SSM Health St. Clare Hospital - Fenton: COVID-19 Vaccine And Fertility, Pregnancy And Breastfeeding

Press release from SSM Health St. Clare Hospital - Fenton:

August 27, 2021

SLUCare Maternal-Fetal Medicine Specialist at SSM Health St. Mary’s Hospital, Dr. Katie Childress helps debunk the common myths surrounding the vaccine and answers your questions about the COVID-19 vaccine and fertility, pregnancy and breastfeeding.

Pregnant women with COVID-19 are 15 times more likely to die, 14 times more likely to need to be intubated, and 22 times more likely to have to have pre-term birth than those who are uninfected, according to a study published in August 2021 in JAMA Network Open.

Women of child-bearing age have been reluctant to get the vaccine because of misinformation widely circulating on social media channels and being excluded from clinical trials for the Pfizer, Moderna and Johnson & Johnson vaccines. Studies on pregnant women began in February, and evidence has shown no increased risk of miscarriage from the shots. Despite the recent recommendations for pregnant women to get the vaccine from the Center of Disease Control and Prevention (CDC), American College of Obstetricians and Gynecologists (ACOG) and Society of Maternal-Fetal Medicine (SMFM), many women are still fearful.

To hear Dr. Childress talk more about the COVID-19 vaccine and fertility, pregnancy and breastfeeding, click on the links below for her interviews with KMOX Radio and Fox2Now or read our Q&A below:

KMOX Radio

Fox2Now

Does the COVID-19 vaccine affect fertility?

No, not at all. That is an important question because that is one of the myths floating around on social media. These falsely propagated articles talk about how antibodies are going to attack the placenta and that is not true. In fact, you probably have better fertility if you’re protected from getting COVID. We don’t know how COVID affects fertility. If these articles are saying that antibodies cause infertility, then anyone who has had COVID could have a higher rate of infertility and miscarriage because it’s the same antibodies. Again, these articles that claim antibodies and the vaccine cause infertility are not true.

Can the vaccine impact my menstrual cycle?

I have not seen any information to suggest that might happen. Sometimes when you get a really bad cold or flu – something where your body might be under some stress or be a little different, you might skip a cycle or two. It shouldn’t be longer than that.

How does COVID-19 affect pregnant women differently than those who are not pregnant?

That’s a really important question. That’s why we feel so strongly about pregnant women getting vaccinated because they’re at a much higher risk for being hospitalized, having to be put on a ventilator and death. There is also a higher risk of preterm birth. Having certain underlying medical conditions, and other factors, including age, can further increase a pregnant person’s risk for developing severe COVID-19 illness. With more variants circulating in our community, we’re also seeing more complications with fetal growth restriction, severe preeclampsia and possibly even stillbirth. We’re in the process of collecting more data about it, but as someone who is seeing this every day, it’s pretty scary. I feel very passionate about women getting the vaccine and it’s the number one thing that women can do right now to protect themselves and their baby.

How does the Delta Variant affect pregnancy?

There is a lot unknown right now. Anecdotally, my colleagues and I are seeing more pregnant women admitted to the hospital right now with different outcomes and complications than we were seeing last year. OB/GYNs and MFMs around the country are starting to see more patterns of preeclampsia, fetal distress, and severe complications.

When you look at risks vs. benefits, we know there is not 10-year data out yet, but we do have about a year’s worth of data and it’s actively being collected. So far, we are finding no difference in adverse events in getting the vaccine and it can provide protection to your baby. The benefits are outweighing the risks right now.

There is a lower vaccination rate of pregnant women – why?

One of the questions I ask my patients is “Has anyone talked to you about the COVID vaccine?” Often times, the answer is no, and they want to know more about it. We spend a significant portion in our first appointment talking about the vaccine and answering questions or addressing concerns. Talking about the vaccine is important.

Has there been any adverse events or side effects from the vaccine?

I think there is an important distinction between side effects and adverse events. No, there hasn’t been any difference in side effects or adverse events from the vaccine in pregnant women and the general population. Tired, sluggish, low grade fever, chills are the same side effects as anyone else after getting the vaccine. If you experience fever following vaccination you should take acetaminophen (Tylenol®) because fever —for any reason— has been associated with adverse pregnancy outcomes.

