COVID-19 vaccines safe for those worried about fertility, pregnancy and breastfeeding
By Erin Podolak
Even without a global pandemic, pregnancy and parenthood can be a joyful but still anxiety-filled time. Fear related to fertility, pregnancy, breastfeeding and COVID-19 vaccination has driven an unknown number of couples to remain unvaccinated. Whether someone wants to be pregnant, is already expecting, or has a newborn, evidence shows that vaccination is safe and can reduce the risks associated with the virus for both parent and child.
The COVID-19 vaccine can’t prevent pregnancy
There is no evidence that any vaccine causes fertility problems. So where did this fear come from? A recent rumor circulating on social media claims that the spike protein on COVID-19, which is the target of the vaccines, is similar to a placental protein called syncytin-1. The rumor asserts that antibodies from the vaccine could make a mistake and target the placenta instead. This is not true.
“There is no way for these vaccines to cause infertility,” said Diego Hijano, MD, Infectious Diseases. “The rumor about the spike protein on COVID-19 attacking the placenta has no grounding in science. A new study has shown that having antibodies to the SARS-CoV-2 spike protein, whether from vaccination or infection, does not prevent embryo implantation or early pregnancy development. We know sterility is not caused by COVID-19 infection or the vaccines.”
People infected with COVID-19 develop antibodies against SARS-CoV-2. If antibodies to the virus caused infertility, getting and surviving COVID-19 would be a greater threat to fertility than getting vaccinated. Clinical data show that vaccination is safe and that some women in the COVID-19 vaccine clinical trials became pregnant and reported no adverse effects.
mRNA and ovary health
A second myth is that mRNA vaccines accumulate in the ovaries. Research in animals found no accumulation of vaccine-related products in the ovaries. Importantly, no effects on fertility were identified through a study called developmental and reproductive toxicology (DART).
For Amanda Green, MD, an Infectious Diseases clinical fellow, getting vaccinated prior to pregnancy was important.
“I’m so thankful that I was able to get the COVID-19 vaccine just before becoming pregnant, so that even if my newborn daughter or I get COVID-19, the vaccine will help us reach full term, stay healthy, together and out of the hospital,” Green said.
“For me, the best part about getting vaccinated is that it’s currently the best way to protect my daughter through the sharing of my antibodies, as she herself will be ineligible for the vaccine due to her age,” Green added. “We know that COVID-19 is much more dangerous for pregnant women, and with the current Delta variant surge I see many more sick infants and children affected by COVID-19 than ever. The vaccine protects me and my unborn baby.”
The COVID-19 vaccine is safe for people who are currently pregnant
More than 100,000 women who are pregnant have been vaccinated against COVID-19, with no safety concerns observed. Additionally, the Centers for Disease Control (CDC) created a registry for vaccinated pregnant women, which has enrolled thousands. The registry data shows no difference in miscarriage, stillbirth, pregnancy complications or neonatal outcomes between the general population and pregnant vaccinated individuals.
Pregnancy and COVID-19 infection
However, if someone is pregnant and becomes infected with SARS-Cov-2, they are at a greater risk than people who are not pregnant of experiencing severe COVID-19. This includes an increased risk of ICU admission and the need for mechanical ventilation. Pregnant individuals have a 70% increased risk of dying of COVID-19, as well as an increased risk of preterm delivery.
“I was offered the vaccine very early in pregnancy—in fact I didn’t even know I was pregnant at the time, but I knew it was a possibility,” Graetz said. “This was January, so most of the data on pregnant women was coming out of clinical trials. I read as much as I could, but more than that, I talked to other women who were making the same complicated decision. A lot of my friends are other women in health care, many of whom were pregnant, and all of them were getting vaccinated.”
“Ultimately, I’m grateful to have been offered the vaccine during pregnancy. Not only does it help me feel safe, but it has been one thing during a crazy time that I have been able to proactively do to protect this baby,” Graetz said.
Pregnant individuals transfer their antibodies to their children through the placenta. Getting vaccinated for COVID-19 transfers those antibodies alongside all the others the parent has to provide protection for the baby during the first few months of life.
Breastfeeding after vaccination can protect your baby
Confusion about vaccine antibodies has also driven hesitation about vaccination. People mistakenly worry that antibodies in breastmilk will alter a child’s DNA. This is not possible because the vaccines do not alter DNA.
In fact, while antibodies from the vaccine during pregnancy give protection to a baby through the placenta, antibodies transferred into milk will also give some protection against COVID-19. This is incredibly important since infants may be more likely to have severe illness from COVID-19, and vaccines are not yet approved for children this young.
Claims linking COVID-19 vaccines to infertility, pregnancy complications or breastfeeding issues are unfounded and have no scientific evidence supporting them. The American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine recommend that all women seeking to become pregnant get a COVID-19 vaccine.
“At this point, it comes down to whether you give in to the misinformation on social media or embrace the facts and do the right thing for you, your family, your patients, your institution and your community,” Hijano said.