- Experts are dispelling myths that COVID-19 vaccinations cause infertility.
- They also say there is no evidence yet that the vaccinations cause any health issues for pregnant women.
- They note that the dangers of COVID-19 should outweigh any hesitation about getting vaccinated.
Some younger women who are eligible for COVID-19 vaccinations are taking a pass.
One reason for the hesitancy is the worry that the vaccines can cause infertility.
It’s the kind of fear that spreads quickly through social media feeds.
As the vaccines become available to more younger people, concerns about infertility, pregnancy, and breastfeeding could mean that many women will skip vaccinations.
With herd immunity still a long way off, that could leave a large share of the population vulnerable to infection and illness.
Conti told Healthline that there’s zero evidence that COVID-19 vaccines interfere with fertility.
“This misinformation is dangerous because the confusion it is based on sounds plausible, but in fact is not,” said Conti.
“The rumors are based on the fear that messenger RNA in the vaccine could cause infertility by accidentally attacking a protein in the placenta called syncytin-1, which has a (sort of) similar structure to the coronavirus spike protein. However, these are totally different structures and there is no reason to think this would happen,” she explained.
Guidance from the Association of Reproductive and Clinical Scientists and the British Fertility Society was recently published in The BMJ. The groups agree that there’s no link between the vaccines and infertility.
The article adds that sperm and egg donors should get vaccinated as well.
The scientists do suggest that if you’re undergoing fertility treatment, you might want to consider the timing of COVID-19 vaccines. That’s so there’s no confusion over whether any symptoms, such as fever, are side effects of the vaccine or fertility treatment procedures.
Pregnancy and breastfeeding
The BMJ article suggests that pregnant women at high risk for COVID-19 should be vaccinated, but those not in a high-risk category should wait.
The authors state, “There is no reason to believe that any of the COVID-19 vaccines would be harmful, but their effects in pregnancy have not yet been fully investigated. The information that is known is reassuring. None of the vaccines contain live virus and so there is no risk that the pregnant woman or her baby could get COVID-19 from the vaccine.”
According to the Centers for Disease Control and Prevention (CDC), a COVID-19 infection while pregnant can increase the risk of severe illness that can result in ICU admission, mechanical ventilation, and even death.
COVID-19 during pregnancy may also increase the risk of adverse outcomes, such as preterm birth.
The CDC acknowledges that data about COVID-19 vaccine safety in pregnancy is limited. It noted that data from animal developmental and reproductive toxicity studies for the Moderna vaccine had demonstrated no safety concerns during or after pregnancy.
“When you weigh the real, potentially fatal risks of COVID in a pregnant person to the theoretical, fear-based risks of a vaccine that is otherwise elegantly designed, the scale tips largely toward vaccination,” said Conti.
“The correct comparison isn’t vaccine in pregnancy versus no vaccine in pregnancy. It’s vaccine in pregnancy versus COVID in pregnancy, and COVID in pregnancy is incredibly risky,” she continued.
Many women are worried about what happens if the vaccine crosses the placenta.
“What we should really be worrying about is what will happen if a pregnant person gets infected and ends up in the ICU,” said Conti. “A better question is: What does severe lung damage and a ventilator do to the placenta?”
Dr. Rashmi R. Rao is a maternal-fetal medicine specialist and assistant clinical professor of obstetrics-gynecology at the David Geffen School of Medicine at the University of California Los Angeles.
Rao told Healthline that concerns are theoretical at best, so it should be weighed against the known risks of having COVID-19 while pregnant.
“Pregnant women were not included in trials. It doesn’t necessarily mean they’re at higher risk. It’s just the decision that was made, so we cannot say. We’ll probably have safety data within the next year or so to give to patients. But I feel very strongly that the vaccines should not be withheld from pregnant women,” said Rao.
According to the CDC, there’s a lack of data on safety of COVID-19 vaccines when it comes to breastfeeding, but mRNA vaccines are not thought to be a risk to the baby.
Rao recommends getting the vaccine if you’re breastfeeding if it’s possible.
“From a biologic and physiologic standpoint, there’s no evidence this could be harmful,” she said.
The American College of Obstetricians and Gynecologists (ACOG) recommends that COVID-19 vaccines not be withheld from pregnant individuals and offered to breastfeeding individuals who meet vaccine criteria.
Weighing your options
Rao said the decision should be made with a healthcare professional and based on data.
“If you have an autoimmune disorder and take medication, discuss the timing of the vaccine. It’s important to discuss it with your doctor. But, in general, there are no contraindications for healthy pregnant women,” she said.
The ACOG also states that pregnant people who decline vaccination should be supported in their decision. They should be reminded of the importance of other prevention measures such as hand-washing, physical or social distancing, and wearing a mask.
“I tell even my patients who have been vaccinated the same thing,” said Rao. “Pregnant women get more severe COVID-19. So, regardless, follow strict prevention protocols from the CDC, and follow local guidelines. Stay up to date with recommendations.”
Clinical trials are underway
Both Moderna and Pfizer are monitoring people in clinical trials who get pregnant after they’ve been vaccinated.
Pfizer has announced that clinical trials for expectant mothers are underway for its COVID-19 vaccine. First doses have already been administered.
“I’ve been shouting from the rooftops that we should not be withholding COVID vaccines at this time,” said Rao. “A lot of us in women’s healthcare feel strongly that women should not be left out from trials because of pregnancy.”
“Pregnancy and underrepresented minorities should not be excluded from clinical trials of any sort. They should be adequately represented. There was not adequate representation and it’s a shame since pregnancy is a high-risk situation,” added Rao.