As COVID-19 vaccines become more and more available in California, so to come questions regarding the vaccine and its safety profile in pregnant women and in those hoping to conceive soon. Here is a brief summary of the pertinent information regarding the vaccines as it may apply to our patients.
The only FDA-approved COVID-19 vaccine as of December 16, 2020, is an mRNA vaccine:
- mRNA is a genetic material (mRNA) that encodes a protein that will help create an immune response to the SARS-COV2 virus.
- The mRNA does not allow for entry in the nucleus (the part of the cell where DNA is kept), eliminating the risk for potential genetic changes.
- Studies have also shown that the mRNA is broken down by our bodies in a relatively short timeframe, thus posing minimal risk to the fetus—although the absolute risk is unable to be quantified due to pregnant patients being excluded in initial studies.
This type of vaccine is distinct from other forms of that are considered to be contraindicated in pregnancy, known as "live" vaccines (i.e. Rubella or varicella/Chicken Pox vaccines). Live vaccines have the theoretical potential of transmitting the virus to the fetus, and thus are not recommended to be administered in pregnancy, however the COVID-19 vaccine does not have the same theoretical risk.
No data supports increase risks of miscarriage or stillbirth with COVID-19 infection, however there are some risks of COVID-19 in pregnancy which include greater chances of severe COVID-19 symptoms, including hospitalizations and admission to intensitve care, as well as a higher risk of complications in pregnancy, including preterm deliveries, when comparied to pregnant women without COVID-19.
Recommendations regarding pregnancy and the COVID vaccine that are supported by The Society for Maternal-Fetal Medicine (sMFM) and the American College of Obstetricians and Gynecologists (ACOG) are:
- Pregnancy (or breast feeding) should not exclude someone from being offered the vaccine,
- The risk of COVID-19 in pregnancy versus potential fetal harm by vaccine should be weighed,
- Pregnancy testing is not needed prior to vaccine administration, and
- There is no concern for potential adverse effects to future fertility.
The decision whether to receive the vaccine is highly dependent on each individual's risk/benefit profile. For further discussion and questions, schedule time to have a detailed discussion with your provider to help clarify any questions you may have.