Should you take the COVID vaccine if you're pregnant or trying to conceive? 

This is a great question to bring to your primary care provider!

Even though I am not a primary care provider, I've been getting this question from many of my clients who are wondering whether to get vaccinated during pregnancy or while trying to conceive. I thought it might be useful to share my perspective in this week's episode. As always, please talk to your own healthcare team to make the best decision for your particular case

Quick summary:

I would feel comfortable getting the vaccine if I were pregnant or trying to become so. 

Resources to Consider:

Transcript of Thoughts on the COVID Vaccine and Pregnancy/Fertility episode

Episode 29 | Thoughts on the COVID Vaccine and Pregnancy/Fertility - powered by Happy Scribe

Well, Hi there. Welcome to In the Clinic with Camille. My name is Camille Freeman. I am a licensed nutritionist and registered herbalist, and in this podcast I just share clinical tidbits that may be helpful for other practitioners. So today, I wanted to talk a little bit about the COVID vaccine specifically as it relates to fertility and pregnancy.

As some of, you know, I do a lot of work with people who are either trying to get pregnant or who are already pregnant. And so since the vaccines have become available, I've gotten a lot of questions from my clients about what I think about them. Do I recommend that people get them and so forth? Now, first of all, I am not a primary care practitioner. I am not in a place to recommend or not recommend vaccines to people, but I can share my own personal thoughts.

I haven't done that publicly thus far just because I'm hoping that people are talking to their own primary care practitioners and kind of working through their questions and risk factors and things like that with trusted medical professionals. And it's been asked enough that I thought, okay, maybe it's helpful for other people for me to share my perspective and what I understand to be true about the COVID vaccines. So here we go. What I'm not doing in this episode is trying to present a full and comprehensive overview of the research that has been done to date.

I will certainly provide a couple of references to get you started on the right track.

But frankly, unless you have an advanced degree in public health epidemiology, you have a lot of experience reading and interpreting papers. You have lots of training and statistics and so forth. You're not really in a position to be doing your own research when it comes to this type of question. For example, I have had multiple graduate level courses in statistics, and I still don't consider myself to be an expert or to be an informed opinion when it comes to taking a comprehensive look at all of the evidence on vaccines and pregnancy and making an assessment personally on their safety.

So what do I do instead?

What I do is look and see, okay, who is qualified to do this work? What publications have been peer reviewed, meaning they have been evaluated by other experts in the field. The statistics have been double checked, and the conclusions have been vetted by people who do have these types of qualifications. So when I'm quote, doing my research, what I'm doing is looking to see who's trained, what are they saying and getting a getting a sense for that and then trying to pass that along to my clients as best I can.


So just to give you a little bit of background. All right. So here's what I tell my clients when they ask me. First of all, I do the feel about hoping that people can check in with their primary care people, or if they are already working with an OBGYN or a reproductive endocrinologist. Those are all great people to ask about this next, from the evidence that we have available to date, and I'm recording this in October of 2021.

From the evidence we have available to date, there does not seem to be any risk in miscarriage, people who get the vaccine. There doesn't appear to be any increased risk in birth effects, birth weight, any of the common things that we check that way we would expect to see differences showing up in people who are vaccinated compared to a standard population, for example, pre, COVID, or control groups of people who were vaccinated, not vaccinated. There's various study designs, but we are not seeing any increased risk in any of these factors.

So as far as we can tell for right now, the vaccine appears to be very, very safe to get either when you are trying to get pregnant or if you already are pregnant.

If it were me and I were trying to get pregnant or we're currently pregnant, I would get vaccinated. There's a couple of reasons for that. One, there is an increased risk of having severe COVID experience during pregnancy in particular. There's a lot of immune system changes that happen in order to facilitate a healthy pregnancy, and those do seem to increase your risk of having a more severe case of COVID. It's a small increase in risk, but it is one, and it appears to be way, way, way bigger than any risks associated with the vaccine, of which we can find very few other than JJ, which does have a low risk for some people.

