louisiana, Massachusetts, Michigan, Nebraska, New Mexico, New York, Washington, Utah and Wisconsin.

The data as pertains to hospitalisations shows the following:

💥 For all adults aged 18 years and older, the cumulative COVID-19-associated hospitalisation rate was about 12-times higher in unvaccinated persons.

💥 The cumulative rate of COVID-19-associated hospitalisations in unvaccinated adults ages 18–49 years was about 14-times higher than fully vaccinated adults aged 18–49 years.

💥 The cumulative rate of COVID-19-associated hospitalisations in unvaccinated adults ages 50–64 years was about 15-times higher than fully vaccinated adults aged 50–64 years.

💥 The cumulative rate of COVID-19-associated hospitalisations in unvaccinated adults ages 65 years and older was about 9-times higher than fully vaccinated adults ages 65 years and older.

The data as pertains to transmission shows that at the peak of the delta wave in August, an unvaccinated person had a 6.1x greater risk of testing positive to COVID-19 compared to a vaccinated person.

And the data as pertains to deaths shows that at the peak of the delta wave in August, an unvaccinated person had an 11.3x greater risk of dying from COVID-19 compared to vaccinated individuals.

That data can be found here 👇🏼

https://covid.cdc.gov/covid-data-tracker/ -by-vaccine-status

And for those who still cry out that ageist anthem ‘it’s only the old that die’, be aware that in the months of August and September 2021, COVID-19 was the leading cause of death for people aged 35-54 across the United States.

That data can be found here 👇🏼

https://www.healthsystemtracker.org/brief/covid19-and-other-leading-causes-of-death-in-the-us/

We keep repeating ourselves because we see the writing on the wall. As doctors, epidemiologists, infectious disease specialists, and scientists, we are all making health recommendations based on evidence in front of us. Not TikTok videos or YouTube commentators.

Please get vaccinated. We will keep trying to spread the message, before it’s too late.

- Sara

16/10/2021

If you are pregnant and still unsure about getting vaccinated, please watch this video of A/Prof Ryan Hodges who is leading the care of Covid positive women in Victoria at Monash Medical Centre. This was filmed on the 10th September. The situation has only worsened, with many more pregnant women in Melbourne infected with Covid-19. I implore you to get your first shot of Pfizer tomorrow. It is the single most important thing that you can do for your pregnancy.

Dr Ryan Hodges from Monash Health has urged pregnant women to get vaccinated, saying they are seeing a surge in adverse reactions from the Delta strain in maternity wards.

14/10/2021

To the women who are pregnant and wanting to defer their COVID vaccinations until after they deliver their babies, I wanted to share with you some key data regarding the effects of COVID-19 in pregnancy from the UK Obstetric Surveillance System (UKOSS).

From the period of 1st March 2020 to 11th July 2021, 3371 pregnant women were admitted to UK hospitals with COVID-19.

Of these 3371 women:
- 43% underwent Caesarean sections.
- 24% had pneumonia
- 21% required respiratory support
- 10% required ICU admission
- 0.4% died

Of the 3036 babies born to these women:
- 21% were premature
- 20% were admitted to neonatal units
- 1% were stillborn (this is 2.5x the baseline stillborn rate in the UK!)

From the period spanning 1st February 2021 to 30th September 2021, when vaccines have been available:
- 1714 pregnant women were admitted to hospital with symptomatic COVID. Only 0.4% had been fully vaccinated, while 98.1% were completely unvaccinated.
- 235 of these women (14%) were admitted to ICU. None of these women had been fully vaccinated.

And the most heartbreaking statistics:
- since July 2021, when the delta strain was the predominant strain, 1 in every 5 people (20%) requiring critical care ECMO in the UK is an unvaccinated pregnant woman. For reference, ECMO is used only when a patient’s lungs are so damaged by COVID that a ventilator cannot maintain oxygen levels.
- out of all women between the ages of 16 and 49 on ECMO in intensive care, pregnant women make up almost a third (32%).

The disproportionate number of unvaccinated pregnant women in intensive care demonstrates that there is a significant risk of severe illness from COVID-19 in pregnancy.

A recent peer reviewed study published in The Journal of Maternal-Fetal and Neonatal Medicine found that symptomatic COVID positive pregnant women had higher rates of gestational diabetes, lower white blood cell counts, heavier bleeding during delivery, and increased respiratory complications in their babies.

I understand that pregnant women are very worried about vaccination in pregnancy.

But the NHS has reported that over 100,000 COVID vaccinations have been given in England and Scotland to women who were pregnant. A further 160,000 vaccinations have been given in pregnancy in the USA. There has been NO subsequent harm to the foetus or infants of these women.

In the same way we encourage pregnant women to get vaccinated for influenza and whooping cough in pregnancy, it is imperative that pregnant women do what they can to protect themselves in pregnancy, while also enabling them to provide important maternal antibodies to their babies.

If you are pregnant and you have concerns, please speak to your doctor today!

Don’t listen to those who peddle misinformation that can result in tragic consequences for you and your precious baby. Protect yourself now before the delta wave becomes a delta tsunami.

- Sara

UKOSS preprint data https://www.medrxiv.org/content/10.1101/2021.07.22.21261000v1