The medical and scientific communities recommend the Pfizer and Moderna coronavirus vaccines as safe for adults of all ages, but even though the medical community is clear, some confusion remains among people with high-risk conditions like cancer, diabetes ... and pregnancy.
That's right: pregnancy. According to the American Society for Reproductive Medicine (ASRM), emerging data show that pregnant women are at higher risk of complications should they contract coronavirus.
Coronavirus and Pregnancy
According to Emily Evans-Hoeker, M.D., Carilion Clinic's chief of Reproductive Medicine and Fertility, studies in pregnant women with severe disease resulting from COVID-19 have now shown the following:
- Increased need for mechanical ventilation
- Increased risk of death compared with non-pregnant counterparts
- Increased risk of preterm labor
- Reports of fetal death and placental abnormalities, including blood clots
The psychological impact is significant as well. COVID-19 and infertility have both been associated with increased stress and feelings of isolation. As always, if you are struggling with these difficulties, we encourage you to reach out to your physician for discussion of options and recommendations for things that may be helpful. The American Psychological Association offers the following evidence-based ways to help manage stress:
- Take a break from the news, social media, or even certain friends.
- At the end of each day, reflect on three good things that happened that day—large or small.
- Take 15- or 30-minute self-care breaks throughout the day; take a short walk, call a friend or watch a funny video.
- Stay connected with friends and family.
- Try to reframe your perspective to reduce negative interpretations of day-to-day experiences.
Receiving the Vaccine
The good news is that the Pfizer and Moderna vaccines are widely available in our region, and ASRM recommends that women at every stage of the fertility journey receive the vaccine. The American Society for Reproductive Medicine and the American College of Obstetricians and Gynecologists make the same recommendation, as do Dr. Evans-Hoeker and Carilion Clinic's Infectious Diseases experts. This is true whether you are:
- Trying to conceive
- Undergoing fertility treatments
- Pregnant at any stage
And for those undergoing fertility treatments, receiving the vaccine does not need to change your timeline in any way. (Find out more about fertility and COVID-19 here.)
Pregnant women were not included in the COVID-19 vaccination clinical trials; however, as Dr. Evans-Hoeker points out, researchers are following the many women who took part in the vaccine studies and conceived during or after them, as well as pregnant women who have chosen to receive the vaccine.
"To date, there have been no safety concerns raised in any of the mechanisms by which safety in pregnancy is being assessed," she said, "including the v-safe pregnancy registry and Developmental and Reproductive Toxicity (DART) animal-model studies."
Based on the vaccine mechanisms of action, pregnant women can expect to be as safe as non-pregnant women when receiving the vaccine.
Potential Side Effects
Some women have reported experiencing heavier or more painful periods as well as irregular bleeding after being infected with COVID-19 or receiving a vaccine against it.
There is no research on the COVID vaccine and menstrual cycles, so these reports are anecdotal. Infectious disease experts have suggested that the changes noted after the vaccine are consistent with the body's immune response, and the aches and pains post-vaccine may be compounding normal menstrual pains. In addition, as Dr. Evans-Hoeker points out (and as many readers have experienced), menstrual cycles can be influenced by many things, including stress, physical activity, weight changes and medications.
These signs of a healthy immune response may not feel very good, but they are not expected to last long or have any long-term effects on fertility.
Trust Your Sources
A social media article is making the rounds that suggests the COVID vaccines would cause infertility. Dr. Evans-Hoeker states clearly: There is no evidence that the vaccination causes infertility and the societies taking care of pregnant women are in favor of the vaccine.
The decision to become vaccinated is a personal and individualized decision. As with any other medical information, your primary care provider or fertility specialist is your best resource to learn about options and risks relevant to you. Reliable sources of information about fertility and pregnancy include:
- The American Society for Reproductive Medicine
- The American College of Obstetricians and Gynecologists
- The Society for Maternal Fetal Medicine
Guidance from these organizations continues to evolve as the scientific community learns more about COVID-19. In the meantime, if you haven't been vaccinated yet, visit vaccinate.virginia.gov to sign up!