COVID Vaccine and Fertility

06.08.21 | by Leigh Anne Campbell, MSN, RN CPN

    Recent conversations with my daughter-in-law and other young women of childbearing age have brought to light concerns that receiving COVID-19 vaccine may affect fertility.  I thought it would be a good idea to provide information based on the evidence for her and others to make an informed decision.  The following is INFORMATION only—-not my thoughts, nor opinions.

    Pregnancy and lactation have been excluded from the vaccine trials. As Pfizer and Moderna are mRNA vaccines, they do not contain the virus that replicates and therefore do not cause the disease. Current data from animal trials, a small study of similar individuals who have been vaccinated, and vaccinated pregnant women have not shown harmful effects.

    The J&J/Janssen vaccine is a viral vector vaccine, using a modified version of a different virus to deliver instructions to the cells. Historically, similar viral vector vaccines have been given in large scale vaccination trials to women in all stages of pregnancy. No adverse pregnancy-related outcomes were found in either the mothers or infants because of these vaccinations. (CDC, 2021) 

    What does the data in the Pfizer/Moderna study show? In the study, antibody titers from vaccinated people were higher than those infected with COVID. In addition, vaccine-generated antibodies were present in blood, breastmilk, and umbilical cord samples. The American College of Obstetricians and Gynecologists and the CDC have recommended vaccination for all eligible adults. Experts believe it is an unlikely risk for pregnant women, the unborn child and breastfeeding newborns based on how mRNA and viral vector vaccines work (Berghella & Hughes, 2021).

    Over 94,000 participants in the CDC’s V-safe After Vaccination Health Checker program have indicated they were pregnant at the time of vaccination. The registry also has data on over 800 completed pregnancies that indicate no obvious pregnancy, fetus or birth related concerns reported at this time. (Berghella & Hughes, 2021)

    What if you are not currently pregnant, but see it as a future possibility? Although limited, evidence suggests that vaccines available for the prevention of COVID-19 are not thought to affect fertility and it is not necessary to delay pregnancy after vaccination (Berghella &Hughes, 2021).

    summary

    Vaccine challenges and maternal/fetal health are not new. Attenuated vaccines (using a live but weakened form of the virus) are not indicated for use during pregnancy, but none of the vaccines currently available in the US contain live COVID-19 virus. Minkoff and Ecker (2021) provide the following recommendations: “If the agent (vaccine) reduces the risk of being infected with a life-threatening virus, as is the case of the COVID-19 vaccination, and the risks to the fetus are unknown, then shared decision making, as recommended by the FDA, should be undertaken, and an informed woman’s choice should be honored.” Berghella and Hughes (2021) recommend the COVID-19 vaccination for pregnant people rather than deferring vaccination until after delivery or after breastfeeding.

    For further information, contact mothertobaby.org or call their hotline at 1-866-626-6847.