For updated information regarding the COVID-19 vaccination and pregnancy/fertility, visit: https://www.asrm.org/news-and-publications/news-and-research/press-releases-and-bulletins/
Original Post: February 10th, 2021
In this blog post, we have summarized available information and research to provide our patients, egg donors, and surrogates with everything we know regarding the COVID-19 vaccination and pregnancy. It is important to note that vaccination studies are still being conducted and information is limited, especially regarding pregnant individuals.
How are Reputable Sources Responding to the COVID-19 Vaccination for Pregnant Individuals?
On December 16th, 2020, reputable leaders in the family-building industry including the American Society of Reproductive Medicine (ASRM) and American College of Obstetricians and Gynecologists (ACOG) released a joint statement supporting public health measures to combat COVID-19. The statement is summarized in the following paragraph:
“It is our collective opinion, after closely monitoring this situation, that the benefits of COVID-19 vaccination far outweigh the risks… It is especially important that certain eligible patient populations, including pregnant women, consult with their trusted physicians when considering whether to take the vaccine.“
Along with the CDC, FDA, and other reputable sources, the ASRM COVID-19 Task Force statement emphasizes the importance of patients consulting with their physicians about their specific situation in order to make an informed decision. Additionally, the Emergency Use Authorization (EUA) Fact Sheet for Recipients and Caregivers for both Pfizer-BioNtech and Moderna vaccines states “If you are pregnant or breastfeeding, discuss your options with your healthcare provider”.
In addition to stressing the importance of a shared decision-making model between patients and healthcare providers, the ASRM COVID-19 Task Force encourages patients undergoing fertility treatments and pregnant individuals to receive vaccination based on eligibility criteria.
Are There Known Risks Associated with the COVID-19 Vaccinations for Pregnant Individuals?
Currently, the available data on both Pfizer-BioNtech and Moderna COVID-19 vaccines is insufficient to inform vaccine-associated risks in pregnancy. Pregnant and lactating people were not included in the vaccine trials and research. However, the ASRM COVID-19 Task Force concludes that since COVID-19 mRNA vaccines are not composed of the live virus, they are not thought to cause an increased risk of infertility, first or second trimester loss, stillbirth, or congenital anomalies.
As stated by American College of Obstetricians and Gynecologists (ACOG),
“Based on the...demonstrated safety and efficacy in Phase II and Phase III clinical trials, it is expected that the safety and efficacy profile of the vaccine for pregnant individuals would be similar to that observed in non-pregnant individuals. That said, there are no safety data specific to mRNA vaccine use in pregnant or lactating individuals and the potential risks to a pregnant individual and the fetus are unknown.”
According to the CDC’s page, COVID-19 Vaccination Considerations for People Who Are Pregnant,
“Limited data are currently available from animal developmental and reproductive toxicity studies. No safety concerns were demonstrated in rats that received Moderna COVID-19 vaccine before or during pregnancy; studies of the Pfizer-BioNTech vaccine are ongoing.”
Also, a more detailed explanation from the article concludes the CDC’s stance:
“mRNA vaccines do not contain the live virus that causes COVID-19 and, therefore, cannot give someone COVID-19. Additionally, mRNA vaccines do not interact with a person’s DNA because the mRNA does not enter the nucleus of the cell. Cells break down the mRNA quickly. Based on how mRNA vaccines work, experts believe they are unlikely to pose a specific risk for people who are pregnant. However, the actual risks of mRNA vaccines to the pregnant person and her fetus are unknown because these vaccines have not been studied in pregnant women.”
However, Pregnant Individuals are at Increased Risk for Severe Illness from COVID-19
According to the CDC, pregnant women with COVID-19 have a higher risk of severe illness compared to non-pregnant women.
Severe illness is defined by the following characteristics:
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ICU admission
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Mechanical ventilation
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Possible adverse pregnancy outcomes
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Death
With this information, some pregnant women have decided that the theoretical risks of the vaccine do not outweigh the known risks of COVID-19.
Choosing What’s Right for You
Many doctors believe that even with the lack of data, the benefits of the vaccines are very likely to outweigh the risk of COVID-19. As stated by Dr. Laura Reilly, an OB/GYN at New York Presbyterian,
“the biology of the way this vaccine works does not make us think in any way that this vaccine is going to be any less safe or any less efficacious in pregnancy than it is in non-pregnant individuals.”
However, the American College of Obstetricians and Gynecologists (ACOG) encourages that pregnant women who decline the vaccination should also be supported in their decision. Ultimately, regardless of the patient’s decision, these conversations serve as a reminder about the importance of other prevention measures such as hand washing, physical distancing, and wearing a mask.
Shared Decision-Making With Your Healthcare Provider
Each individual and each pregnancy is unique -- there is no blanket recommendation we can provide. There are many personal factors to consider and discuss with healthcare providers, such as:
- your underlying medical conditions
- how far along you are in your pregnancy
- any possibility of an allergic reaction based on your history
- the level of activity of the virus in the community
- the likelihood of exposure to the virus
- risks of COVID-19 and the potential risks to the fetus
- the efficacy of the vaccination
Although it is not required that you speak with your doctor prior to receiving the vaccination, it is a good idea as your physician may be able to provide you with a more personalized recommendation. As you’ve read on this page, it is highly recommended that pregnant individuals discuss their options with their healthcare provider.
With rapid changes being made in the vaccine development and approval process, the recommendations will continue to evolve as more data is collected. We hope that the available information provided in this post helps you in weighing out the pros and cons for your specific situation, and we encourage you to discuss any concerns you may have with your healthcare provider.
Resources:
https://www.acog.org/covid-19/covid-19-vaccines-and-pregnancy-conversation-guide-for-clinicians
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html