While many people eagerly await the COVID vaccine, others are more anxious than anticipating it. This is especially true for women who are or are considering becoming pregnant. Why is this? It’s primarily because very few published data on the COVID vaccine during pregnancy. Due to ethical and historical reasons, pregnant women were deliberately excluded from the initial studies examining the vaccine’s safety and effectiveness. However, a small percentage of enrolled women became pregnant as the trials progressed. No adverse outcomes have been reported in this group. Let’s now look at what we know.
The COVID vaccination is safe.
Although it may seem that these vaccines were developed quickly, scientists have been studying the science behind them for many decades. It is possible to believe that trials were completed quickly, but this perception should be dispelled by data collected during a pandemic. This allowed for huge amounts of information to be collected about the safety and effectiveness of the vaccine in record time. The vaccine was tested and approved by the same standards as other vaccines on the market. This allowed the vaccine to be developed faster, which is a great benefit.
While safety is assured, it’s important to note that the COVID vaccine can still cause short-term side effects similar to those we see in other vaccines (e.g., the flu vaccine that is routinely given during pregnancy). These side effects include fever, headaches, fatigue, and body aches. They are all caused by the body’s healthy immune system. It signifies that the body has a strong defense against foreign invaders. If necessary, these effects can be easily managed by pregnant women using acetaminophen.
Is the vaccine likely to affect my fertility?
No evidence has shown that the vaccine can affect your ability or future fertility. After the vaccine molecules have been used to prime the immune system for future COVID infections, they are rapidly degraded. The vaccine molecules are completely gone within one week. You don’t have to worry about any foreign substances affecting fertility. It is impossible to prove that these vaccines have any effect on fertility, ovulation, sperm production, fertilization, or implantation.
We know very little about the effects of the COVID vaccine on pregnant women. This is despite years of data on other vaccines used in pregnancy, such as Tdap and flu. You can argue that the vaccine’s potential benefits and the prevention of COVID infection could increase the chance of a healthy pregnancy. The risk of developing a more severe case of COVID is increased when you are pregnant. There has been an increase in ICU admissions and hospitalizations among pregnant women. Healthy mothers have a better chance of having healthy babies. The regular use of vaccines during pregnancy has historically helped to ensure this.
When is the best time to get vaccinated if you are pregnant?
No data has shown that vaccinating later in pregnancy is safer than getting it done earlier. Talk with your doctor about the timing of the vaccination. The risks and benefits of getting the vaccine depend on many factors, such as the amount of active virus transmission in the community, the efficacy of the vaccine, and the potential risks for the baby or mother. A more timely schedule for vaccination may be recommended for mothers with chronic health problems (such as hypertension or diabetes).
We know that the benefits for the baby can be measured in the form of antibodies produced by mothers in response to vaccines. These antibodies, also known as passive immunity, cross the placenta to protect the infant. Imagine that infants whose immune system is not fully developed at birth who are vaccinated mothers are already protected from COVID. The same principle applies to the Tdap vaccine given to mothers during pregnancy. This will give infants passive immunity to whooping cold (a potentially fatal condition for babies) when they are born.
What vaccine should I get?
Two types of vaccines are currently available: a 2-dose mRNA vaccination (made by Moderna and another by Pfizer BioNTech) and a 1-dose virus vector vaccine (made by Johnson & Johnson/Janssen). The mRNA vaccine doesn’t contain any live viruses and delivers genetic information to our cells that encode a small amount of the COVID virus. Our cells use this information to make a copy of the coronavirus Spike Protein. This is what activates our immune system against the virus. Although this is a new vaccination method, it has been used for years in cancer research.
The virus vector vaccine, which uses a modified virus that is harmless to deliver a small amount of the COVID virus (the Spike Protein) to our cells, can also be used. The body then produces an immune response against coronavirus. Janssen used the same delivery method with its Ebola vaccine. It was tested on all three trimesters of women, and there were no adverse pregnancy outcomes. Nonhuman animal studies were also completed using all three COVID vaccines (both mRNA-virus vector models), and there have been no adverse outcomes.
Which vaccine should you choose if your baby is already vaccinated? Although the long-term safety of these vaccines has not been proven in pregnant women, ongoing studies show encouraging results. Due to their high safety profiles, most health officials recommend you take any vaccine you are given. Despite their differences in the mechanism of action, no one vaccine is better than another. They all offer almost 100% protection against serious COVID infections or hospitalizations.
Bottom line: Should pregnant women be vaccinated?
This is ultimately a personal decision. However, pregnant women owe themselves to be as informed as possible. It is recommended that pregnant women have a conversation with their doctor to discuss the benefits and risks of being vaccinated.
We know the vaccine is safe and effective, so pregnant women should consider getting it. There is no reason to believe that the vaccine is safer than being given later in pregnancy. If you are trying to conceive, you should not delay getting it. Several medical groups have supported these recommendations, including ACOG, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine. They encourage pregnant women and couples trying to conceive to get the vaccine as soon as it becomes available.
