82% COVID vaccine miscarriage claim is false; broken promise to pregnant women isn’t

Greg J. Marchand, M.D.

Submitted photo/Marchand Institute

The outcome data are reassuring. That does not retroactively excuse the disclosure failure. Being right in the end is not the same as being honest at the time. If public health wants trust back from pregnant patients, and it badly needs it back, that is a distinction it will have to learn to make out loud.”

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OPINION — Two claims about COVID-19 vaccines and pregnancy are moving through the country this week, and the reflex is to pick a team. One of them is arithmetically false. The other is documented in writing. Both things are true at the same time, and an honest reading of the record has to say so.

Start with the number, because it is the easier of the two. The claim that 82% of vaccinated women miscarried comes from a reworking of a 2021 New England Journal of Medicine paper reporting outcomes from the Centers for Disease Control’s v-safe pregnancy registry. That paper counted 104 spontaneous abortions among 827 completed pregnancies, a rate of 12.6%. Critics kept the same 104 losses but divided them by only the 127 completed pregnancies among women vaccinated before 20 weeks. That produces 82%.

This is not a reanalysis. It is a broken denominator.

Ask what it takes for a pregnancy to be counted as completed at an early data cutoff. A pregnancy lost at eight weeks completes almost immediately. A pregnancy that ends in a healthy birth does not complete for another seven months. At that snapshot, the denominator is made almost entirely of losses by construction. Run the identical arithmetic on a cohort of unvaccinated women and you get the same terrifying number. The method cannot tell what the exposure was, which is how you know it is measuring the calendar and not the vaccine. Epidemiologists call this left truncation, and the CDC statisticians who returned to the same registry corrected for it by name.

Analyzed properly, with life table methods that account for how long each pregnancy was actually observed, the cumulative risk of spontaneous abortion from 6 to 19 weeks was 14.1%, and 12.8% after adjusting for maternal age. The background rate in recognized pregnancies is 11% to 22%. The authors even ran the worst case, assuming every participant lost to follow-up in the first trimester had miscarried, and that ceiling came in at 18.8%, still inside the normal range.

Everything since has landed in the same place. A Norwegian national registry study found no increase in first trimester loss. A 2023 meta-analysis in Human Reproduction covering nearly 150,000 women produced a relative risk of 1.07, a confidence interval that comfortably includes no effect at all. A 2022 meta-analysis in Nature Communications covering more than 117,000 women found no increase, and a stillbirth rate 15% lower among the vaccinated. The 82% figure is dead, and it deserves to be.

Now the harder half.

On Aug. 10, Sens. Ron Johnson and Rand Paul released the first tranche of messages recovered from Dr. Anthony Fauci’s government phone. In a Jan. 25, 2021, exchange with Centers for Disease Control Director Rochelle Walensky and Dr. Vivek Murthy, Dr. Fauci wrote that because many people experience significant cytokine response and fever after the second dose, this theoretically could be associated with miscarriage in the first trimester.

Nine days later, he told a Journal of the American Medical Association audience that vaccination in more than 10,000 pregnant women had produced no red flags. He repeated the phrase at a White House briefing on Feb. 10, 2021. The private hypothesis was never raised publicly.

I take no position on motive, and none is required. A theoretical mechanism, raised in private by the most powerful voice in American infectious disease and then never mentioned to the public, is not nothing. Informed consent has never required certainty. It requires telling people what you know, and telling them honestly what you do not.

The biology behind that private message was reasonable, which is the point. Sustained maternal fever in early pregnancy has been studied for decades as a possible contributor to pregnancy loss and neural-tube defects. A question that serious deserved a public answer rather than silence.

It is also worth asking what the reassurance was resting on. In early February 2021, the vaccinated pregnant population was overwhelmingly health-care workers vaccinated later in pregnancy. First trimester outcome data barely existed. No red flags, at that moment, described an empty file drawer more accurately than a completed safety evaluation.

Here is the part that should trouble everyone. The 82% claim and the no-red-flags claim failed in the same way.

Both were confident statements that ran ahead of the evidence. One came from critics, one came from the government, and the women who had to decide in the first trimester of 2021 were served badly by both.

The outcome data are reassuring. That does not retroactively excuse the disclosure failure. Being right in the end is not the same as being honest at the time. If public health wants trust back from pregnant patients, and it badly needs it back, that is a distinction it will have to learn to make out loud.

Greg J. Marchand, M.D. is founder and medical director of the Marchand Institute for Minimally Invasive Surgery, a nonprofit research and educational institution in Mesa. Please submit comments at yourvalley.net/letters or email them to AzOpinions@iniusa.org. We are committed to publishing a wide variety of reader opinions, as long as they meet our Civility Guidelines.