Trying to get pregnant or already pregnant and worried about the COVID-19 vaccine? See answers to some frequently asked questions surrounding the COVID-19 vaccine.
Introduction
It has been more than a year since the first case of COVID-19 was identified in the United States. We have learned so much about the coronavirus and developed ways to safeguard the health and wellbeing of our patients and staff. Though mitigation strategies like face masks, physical distancing, and hand hygiene are the mainstays for disease prevention, the development of the COVID-19 vaccine is a huge leap forward in our fight against COVID-19. Widespread vaccination is important to slowing down the spread of the virus, but you may have some questions about the vaccine.
In this Rise Fertility Blog, we address the most pressing and common questions asked by patients about the COVID-19 vaccine. The information presented here is based on updates and statements from the American Society for Reproductive Medicine (ASRM) Coronavirus/COVID-19 Task Force as well as information from the Center for Disease Control (CDC), Food and Drug Administration (FDA), and other trusted sources. As always, please speak to your doctor when considering whether or not to get the vaccine.
“What COVID-19 vaccines are available?”
The two currently available mRNA-based COVID-19 vaccines are from Pfizer-BioNTech and Moderna. The FDA issued Emergency Use Authorization (EUA) for both vaccines in December 2020. Additional COVID-19 vaccines are currently in development and are expected to be available soon.
“How does the COVID-19 vaccine work?”
The Pfizer and Moderna vaccines are mRNA-based vaccines that do not contain any live virus. The vaccine delivers mRNA into muscle cells at the injection site, which then instructs the body’s own cells to replicate the coronavirus’s spike (S) protein. This protein is then recognized by the body as foreign, which triggers the body to create protective antibodies. The mRNA is then rapidly broken down in the cell once the protein is made so it does not stay in the cell or cross the placenta.
“How effective is the COVID-19 vaccine?”
Both of the currently available COVID-19 vaccines have demonstrated safety and efficacy in large randomized clinical trials. The Pfizer and Moderna COVID-19 vaccines are about 95% effective in preventing severe disease.
These vaccines are a two-injection series with the second dose given 21 days (Pfizer) or 28 days (Moderna) after the first dose. It’s important to note that after only one dose, the vaccines are only about 50% effective in preventing COVID-19. Both doses of the vaccine are needed to get the full protective benefit.
New variants of the SARS-CoV-2 virus have been identified recently. While studies are underway to compare these new mutations with the current strain, early data suggests that the mRNA vaccines currently available may be effective against these variants of COVID-19.
“What are the side effects of the COVID-19 vaccine?”
The most common side effects of the vaccine include:
- Tenderness, redness, or swelling at the injection site
- Fever, chills
- Muscle aches, joint pain
- Fatigue
- Headache
Side effects tend to be more common after the second dose and they are usually mild. Symptoms can last about 1-2 days and generally improve with Tylenol or ibuprofen.
“Can I get COVID from the COVID-19 vaccine?”
No, it is impossible to get COVID-19 from the COVID vaccine because it doesn’t contain any live virus. The vaccine does not contain ingredients that are known to be harmful to pregnant women or a fetus. Many vaccines, such as the flu vaccine and Tdap are routinely given in pregnancy and are known to be safe.
It generally takes a few weeks for the body to develop immunity to a virus after receiving a vaccine, which means that you can become infected with the virus just before or after vaccination and still be vulnerable. This is why mitigation strategies like mask wearing, hand hygiene, and physical distancing are still important.
“Does the COVID-19 vaccine cause infertility?”
No, available data shows that the COVID-19 vaccine does not cause infertility in women or men. The vaccine has no known effect on eggs or sperm. Additionally, there is no known effect on placental proteins nor has the vaccine been shown to increase the risk of miscarriage or pregnancy loss.
“I am trying to get pregnant. Should I get the COVID-19 vaccine?”
Women trying to conceive or undergoing fertility treatment are encouraged to receive the COVID-19 vaccine based on current eligibility criteria in order to minimize risks to themselves and their future baby. Because the vaccine does not contain a live virus, it is not thought to cause any increased risk of infertility, miscarriage, stillbirth, or congenital anomalies. This recommendation comes from the Advisory Committee for Immunization Practices (ACIP) of the U.S. Centers for Disease Prevention and Control (CDC), the American College of Obstetricians and Gynecologist (ACOG), the Society for Maternal-Fetal Medicine (SMFM), and the American Society for Reproductive Medicine (ASRM).