Serious adverse events like blood clots are very rare – about 1 in 10,000. That is the same as the general population and being pregnant does not increase your chances of having an adverse event.

Can the vaccine cause birth defects?

A lot of what we do in medicine is weigh the risks and benefits. We have almost a year’s worth of data and they are collecting more every day. There have been over 150,000 pregnant women in the U.S. that have been vaccinated and studies have found no increased adverse events in mom and baby after the vaccine. The vaccine does not cross the placenta and disappears pretty quickly – usually in 1-2 days. It basically tells your body to make a certain protein so that your body makes antibodies. The antibodies are the “good fighters” and they do cross the placenta, so they actually provide protection to the baby.

We haven’t found any birth defects associated with getting the vaccine. There is always about a 2% chance of birth defects in any pregnancy. When we look at a specific medication or vaccine to see if there is any correlation of birth defects, we look at patterns and not just isolated cases since birth defects can happen in the general population. We have a lot more women than what people realize that we have gotten outcomes for and we have not seen a pattern of the COVID vaccine causing birth defects.

If you had COVID while you were pregnant, does your baby have antibodies? Do you still need to get vaccinated?

Yes, and yes. Babies do have antibodies from Mom from passive immunity for a couple months after delivery, but we know that antibodies wane over time. The antibodies start to wane 6-9 months after getting COVID or the vaccine. It’s important to get the vaccine to trigger your body to keep making the good antibodies to protect you and your baby.

Which vaccine should I get?

I do recommend the Pfizer and Moderna vaccines first. The Moderna and Pfizer-BioNTech vaccines are mRNA vaccines that do not contain the live virus that causes COVID-19 and therefore, cannot give someone COVID-19. Additionally, mRNA vaccines do not interact with a person’s DNA or cause genetic changes because the mRNA does not enter the nucleus of the cell, which is where our DNA is kept.

The Johnson & Johnson Janssen COVID-19 Vaccine is a viral vector vaccine, meaning it uses a modified version of a different virus (the vector) to deliver important instructions to our cells. Vaccines that use the same viral vector have been given to pregnant people in all trimesters of pregnancy, including in a large-scale Ebola vaccination trial. No adverse pregnancy-related outcomes, including adverse outcomes that affected the infant, were associated with vaccination in these trials. However, women younger than 50 years old especially should be aware of the rare risk of blood clots with low platelets after vaccination, and that other COVID-19 vaccines are available where this risk has not been seen.

Tell us more about the FDA approval of the Pfizer vaccine.

I think it’s exciting news that we have full approval now of the Pfizer vaccine and it gives people more confidence about the safety of the vaccine. The U.S. Food & Drug Administration (FDA) has very stringent criteria and guidelines for full approval of vaccines and medications. Even though the COVID vaccine was submitted fairly quickly, the FDA made a point to say that it still met all of those guidelines and criteria. Since we’re in a public health crisis and global pandemic, a lot of resources went into focusing on this vaccine to make sure it was safe and effective for people.

Is breastfeeding safe after getting the COVID-19 vaccine?

Recent reports have shown that antibodies from the vaccine can also be passed to newborns through breastfeeding. ACOG and SMFM recently came out with some strong statements that say the vaccine benefits far outweigh any risks. They do recommend that breastfeeding moms get the vaccine.

What is your number one message for women who are considering getting the vaccine while trying to conceive, pregnant or breastfeeding?

Overall, I have seen so many sad things happen, and this is preventable. The important thing is to talk to your doctor about the vaccine. The number one thing to keep you and your baby safe is to get the vaccine.

SLUCare maternal-fetal medicine physicians at SSM Health St. Mary’s Hospital – St. Louis are leaders in providing specialized care for every aspect of high-risk pregnancy. For more information, visit https://www.ssmhealth.com/maternity/high-risk-pregnancy.

For more information on maternity care at SSM Health, visit https://www.ssmhealth.com/maternity.

This press release was produced by SSM Health St. Clare Hospital - Fenton. The views expressed here are the author’s own.