With the recent FDA emergency use authorization (EUA) for Covid 19 vaccination, questions have arisen about whether pregnant women or women attempting pregnancy should receive this vaccine. Pregnant women were excluded from the studies that led to this EUA so there is no information regarding the safety of this vaccine in pregnancy. Most other vaccines, with the exception of live vaccines, are safe in pregnancy. The Covid 19 vaccination is not a live vaccine but rather uses a new technique called “messenger RNA (mRNA)” to stimulate an immune response. The mRNA is rapidly taken up by the muscles cells at the site of injection. After it stimulates an immune response it is quickly degraded. None of the existing vaccinations have used mRNA technology so we do not have any long-term outcome on such vaccines. However, the safety profile of the recent Covid 19 mRNA vaccines looks very reassuring. Animal studies of this vaccine in pregnancy also look reassuring although human data are lacking at present.
Pregnancy is a risk factor for severe disease. Pregnant women who get symptomatic covid infection are at higher risk for ICU admission, being placed on a ventilator and death compared to patients with symptomatic covid who are not pregnant. Therefore, prevention of this viral infection in pregnancy is of utmost importance. Current data indicates the covid vaccine does not cause infertility in males or females. It does not cross the placenta nor does it cause miscarriages. It does not enter the cell nucleus or alter your DNA. The American College of Obstetricians & Gynecologists (ACOG) and the American Society for Reproductive Medicine (ASRM) recommend that pregnant women or women contemplating pregnancy should receive the covid vaccine unless they have contraindications to the vaccine. These vaccines require 2 doses at 3 or 4 week interval. Based on current available evidence we recommend the following to our patients: