Author: Lori Marshall, MD
Beginning April 15, all Washingtonians over the age of 16 can sign up to get vaccinated. We are getting lots of questions about the vaccines and pregnancy as well as the impact of the available vaccines on fertility and fertility treatments. We hope to answer as many as we can for you here.
Can I get vaccinated while I am undergoing fertility treatments?
Yes, you may! However, we are recommending that you don’t get the vaccine 3 days before or 3 days after a procedure in the clinic, such as an egg retrieval, embryo transfer, hysteroscopy or IUI. The vaccine will not affect the outcome of these procedures, but could cause confusion if you get a fever after the vaccination. We won’t know if the fever is from the shot, from your procedure, or from a new COVID infection.
Does the coronavirus vaccine cause infertility?
Absolutely not! Beginning in December 2020 there were rumors that the vaccine would lower sperm counts or that it included a protein that would prevent implantation of an embryo. Those are unfounded myths not based in science or research. ASRM and ACOG, the professional bodies for reproductive medicine, issued a statement as follows: “There is no evidence that the vaccine can lead to loss of fertility. While fertility was not specifically studied in the clinical trials of the vaccine, no loss of fertility has been reported among trial participants or among the millions who have received the vaccines since their authorization, and no signs of infertility appeared in animal studies. Loss of fertility is scientifically unlikely.” Although it has not been demonstrated, men who get a high fever after a vaccine could theoretically experience a slight and temporary decrease in sperm count, so we recommend they take acetaminophen (Tylenol) if they have a fever after their vaccination.
Why don’t we know more than we do about coronavirus vaccines and pregnancy?
Most people are aware that pregnant women were unfortunately excluded from the initial clinic trials of vaccines. This is a common practice when testing new medications and treatments and has been sharply criticized by our professional societies and others. The consequence is that pregnant women don’t get the same reassurance of safety that others get.
The CDC and manufacturers of the vaccines are tracking pregnant women who have received coronavirus vaccines, and all companies are starting studies that include pregnant and breast-feeding people. The data so far suggest that vaccines are just as effective and safe in pregnant as in non-pregnant women.
What do professional societies say about pregnant women getting the vaccine?
ASRM (American Society for Reproductive Medicine) says, “In accordance with the CDC guidance stating that pregnant women are at high risk for severe disease, the Task Force recommends that pregnant women, considering guidance from their own states, should be prioritized to receive vaccination. It is recommended that patients receive vaccination at the soonest possible time, whether pre-conception or during pregnancy, while considering the timing of any surgical procedure.” Other professional societies, including the American College of Obstetrics and Gynecology (ACOG) and the Society for Maternal Fetal Medicine also encourage pregnant women to get vaccinated.
Everyone keeps saying I have to balance the risk of harm to me or my baby from COVID-19 infection with the potential risks of taking the vaccine in pregnancy. How do I do that?
Yes, that is an uncomfortable task—and “talk to your health care provider”! It has become clear that getting COVID-19 during a pregnancy can be very harmful to the mother and/ or to the fetus. Vaccines markedly lower your risk of getting coronavirus, and may pass antibodies and immunity to the newborn. Because the vaccines have not been well studied in pregnant people, we usually say “the risks are unknown.” However, we do know that 1) many vaccines can be safely given during pregnancy 2) there is no scientific mechanism by which any of the vaccines could be harmful to mother or baby 3) all of the studies on animals show the vaccines are safe and 4) there are more and more studies suggesting that all three available vaccines are safe for mother and baby
If I am pregnant, should I take any special precautions before or after my vaccination?
We suggest that you have acetaminophen (Tylenol) on hand, so that you can take it if you feel feverish. We prefer that you not have a high fever in early pregnancy.
When during my pregnancy should I get vaccinated?
In general, we recommend that you get vaccinated as soon as you are eligible. Women who have severe nausea or other symptoms in early pregnancy might want to wait until those symptoms clear before they get the vaccine. All available data shows that the vaccine does not increase your risk of miscarriage or other complications of pregnancy. The greatest risk of preterm labor and severe respiratory disease from COVID-19 is probably in the third trimester of pregnancy, so definitely try to get vaccinated before then.
Which vaccines are safest in pregnancy?.
Since none of the three vaccines currently available contain live virus, they are all expected to be safe in pregnancy.
For several months, we have been advising patients on taking the Pfizer and Moderna vaccines, both mRNA vaccines, and there are now reassuring data on pregnant patients taking these types of vaccines.
The Johnson & Johnson vaccine is a viral vector vaccine which also makes the coronavirus spike protein and stimulates an antibody response. This type of vaccine has been used against other viruses like Ebola virus, where data on pregnant women has also been reassuring.
Is it true that the vaccine might give my baby immunity to coronavirus infection?
Yes! We know that the antibodies that develop in response to many vaccines can cross the placenta during the last three months of pregnancy and provide the newborn with some immune protection. We now know that a pregnant or breast-feeding individual who gets a COVID-19 vaccine can pass antibodies to their newborn, which hopefully confer protection against COVID-19 infection.
Hopefully, the end of the pandemic is in sight.
The pandemic has affected every one of us in some way over the past year. Although our staff members have now been fully vaccinated, we know that many of our patients have not been. At PNWF we continue to look to guidance from the CDC and Washington Department of Health to keep our patients, staff and community safe. We have not changed our clinic policies that have been in effect since March of last year, including universal masking, social distancing, and limiting partners and visitors.
As health care providers, we believe that these policies, paired with vaccinating everyone possible, is the best pathway to end this pandemic.
Please reach out to our team members if you have any more questions.