“I plan to start fertility treatment. Should I wait until I get the COVID-19 vaccine to start my cycle?”
There is also no reason to delay pregnancy attempts until you get the vaccine or to defer fertility treatment until the second dose of the vaccine is given. Additionally, there is no recommendation to withhold the vaccine from patients who are planning to conceive.
While there is no recommendation to avoid pregnancy during the coronavirus pandemic, keep in mind that trying to conceive during this time has its own challenges. It’s important to take all precautions to decrease your risk of exposure to COVID-19 and to follow all current CDC recommendations regardless of whether you have received the vaccine or not. For more information, please ask your doctor about the clinic’s COVID-19 policy for fertility patients.
“I’m currently pregnant. Should I get the COVID-19 vaccine?”
Yes, patients who are pregnant or lactating are encouraged to receive the vaccine based on eligibility criteria. The known and potential benefits of the COVID-19 vaccine especially in the setting of pregnancy outweigh the known and potential risks and harms of COVID-19 infection.
Pregnant women who contract COVID-19 are 5 times more likely to end up in the intensive care unit (ICU) or on a ventilator than non-pregnant patients who get COVID-19. In addition, some pregnant women have additional risk factors like obesity, high blood pressure, or diabetes which may increase the chance of more severe COVID disease. Given how dangerous COVID-19 infection can be during pregnancy, we recommend eligible women receive the vaccination.
It’s important to note that pregnant and breastfeeding women were excluded from the initial phase 3 trials of the two vaccines that are currently available. Specific safety data in pregnant or lactating women are not yet available and further studies are planned. However, the mechanism of action of mRNA-based vaccines and existing safety data provide reassurance regarding the safety of COVID-19 mRNA vaccines during pregnancy.
Women who get pregnant in the time period between the first and second dose of the vaccine should be offered the second dose of the vaccine at the appropriate time interval.
Because COVID-19 mRNA vaccines don’t contain any live virus, they are not thought to cause an increased risk of infertility, first or second trimester pregnancy loss, stillbirth, or congenital anomalies.
“Should my husband get the COVID-19 vaccine? Are there any effects of the vaccine on male fertility?”
Available data shows that the COVID-19 vaccine does not cause infertility in men or women. Men are also encouraged to receive vaccination based on eligibility criteria.
“If I get the COVID-19 vaccine, should I still get a flu vaccine?”
Getting a flu vaccine will not protect you against COVID-19 and getting the COVID-19 vaccine will not protect you against the flu. Getting a flu shot has several important benefits, it’s considered safe in pregnancy, and it’s recommended for all pregnant patients and women trying to conceive.
“If I get the COVID-19 vaccine, do I still need to wear a mask?”
Yes, all efforts and measures to decrease the spread of COVID-19 (wearing a mask, physical distancing, good hand hygiene, avoidance of large crowds, limiting social interactions, etc.) should remain in place even while vaccination efforts are underway. This is true for several reasons:
- It is not yet known whether a vaccinated individual can spread the virus if they become infected with COVID-19.
- Protective immunity against COVID-19 takes time to develop.
- Although the 2-dose vaccines that are currently available are 95% effective against COVID-19, they do not give you 100% immunity.
Summary
The COVID-19 vaccine is important in our fight against the coronavirus and will hopefully help bring an end to the pandemic. As more information about the virus and the vaccine become available, clinical guidelines will also be updated. Talk to your Fertility Specialist if you are thinking about getting pregnant or starting fertility treatment and you have more questions about whether or not you should receive the COVID-19 vaccine.
Dr. Ghazal is a double board certified Fertility Specialist, a Southern California native, and an award-winning Top Doctor and Rising Star in the field. She specializes in all aspects of female and male infertility, IVF, egg freezing, LGBTQ+ family building, miscarriage & pregnancy loss, PCOS, ovulatory disorders, intrauterine insemination, fertility preservation for cancer patients, endometriosis, and preimplantation genetic testing. Her research has covered a wide variety of topics in the field of reproductive medicine including assisted reproductive techniques, embryo culture, fertility preservation, endometriosis, implantation, and IVF outcomes. She has authored numerous book chapters and articles that have been published in top journals and she has been invited to present her research at national meetings.
