28th April 2021: COVID-19 Vaccination
Whilst the global COVID-19 pandemic is still evolving and there are many unknowns about the long-term effects of the virus on fertility and pregnancy, we know enough to be able to offer some evidence-based guidance. We believe that it is vital that everyone gets vaccinated, as this is the way out of the global pandemic and will also help limit the potential spread of the virus, which survives by changing or mutating.
Pregnant women with COVID-19 may become very seriously unwell and are at increased risk of pregnancy complications, which may affect both mother and baby (for example by causing premature birth). Therefore it is important now to try to become vaccinated before pregnancy if possible. A high fever can lead to miscarriage and premature labour and also potentially to developmental anomalies very early in pregnancy (even before a pregnancy test is positive). There is no evidence to date, however, that COVID-19 itself or the vaccines have caused developmental anomalies.
Vaccines have been developed using different methods. One is using RNA, which produces COVID-19 antigens (proteins) once injected into the body. This in turn triggers an immune response to COVID-19. The main vaccines that use this technology are the Pfizer and Moderna Vaccines. The other type of vaccine use an inactive modified chimp adenovirus with the gene for the COVID-19 spike protein inserted so that, again, antibodies to COVID-19 are produced and immunity develops (Oxford/Astra Zeneca and Johnson & Johnson Vaccines).
Serious side-effects are rare. The AstraZeneca and Johnson and Johnson vaccines have been associated with a very rare blood clotting reaction. The risk does not appear to be increased if you have an underlying risk for blood clotting. The AstraZeneca and Johnson vaccines are currently not recommended for people younger than 30 or for pregnant women - because the possible small risks outweigh benefit. Therefore you should be given the Pfizer or Moderna Vaccines. It is important to appreciate that you are still at greater risk of blood clots from COVID-19 than from the vaccine, irrespective of which vaccine you receive.
Will the vaccine affect my fertility?
There is no evidence or known mechanism by which vaccines will impact male or female fertility. There is on-going research looking at what is known as reproductive toxicity, including animal studies, and no concerns whatsoever have arisen to date.
Should I get vaccinated if I am trying to conceive or already pregnant?
The current advice in the UK is that it is safe to be vaccinated if you are planning a pregnancy and, more recently in the UK, if you are pregnant. None of the vaccines contain the live virus and so they appear to be safe if given during pregnancy, although there is limited data at the time of writing and studies are ongoing. However, thousands of women have now been vaccinated around the world in the third trimester of pregnancy and no safety concerns have arisen to date.
Fever is a potential side effect of the vaccine. The very early developing embryo is undergoing major developmental changes even before a pregnancy test is positive and a high fever may have an impact on organ development and even cause miscarriage. So perhaps the safest approach would be to receive the vaccine in the first ten days of the menstrual cycle, so that there is no chance of an early pregnancy. Or if you find yourself pregnant before being vaccinated, wait to be vaccinated until after 12weeks of pregnancy (usually 2 months after a positive pregnancy test).
The most up to date information for the UK can be found on the websites of the The Royal College of Obstetricians and Gynaecologists (RCOG) and the British Fertility Society (BFS).