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COVID-19 vaccine does not affect fertility, immunization experts say

Image of Black and white photo of a couple holding hands. An Army couple holds hands while listening to a counselor explore reasons why the woman should or should not receive a COVID-19 vaccination while pregnant. Ultimately, those eligible for the immunizations must make their own choices about getting vaccinated while pregnant or choose to wait until after birth to get vaccinated. The same decision extends to people who are breastfeeding. (Photo by Army Sgt. Maricris C. McLane.)

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You’re pregnant, or you’re breastfeeding. Should you get a COVID-19 vaccine?

That’s a question on the minds of many military frontline health care workers today. The short answer is that it’s an individual’s choice, and military health experts say the vaccine is well worth considering.

As the COVID-19 vaccines continue to be administered across military hospitals and smaller clinics and outposts under Centers for Disease Control and Prevention guidance, the advice from the military and a multitude of national maternal and fetal health professional associations is the same: For most pregnant people, getting the COVID-19 vaccine as soon as possible is the safest choice based on the science to date.

The COVID-19 vaccines made by Pfizer and Moderna are mRNA vaccines. These vaccines contain no live viruses that could directly infect a mother or baby.

“As of Jan. 21, more than 15,000 pregnant patients had received an mRNA vaccine,” said retired Navy Capt. (Dr.) Margaret Ryan, medical director, Defense Health Agency Immunization Division, Pacific Region Vaccine Safety Hub, San Diego. “The experiences of these pregnancies are being followed very closely, and no specific safety concerns have been reported so far.

“As COVID-19 vaccines were being developed, studies in the laboratory and animals showed no reproductive health problems,” Ryan added.

Pregnant people are entering clinical trials for COVID-19 vaccines “literally now and going into March, so more data will be known soon,” Dr. Anthony Fauci, President Joe Biden’s chief medical adviser on COVID-19, told a Blue Star Families virtual town hall Feb. 4.

Of the 15,000 pregnant people who have received at least one of the 32 million vaccinations in the United States, “there have been no red flags of adverse events. Many who are pregnant are health care providers who said the risk of getting COVID-19 from their patients was worse than that from getting the vaccine,” said Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.

Said Ryan: “Although it is unclear how pregnancy may affect infection risk, some women who have been infected with COVID-19 during pregnancy have experienced serious illness or death. COVID-19 infection in pregnancy also seems to increase risk of preterm birth.”

As for those who do not want to take the vaccine, “we know there are significantly increased risks for pregnant people who contract COVID-19, e.g., they are three times more likely to be admitted to the ICU and need breathing support,” said Navy Cmdr. (Dr.) Monica Lutgendorf, division head Maternal Fetal Medicine, Naval Medical Center-San Diego (NMCSD), and chair, DHA Women and Infants Clinical Community. “People with comorbidities such as diabetes, Latinx, and Black people are also more at risk for COVID-19 and death. Therefore, it is often beneficial to get the vaccine, especially for pregnant or nursing individuals at increased risk of severe disease.”

Lutgendorf noted that although relative risks of COVID-19 are increased in pregnancy, this information should be provided in the context of overall low absolute risks for breathing support (2.9 per 1,000), heart and lung support (0.7 per 1,000), and death (1.5 per 1,000).

Ryan went on to say that specialists from the CDC, American College of Obstetrics and Gynecology, and American Academy of Breastfeeding Medicine “all agree that breastfeeding should not be a barrier to receipt of a COVID-19 vaccine. Breastfeeding should never be equated to pregnancy in terms of health considerations for mother or child.”

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