28 Dec 2020 Reproductive Medical Doctors Advise COVID-19 Vaccination for Pregnant Women

In this pandemic season of uncertainty and fear, images from around the world of the first health care workers and elderly people being vaccinated has brought hope to many hearts that we may finally bring the COVD-19 pandemic under control and get back to a more normal way of life.

But for women who are pregnant or breast-feeding, or intended parents who are trying to conceive, the question of whether or not to receive the COVID-19 vaccine comes with an additional set of considerations and concerns that most of us don’t have to think about: Is the vaccine safe for my health during pregnancy, for my baby, or for the baby I am hoping to conceive?

The good news for the New Year is that the reproductive medicine experts of the American Society for Reproductive Medicine (ASRM) concur: In most cases, women who are pregnant, breast feeding or who are currently trying to become pregnant should get vaccinated, according to the organization’s most recent update on the COVID-19 pandemic and its impact on conception and pregnancy.  

Disclaimer: IFLG is not a medical provider, and all individuals are urged to consult with their personal physycians when making decisions about vaccination or any other medical issues.

COVID-19 Vaccines Offer Protection for Pregnant Women and Their Families

Although some people remain distrustful of two new vaccines that have thus far received FDA Emergency Use Authorization, recent polls indicate a growing number of Americans are ready and willing to receive the vaccines. Epidemiologists such as Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, estimate that some 75 percent to 85 percent of Americans must be immunized in order for the country to achieve “blanket” or “herd immunity” protection from COVID-19 outbreaks. “If you have a highly efficacious vaccine, and only 50 percent of the country gets vaccinated, you’re not going to have that umbrella of protection of herd immunity,” Fauci said in a Facebook Live discussion on November 30.

Released on December 16, 2020, the latest guidance from the Coronavirus/COVID-19 Task Force of the American Society for Reproductive Medicine is provided as a service to ASRM members, physicians and their patients and comes with the caveat that clinicians should act based on their own best judgement and the unique needs of each patient.

Here is a summary of recommendations from the task force update:

Do not withhold the COVID-19 vaccine due to pregnancy.

The Task Force does not recommend withholding the COVID-19 vaccine from patients who are planning to conceive, are currently pregnant, or are breastfeeding—in agreement with the guidance from other professional healthcare associations.

Pregnant women should take the COVID-19 vaccine when they are eligible to do so.

Patients undergoing fertility treatment and pregnant patients should be encouraged to receive vaccination based on eligibility criteria, such as front-line employment, age and pre-existing health conditions. Since the vaccine is not a live virus, there is no reason to delay pregnancy attempts because of vaccination administration or to defer treatment until the second dose has been administered.

The decision whether to be vaccinated for COVID-19 should be between patient and doctor.

The decision of whether or not a patient should be vaccinated should be made by the patient and her doctor, keeping in mind the “ethical principles of autonomy, beneficence, and non-maleficence.”

Doctors and patients should make decisions about receiving the COVID-19 vaccine based on all relevant risk factors and local conditions.

Patients and their doctors should assess several factors in making a decision on receiving the vaccine, including local COVID-19 transmission risk, personal factors that increase risk of contracting the disease, potential health risks of either patient or fetus contracting COVID-19, efficacy of the vaccine and known side effects, and the fact that there is little data available about the effect of the vaccine during pregnancy.

Pregnancy is a risk factor for severe COVID-19 disease.

Recent studies have suggested that women who are pregnant are at higher risk of becoming severely ill from COVID-19 disease, even more so for patients with conditions such as obesity, hypertension or diabetes. This heightened risk of severe illness should be a consideration in weighing the protective benefits of vaccination.

COVID-19 mRNA vaccines do not carry the risks to reproductive health of “live virus” vaccines.

mRNA vaccines such as the two currently authorized for emergency use in the United States do not contain live virus, avoiding many of the potential risks of a “live” vaccine, such as infertility, miscarriage or congenital anomalies.

People who are prone to severe allergic reactions should take extra precautions such as close monitoring when receiving one of the COVID-19 vaccines.

Specifically, according to the report, a lipid nanoparticle used in the Pfizer vaccine and commonly used in other injectable medicines can trigger a rare allergic reaction in some individuals. “Consequently, caution is advised when administering the vaccine to those individuals who have experienced severe allergic reactions to prior vaccines or injectable drugs,” the update concludes.

COVID-19 vaccines currently in use were not tested on pregnant women.

While the overwhelming consensus of the ASRM task force members and other reproductive health professionals is that the protective benefits of the COVID-19 vaccines for women who are pregnant or trying to conceive outweigh the risks of getting the vaccine, the vaccines were not tested on pregnant and lactating women during initial phase III clinical trials. For that reason, the report emphasizes that women, intended parents and their doctors should carefully weigh the risks of receiving the vaccine against the risks to patient, baby and family of remaining unprotected.

As all of us prepare to celebrate the New Year with the excitement of vaccines we hope will make it possible for us to safely gather again with family and friends, it’s also important not to let down our guards too soon. Even with a fast and efficient rollout of the two existing vaccines and others on the horizon, the logistics of getting enough people vaccinated to provide widespread protection in the United States mean we must continue safe practices to continue protecting one another for the next several months.

There is still a lot we don’t know about the vaccines’ effectiveness and the extent of the protection they provide. As the ASRM update reminds us, “1) it is not yet known whether a vaccinated individual can spread the virus if they become infected with SARS-COV-2 [COVID-19]; 2) protective immunity against COVID-19 takes time to develop; and 3) although a two-dose regimen of the Pfizer-BioNTech vaccine is 95% effective against the development of COVID-19, it does not confer 100% immunity.”

So in the spirit of taking ASRM’s advice to heart, our IFLG team of assisted reproduction attorneys and legal professionals wishes you a 2021 filled with health, happiness and the ability to safely hold your loved ones close once again, even as we urge you all, for just a little while longer: Wear a mask, wash your hands, stay 6 feet apart. Keep your loved ones safe by staying home.

If you are considering becoming a parent using assisted reproductive technology, contact us today! Our team of experienced ART attorneys and paralegals can answer all your questions about how to legally protect your family. We look forward to seeing you in 2021 and beyond!