Having a COVID-19 Vaccine if you are planning to conceive
- Covid-19 is a very serious disease and may be very dangerous during pregnancy.
- Vaccination is the way out of the Covid-19 pandemic and we encourage everyone to get vaccinated.
- There is no evidence that the vaccine affects either male or female fertility.
The guidance for women trying to conceive who are offered vaccination against Covid-19 has changed since the vaccines were first introduced. Originally it was suggested that pregnancy should be avoided until 2 months after the second dose of the vaccine and that if you find yourself pregnant, vaccination should be avoided unless you are in a high risk group (see below).
On December 30th, the Joint Committee on Vaccination and Immunisation (JCVI) published additional advice for the priority groups to receive the Pfizer/BioNTech and the Oxford University/AstraZeneca vaccines. The JCVI confirms that although the available data do not indicate any safety concern or harm to pregnancy, there is insufficient evidence to recommend routine use of COVID-19 vaccines during pregnancy. On the other hand the JCVI does not advise routine pregnancy testing before receipt of a COVID-19 vaccine. Furthermore they have indicated that those who are trying to become pregnant do not need to avoid pregnancy after vaccination.
The JCVI advises that if a pregnant woman meets the definition of being clinically extremely vulnerable (see below), then she should discuss the options of COVID-19 vaccination with her doctor. This is because her underlying condition may put her at very high risk of experiencing serious complications of COVID-19. Additionally, pregnant women who are frontline health or social care workers, including carers in a residential home, can also discuss the option of vaccination.
It is important to appreciate that there is still a lack of safety data for these vaccines for pregnant or breastfeeding women. Whilst there is no known risk associated with giving non-live vaccines to pregnant women, such as the Oxford University/AstraZeneca vaccine, the Pfizer/BioNTech is an mRNA vaccine which is a new type of vaccine.
The British Fertility Society and Association of Reproductive and Clinical Scientists have issued guidance to say that people of reproductive age should have their vaccination when they receive their invitation, including those who are trying for a baby.
The vaccine may be associated with bothersome side effects including fever. A high fever may be associated with early miscarriage and may also have an effect on an extremely early pregnancy at a time that the baby is being formed and before a pregnancy has become properly established.
Therefore it may be sensible to separate the date of vaccination by a week or more before the day of ovulation or some fertility treatments (for example, egg collection in IVF).
In Summary - We still do not know for sure that the vaccine is safe in pregnancy or if it can be safely given if you are trying to conceive. However, on balance, if would like to be vaccinated, it would be reasonable for you to do so. There is no doubt that vaccination is the way out of the Covid-19 pandemic and we encourage everyone to get vaccinated.
A precautionary approach would still be to wait before conceiving for a period of time (1-2 months) until after you have had the second dose of vaccine, to avoid any risks and ensure that you are properly immunised during a future pregnancy.
If you are trying to conceive naturally then it may be preferable to be vaccinated around the time of your period or at least in the first 10 days of your cycle so that there is no risk of a fever around the time of conception.
Clinically extremely vulnerable women:
The most relevant groups of pregnant women are as follows, however they are unlikely to be attending for fertility treatment at the present time:
- Solid organ transplant recipients
- Those with severe respiratory conditions including cystic fibrosis and severe asthma
- Those who have homozygous sickle cell disease
- Those receiving immunosuppression therapies sufficient to significantly increase risk of infection
- Those receiving dialysis or with chronic kidney disease (stage 5)
- Those with significant congenital or acquired heart disease