Author: Pacific NW Fertility Team
To Our PNWF Family:
It’s exciting to finally have some positive news during this unusual year, as we celebrate the first vaccinations against COVID-19! This reassuring news has prompted many questions from our patients regarding the use of these vaccines when they are pregnant or trying to conceive.
Our professional societies, the American Society of Reproductive Medicine and the American College of Obstetrics and Gynecology, as well as the CDC, have weighed in on this issue. Their recommendations apply only to the first two vaccines available and will likely be updated when vaccines with different mechanisms of action become available.
At PNWF we support the positions of these societies, which we summarize for you in the following statements:
The vaccines from Pfizer (FDA approved) and Moderna (likely approved next) are both mRNA vaccines that do not contain live virus. Both vaccines require a two-injection series at 21-day (Pfizer) or 28-day (Moderna) intervals. The vaccines deliver mRNA into cells near the injection site. This mRNA instructs the body’s own cells to replicate the coronavirus’s spike (S) protein. The protein, in turn, is recognized by the body as foreign, generating protective antibodies. The mRNA itself is rapidly degraded and does not enter the cell’s nucleus.
ASRM does not recommend withholding the vaccine from patients who are planning to conceive, who are currently pregnant, or who are breast-feeding.
Patients undergoing fertility treatment and pregnant patients should be encouraged to receive vaccination based on eligibility criteria. Since the vaccine is not a live virus, there is no reason to delay pregnancy attempts because of vaccine administration or to defer treatment until the second dose has been administered.
Your decision on whether or not to receive the COVID-19 vaccine should be made in consideration of local COVID-19 transmission and risk, personal risk of contracting COVID-19, risks of COVID-19 to you and your fetus, efficacy of the vaccine and known side effects, and the lack of data about the vaccine during pregnancy. Some individuals may elect to defer conception attempts until both doses of vaccine have been administered.
Because the COVID-19 mRNA vaccines are not composed of live virus, they are not thought to cause an increased risk of infertility, first or second trimester loss, stillbirth, or congenital anomalies. It should be noted that pregnant women were excluded from the initial phase III trials of these two vaccines, so specific safety data in these populations are not yet available and further studies are planned and necessary. However, the mechanism of action of mRNA vaccines and existing safety data provide reassurance regarding the safety of COVID-19 mRNA vaccines during pregnancy.
While the COVID-19 vaccination can cause fever in some patients (up to 16% of those vaccinated and mostly after the second dose), this risk should not be a concern when deciding whether to get vaccinated while pregnant or attempting to conceive. If you experience fever following the vaccine, you should take a fever-reducing medication, like acetaminophen.
Patients who conceive in the window between the first and second dose of the vaccine should be offered the second dose of the vaccine at the appropriate interval.
All patients who decide to get vaccinated should continue to follow the current guidelines to prevent the spread of COVID-19 after they are vaccinated. That means:
Wearing a mask
Staying at least six feet away from others
Washing hands with soap and water for 20 seconds or using hand sanitizer with at least 60% alcohol
Following CDC travel guidance
Following quarantine guidance after exposure to COVID-19
Following any applicable workplace guidance
If you want more detailed information, we encourage you to read the original statements from ASRM, ACOG and the CDC.
As always, we appreciate your trust and will continue to keep you up-to-date as more information becomes available.
We acknowledge the many challenges 2020 has presented all of us, and realize the strong desire to gather with family and friends during the holidays. However, we encourage everyone to continue to follow the CDC and state guidelines regarding holiday gatherings to keep yourselves and your loved ones safe.
We wish you a safe and happy holiday season!
Your team at Pacific NW Fertility