Our advice for pregnant women or those considering pregnancy is to talk to your doctor, then if recommended, get the COVID-19 vaccine when it is available
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.
Is the COVID-19 vaccine safe for pregnant women and parents-to-be?
After carefully studying all information and evidence, the American College of Ob/Gyn (ACOG) recommends that this vaccine be offered to women who are pregnant or lactating.
ACOG’s practice advisory
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.
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.
Should I get the COVID-19 vaccine if I am pregnant or thinking about it?
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 of 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.
Recommended COVID-19 vaccine timing for fertility patients
The American Society for Reproductive Medicine (ASRM) recommends that individuals undergoing any elective surgery or outpatient procedure (including oocyte retrieval, embryo transfer and intrauterine insemination) avoid receiving a COVID-19 vaccination at least three days before and after their procedure.
This recommendation is being made due to the known side effects of the vaccine and not because the vaccine is unsafe.
What are potential risks for pregnant women getting the vaccine?
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 can 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-19 vaccine should be monitored for 15 to 30 minutes after receiving the shot to mediate any complications.
Will the COVID-19 vaccine make me infertile or miscarry?
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.
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.
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. 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, tells USA Today that there has been no evidence among the 44,000 COVID-19 cases in pregnant women this year that spike protein antibodies attacked any cells in the placenta, which would cause pregnancy complications or miscarriage.
COVID-19 and Infertility FAQ
What if I can’t get access to the vaccine?
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 those 44,000 pregnant women in this country tested positive for COVID-19 this year, more than 8,500 had to be hospitalized, and of those, 300 were admitted to intensive care and 57 died.
Can the coronavirus be transmitted through IVF or to or from embryos?
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.
Conclusion: precautions are still the best medicine
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.
- Continue to limit your exposure to individuals outside your household.
- Wear a mask.
- Practice good hand and mouth hygiene for the next several months.
If at any time you have questions about COVID-19 symptoms or prevention, contact your healthcare provider.
For more information online, see information on COVID-19 and the vaccine on the website of the American Society for Reproductive Medicine.