So that's one thing to think about that if you are pregnant, you are more vulnerable to COVID. So that's something to take into account. And then, of course, there's the public health factors and a bunch of other considerations which I won't get into here. So some of the things that my clients have brought to me, as they said, well, I went and I looked at the adverse event registry and I was looking and it was like miscarriage, miscarriage, miscarriage, miscarriage. It looks like there were just so many people who had miscarriages associated after they took the vaccine, and that felt really scary to me.

So just a couple of things that I will say there. First of all, a lot of people don't realize how common miscarriage is. So a lot of people are having miscarriages, whether they got the vaccine or not, depending on what age group you're in and a bunch of other factors. The numbers are different, but somewhere in the range of 25% to 30% or sometimes even more, if you're older and so forth, the pregnancies are going to end in miscarriage. So if you're looking at any kind of database where people are tracking symptoms associated with pregnancy or outcomes associated with early pregnancy, you are going to see a lot of miscarriage.

And that doesn't necessarily mean that the miscarriage is due to the COVID vaccine. Somebody had a miscarriage after a COVID vaccine, it's possible that they would have had that miscarriage anyway. The way that we can tell is we look at the number of miscarriages in the population as a whole.

Then we look at the number of miscarriages and people who have received the COVID vaccine and look to see if there's any difference overall. And there's been studies on thousands and thousands of people who are pregnant, and they have found that the rate of miscarriage in those folks is rate within the range of what we would expect in the standard regular population, something in the range of about, if I'm remembering correctly, it's about 13% of the study population. So that indicates to us that there isn't really an increased risk of miscarriage, although it is still pretty common more than one in ten pregnancies in this kind of lower age bracket.

And then, of course, the older you get, the more increased chance of miscarriage is. The same types of studies have been done on people getting vaccinated in pregnancy, early pregnancy, late pregnancy, and so forth.

There just doesn't seem to be an increase in risk, and there is a lot of protection to be had from the vaccine. So my recommendation is to think it over. Talk about it with your primary care folks and so forth. But the evidence suggests that it is safe to get the vaccine in pregnancy or if you're trying to get pregnant, and that's what I share with my clients. So I hope that is helpful to you.

I'm not particularly interested in any debate about the vaccine. Like I said, I am just passing along the information that's been published in peer reviewed articles and journals. We can certainly reassess if any articles become published to that refute this, but at this point, it's very, very unlikely. The last thing I'll say here is that the mechanisms by which mRNA vaccines work, there's just no plausible mechanism for long term interference with fertility. So even though we're not seeing any issues right now, is there a chance that there's long term implications?

There's not much of a mechanism. There's not much of a pathway there by which something like that could happen. So of course, we don't have the data right now because people just started getting them a little over a year ago, a little less than a year ago. Pardon me. So we're still waiting on that.

But just based on the physiology and the mechanisms of the vaccine, that's very, very unlikely. I keep saying one last thing, but this is actually one last thing. What we do find in some people is that there is a little bit of a disruption of the menstrual cycle for one to two cycles after the vaccine, and that is common after vaccines in general, it usually is just a response to inflammation you can see the same thing with if you were to actually get the flu or have some kind of other inflammatory event, go on.

You would probably have a cycle or two of disrupted menstrual cycle as well. That can look like either a slight delay or a slight shortening of a cycle.

It can look like a little bit of a difference in the length of bleeding having this of bleeding. But again, what we're finding, what the studies are showing is that that that only lasts for one to two cycles after each vaccine dose and that it does not appear to be a longterm impediment infertility. If you are tracking your cycles, that's something to be aware of to make a note of when you get vaccinated so that you'll kind of know what's going on. If you do see a little bit of cycle disruption for a couple cycles, so that's an important thing to take a note of.

But otherwise.

Of course, if you have a planned IVF or something along those lines, your RE can direct to you about when would be an appropriate time to get the vaccine relative to any kind of, you know, retrieval or anything along those lines. You'd want to check in with them about that, but otherwise my recommendation is check with your provider and then go ahead and get the vaccine. If you want to protect yourself and potentially protect your baby if you do get pregnant, alright, I hope that is helpful and I'll be back next week with another episode.

Take care.

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