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August 17 2021
Many prospective parents approach us with questions in relation to COVID-19 vaccination and pregnancy. This issue became even more important with spread of the new highly contagious delta variant of the virus.
Below we try to summarise important information on this issue that comes from a trustworthy official sources. We hope that this summary will assist you in making an informed and responsible decision.
- There is an increased risk of adverse outcomes for women infected with COVID-19 during pregnancy I;
- Vaccination either pre-conception or early during pregnancy is the best way to reduce maternal/fetal complications II;
- None of the currently available (internationally recognised) COVID-19 vaccines reach or cross the placenta. The intramuscularly administered vaccine mRNA remains in the deltoid muscle cell cytoplasm for just a few days before it is destroyed III;
- Protective antibodies to COVID-19 have been shown to cross the placenta and confer protection to the baby after delivery IV;
- COVID-19 vaccination does not induce antibodies against the placenta V;
- Existing data suggest COVID19 vaccination during pregnancy does not increase risk of miscarriage VI;
- COVID19 vaccination does not impact male or female fertility or fertility treatment outcomes VII.
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I Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–October 3, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1641–7. Villar J, Ariff S, Gunier R, Thiruvengadam R, Rauch S, Kholin A, et al. Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection. The INTERCOVID Multinational Cohort Study. JAMA Pediatr. Published online April 22, 2021. Available at https://jamanetwork.com/journals/jamapediatrics/fullarticle/2779182, last accessed July 2021.
II UCSF Aspire. Assessing the Safety of Pregnancy In the CoRonavirus PandEmic, Unpublished data. Available at https://aspire.ucsf.edu, last accessed July 2021.
III Centers for Disease Control and Prevention, Infectious Diseases Society of America. COVID-19 Realtime Learning Website. Vaccines FAQ, mRNA vaccines. Available at https://www.idsociety.org/covid-19-real-time-learning-network/vaccines/vaccines-information–faq/, last accessed July 2021. Pardi N, Tuyishimea S, Muramatsua H, Karikoa K, Muib BL, Tamb YK, et al. Expression kinetics of nucleoside-modified mRNA delivered in lipid nanoparticles to mice by various routes. J Controlled Release 2015;217:345-51. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624045/, last accessed July 2021.
IV Gray KJ, Bordt EA, Atyeo C, Deriso E, Akinwunmi B, Young N et al. Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study. Am J Obstet Gynecol Gynecology. Published online March 2021, available at https://www.ajog.org/article/S0002-9378(21)00187-3/fulltext, last accessed July 2021. Beharier O, Mayo RP, Raz T, Sacks KN, Schreiber L, Suissa-Cohen Y, et al. Efficient maternal to neonatal transfer of antibodies against SARS-CoV-2 and BNT162b2 mRNA COVID-19 vaccine. J Clin Invest 2021;131:e150319. Available at https://doi.org/10.1172/JCI150319, last accessed July 2021.
V Shanes ED, Otero S, Mithal LB, Mupanomunda CA, Miller ES, Goldstein JA, et al. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccination in Pregnancy. Obstet Gynecol. Published online July 08, 2021. Available at https://journals.lww.com/greenjournal/Fulltext/9900/Severe _Acute_Respiratory_Syndrome_ Coronavirus _2.206.aspx, last accessed July 2021.
VI Shimabukuro TT, Kim SY, Myers TR, Moro PL, Oduyebi T, Panagiotakopoulos L, et al. Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons. N Engl J Med 2021;384:2273-82.
VII Gonzalez DC, Nassau DE, Khodamoradi K, Ibrahim E, Blachman-Braun R, Ory J, et al. Sperm parameters before and after COVID-19 mRNA vaccination. JAMA 2021;326:273-4. Morris RS. 2021 SARS-CoV-2 spike protein seropositivity from vaccination or infection does not cause sterility. Fertil Steril Reports. Available online June 2, 2021. Available at https://www.sciencedirect.com/science/ article/pii/S2666334121000684, last accessed July 2021. Orvieto R, Segev-Zahav A, Aizer A. Does COVID-19 infection influence patients’ performance during IVF-ET cycle?: an observational study. Gynecol Endocrinol. Published online May 11, 2021. Available at https://pubmed.ncbi.nlm.nih.gov/33974475/, last accessed July 2021.
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