Written By: Women & Infants Fertility Center on February 3, 2021
Many of our patients trying to get pregnant or who are already have asked us if it is safe for mother and her baby for the woman to be vaccinated against COVID-19 when the opportunity arises. Here is our answer, along with other related information.
On December 11, 2020, the U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the Pfizer-BioNtech mRNA vaccine for use against the virus that is causing the illness known as COVID-19. The vaccine has been 95% effective in large-scale clinical trials and has already been approved for use in five other countries.
Another vaccine for the prevention of coronavirus disease 2019, this one from manufacturer Moderna called mRNA-1273, received EUA approval on December 18. Its efficacy rate is reported to be 94%.
According to Centers for Disease Control and Prevention (CDC) guidelines, frontline healthcare workers and residents of long-term care facilities will be the first to be inoculated. However, the decision about priority rests with each state’s governor.
While the majority of U.S. citizens may not have access to the vaccine until months into 2021, it is important for infertility patients and pregnant women to start thinking about whether the vaccine is a good choice for them.
We recommend each woman carefully look at her risk of contracting COVID-19 and decide in conjunction with her providers on whether she should get vaccinated.
The CDC experts say that, based on how mRNA vaccines work, “they are unlikely to pose a risk for people who are pregnant.” This is because mRNA vaccines do not contain the live virus that causes COVID-19, so the shot cannot give a pregnant woman the disease. But the CDC says that the potential risks of the COVID-19 vaccine to a pregnant woman and her fetus are not yet fully known.
While a June CDC study found that pregnant people are at an increased risk of severe COVID-19 illness, this segment of the population was not included in the Operation Warp Speed vaccine trials.
The American College of Obstetricians and Gynecologists’ (ACOG’s) COVID-19 working group reports that while pregnant women are typically excluded from most clinical trials, they have been vaccinated for decades with few complications. One ACOG working group doctor, Denise J. Jamieson, MD, MPH, said that because the COVID-19 vaccine uses messenger RNA technology and not a live dose of the actual virus, she anticipates the vaccine should be very safe in pregnancy.
Pfizer reported that about two dozen women became pregnant during the clinical trials, and so far, no evidence exists that the vaccine affects gestation or fertility.
If you have an underlying health condition or are one of the estimated 330,000 healthcare workers who are pregnant or breastfeeding during the initial months of the vaccine’s release, then it is imperative that you speak to your doctor about inoculation.
Even if you don’t fall into the above categories and you are pregnant or thinking about getting pregnant, it’s best to speak with your doctor. Review the potential risks of vaccines in general, the science behind mRNA vaccines, and your timing to determine whether getting vaccinated is the right choice for you.
For otherwise healthy people in general, the COVID Task Force of the American Society for Reproductive Medicine does not recommend withholding the vaccine from patients who are planning to conceive, who are currently pregnant, or who are breastfeeding. It does encourage patients undergoing fertility treatment to receive the vaccination based on current eligibility criteria. Because the vaccine is not a live virus, the Task Force says there is no reason to delay pregnancy attempts due to vaccine administration or to defer treatment until receiving the second dose.
At the same time, the ASRM Task Force notes that recent studies suggest that pregnancy poses a higher risk for severe COVID-19 disease along with factors such as obesity, hypertension and diabetes. Therefore, each person should weigh individual risks and benefits with her own doctor before receiving the vaccination.
Because there has been no specific research on the COVID-19 vaccine on pregnant women, no known risks have been documented. However, vaccines pose risks to the population at large in general. One is that inoculations can trigger a fever in pregnant women (a dose of acetaminophen is usually the recommended treatment).
Another is that, sometimes, ingredients in the vaccine can on rare occasions cause allergic reactions similar to those caused by allergies to bee stings and peanut butter. Reactions can include anaphylaxis, a severe condition that can cause shock, a rapid pulse rate, difficulty breathing, nausea and vomiting. Whether pregnant or not, anyone receiving the COVID vaccine should be monitored for 15 to 30 minutes after receiving the shot to mediate any complications.
Currently, there is no data connecting the vaccine and infertility, and social media posts saying otherwise are “inaccurate,” according to Yale University vaccine expert Saad Omer in a Dec. 11, 2020 The New York Times wire story.
The key ingredient in Pfizer’s and Moderna’s vaccine is a genetic material that “teaches” human cells how to produce a protein, called spike, that can fight the coronavirus. No placental proteins or genetic material in the vaccine teaches the body how to make placental proteins.
Instead of delivering a live virus, the Pfizer and Moderna vaccines contain mRNA, a variation of a naturally occurring substance that directs the production of protein in cells throughout the body. The vaccine’s mRNA instructs the body’s immunological system to recognize the actual virus as a foreign invader and resist.
Duke University immunologist and expert in neonatal immunity Stephanie Langel explains in the same The New York Times article that the coronavirus spike and placental proteins have nothing in common, “making the vaccine highly unlikely to trigger a reaction to these delicate tissues.”
Regarding miscarriage, Mary Jane Minkin, MD, of Yale School of Medicine, told USA Today in December 2020 that there had been no evidence among the pregnant women with COVID-19 that spike protein antibodies attacked any cells in the placenta, which would cause pregnancy complications or miscarriage.
Regardless of whether you get the COVID-19 vaccine, it is imperative to continue wearing a mask and social distancing. Stay in touch with your doctor to learn when the COVID-19 vaccine will become available in your area.
If you become pregnant during the pandemic, notify your doctor immediately. According to the CDC, of 44,000 pregnant women in this country tested positive for COVID-19, more than 8,500 had to be hospitalized, and of those, 300 were admitted to intensive care and 57 died.
To date, no published scientific research suggests that the coronavirus is transmissible from gametes (reproductive cells such as embryos, eggs and sperm) to an intended mother or a gestational carrier.
Organizations such as ACOG are urging the FDA, CDC and state leaders to allow the vaccination of pregnant women against COVID-19. Doing so would not only protect the mother and unborn child, but also the healthcare providers tending to them.
In the meantime, the best medicine for intended parents and pregnant women is to continue following state-mandated orders and CDC recommendations to protect yourself and others from COVID-19.
If at any time you have questions about COVID-19 symptoms or prevention, contact your healthcare provider.
For more information online, see advice on COVID-19 and the vaccine on the website of the American Society for Reproductive Medicine.
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