30th July 2021: COVID-19 Vaccination
Whilst the global COVID-19 pandemic is on-going and data is still being collected, there is increasing evidence about the effects of the virus on fertility and pregnancy, and also the benefits of vaccination. We now 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).
COVID-19 poses significant risks to both mother and baby. Pregnant women are particularly vulnerable to becoming severely ill from COVID-19 and are at increased risk of pregnancy complications, which may affect both mother and baby (for example by causing premature birth). The latest data from the UK published on 29th July 2021 shows that around one in ten pregnant women admitted to hospital with symptoms of COVID-19 require intensive care and one in five gives birth prematurely. There has been a worrying rise in unvaccinated pregnant women being admitted to hospital with severe COVID-19 (99% of those admitted were unvaccinated), and evidence that the Delta variant poses a significantly greater risk than all previous strains. Therefore it is important now to become vaccinated before pregnancy if possible.
There is no evidence to date that COVID-19 or the vaccines against it 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 of vaccines 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 am already pregnant?
The current advice in the UK is that it is safe to be vaccinated if you are planning a pregnancy and, if you are already pregnant, at any stage of pregnancy. None of the vaccines contain the live virus and so they appear to be safe if given during pregnancy. Many thousands of pregnant women have now been vaccinated around the world 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 - to date there is no evidence of any harm caused by the vaccine on the developing baby or on the risk of miscarriage. If you have any concerns, the safest approach may be to receive the vaccine in the first ten days of the menstrual cycle, so that there is no chance of an early pregnancy and, if you are having fertility treatment, avoid vaccination around the time of ovulation or embryo transfer. If you find yourself pregnant before being vaccinated, it is still important to get vaccinated as soon as you can and if you have already received the first dose we advise you to receive the second dose when you are invited to have it.
If you have any doubts or questions, please ask a member of our medical and nursing team.
The most up to date information for the UK can be found on the websites of The Royal College of Obstetricians and Gynaecologists (RCOG) and the British Fertility Society (BFS).