An Essential Review for Women on Vaccination and Fertility
This is probably the most pervasive reason for vaccine hesitancy among women. If you are worried about getting the COVID vaccine and your fertility, I encourage you to read the references listed and talk with your OB/GYN if still uncertain. This resource (American College of Obstetricians and Gynecologists (ACOG)) thoroughly details everything your health care provider may share - https://www.acog.org/.../covid-19-vaccination.... ACOG recommends vaccination for ALL eligible persons.
If you are planning to become pregnant or actively trying, vaccination is urgent for you. Pregnant women experience disproportionately severe illness from COVID especially in later terms.
I empathize with women who see misinformation on COVID-19 vaccination and fertility and hesitate to proceed. Fertility is challenging enough for so many women. A few notes before we go into the science on COVID-19 vaccination. The US birth rate did decline in 2020; however…
• Prior to the pandemic, the US birth rate hit an all time low in 2019 at 58.3 births for every 1,000 women due to declining birth rates in women under 34, increased educational attainment, dramatic reductions in teen births, and delays in marriage.
• The percent of women at the end of their childbearing years who had ever given birth was higher in 2018 than in 2008, meaning more older women were giving birth than ever before.
• Birth rates do not equate to fertility rates.
Numerous vaccines are administered before, during, and after pregnancy. Some vaccines are critical to preventing serious harm to an unborn child and/or the mother, such as rubella.
The origin of this misunderstanding…
• Infertility is a common fear tactic anti-vaxxers or those with medically disordered thinking use to discourage vaccination. This is one reason we haven’t eliminated Polio as rumors in developing countries such as Nigeria resulted in widespread, unsubstantiated fear.
• The spike proteins on the placenta and COVID-19 virus are in the same “family” so similar functioning was assumed. FALSE. The sequence of these proteins is NOT similar enough to cause the immune system confusion. This site gives an excellent, very detailed and cited explanation - https://www.deplatformdisease.com/.../are-covid-19...
• Having COVID-19 disease CAN affect both female and male fertility as it can cause chronic inflammation. This is confused with vaccination. The vaccine does not cause chronic inflammation.
• The vaccine may cause short-term abnormalities in menstrual cycles. True for some; about 20%. While there is no biologic mechanism for a cycle change, immune response can affect the reproductive system, though for a short period of time. Stress and anxiety, body temperature disruption, or simple random occurrence could be the reason. There are currently no reports of long-term menstrual cycle disruptions.
Myths…
• The vaccine is causing infertility. There is no evidence to support this. As of early June, 124,597 pregnant women received the vaccine. Of those, 5,102 were closely followed. The incidence of miscarriage (spontaneous abortion), still birth, neonatal death, and birth defects were lower than average. Pre-term birth and low birth weight babies occurred in alignment with average. https://www.nejm.org/doi/full/10.1056/NEJMoa2104983
• The spike proteins are puncturing female reproductive organs. This is completely biologically unfeasible as the spike protein is too tiny to puncture an organ.
• Virus is being shed from vaccinated people affecting the health of unvaccinated. This is also biologically impossible. None of our vaccines contain the virus. mRNA vaccines create copies of mRNA not actual virus. You do not shed mRNA. J&J use an adenovirus to deliver viral particles, but the strain of adenovirus does not replicate in the body. Same premise as Influenza – you do not get the flu from the flu shot.
How does COVID negatively affect pregnant women?
Pregnant women are more likely to experience the following if infected with COVID-19 while expecting –
• ICU admission, requiring ventilation and/or supplemental oxygen
• Preeclampsia
• Pre-term or stillborn babies
• Death
• Infant admission to the neonatal intensive care
Here is a 42-study analysis of the outcomes of pregnant women who had COVID-19 - https://www.cmaj.ca/content/193/16/E540.
In sum, there is NO risk to fertility associated with COVID-19 vaccination. Please review and share these resources and do not hesitate to vaccinate your teenage daughter, female family members or friends. Protection of pregnant women is critical. As previously noted, all clinical concerns should be discussed with your OB/GYN. Take care and stay healthy!
References:
Much of this post was adapted from YLE (excellent ongoing resource) - https://yourlocalepidemiologist.substack.com/archive...
Pew Research Foundation - https://www.pewresearch.org/.../with-a-potential-baby.../
A good Iowa-specific editorial on declining birth rates - https://www.desmoinesregister.com/.../declini.../7908443002/
Pregnancy outcomes - https://www.cmaj.ca/content/193/16/E540, https://obgyn.onlinelibrary.wiley.com/doi/10.1002/uog.23619
Maternal antibody protection - https://www.medrxiv.org/con.../10.1101/2021.03.07.21253094v1
Preliminary research on the efficacy of Pfizer - https://jamanetwork.com/journals/jama/fullarticle/2782047
Effects of COVID on male fertility - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442377/...
Menstruation and hormones - https://www.sciencedirect.com/.../abs/pii/S1472648320305253