COVID-19 Vaccine: Is it recommended for pre-pregnancy and pregnancy patients?
The upcoming availability of the SARS-CoV-2 vaccine to reduce the risks of contracting the virus and to reduce the risks becoming ill with COVID-19 is certainly encouraging news during this difficult year. Many of you have asked us about receiving a vaccine when it becomes available. The information we have now may evolve over time, as with many things during this pandemic, but here is what we know:
COVID-19 during pregnancy can lead to severe problems with breathing that can require intensive care unit stays and the use of ventilators. COVID-19 infection might be associated with preterm delivery and stillbirth, as well, when the mom’s body is not getting enough oxygen. Therefore, we know that COVID-19 infection can be harmful during pregnancy, and therefore it is reasonable to consider protecting against infection. Although the current vaccine has not been tested in pregnant women, there is enough information based on how the vaccine is made to provide some insights to people planning to become or who are already pregnant.
SART-CoV-2 virus looks like a ball with spikes on it, and the spikes are made of protein. Our immune system can attack the virus by recognizing the spikes of the virus. The current vaccines do not contain any live virus, and they do not contain any extra ingredients that could cause harm. The vaccine disappears from the cell very quickly, and that is why it needs to be given one more time as a 2nd dose approximately three weeks later. They contain a tiny fragment from the virus called messenger RNA (mRNA), which tells our cells to produce protein, in this case specifically a portion of the spike protein of the virus.
The vaccine stays outside of the cells’ nucleus. Therefore, it does not alter our chromosomes or our DNA and is not expected to cause genetic changes to a pregnancy. This spike portion does not act like a virus, it does not have any virus activity to it, but having a lot of it around will make our immune system produce antibodies that protect against the actual virus if we become exposed to it. The spike protein of the virus is somewhat similar to a protein found on the placenta, and that has raised concerns for pregnancy. However, placental problems, miscarriages, nor infertility have not been found to occur more frequently with COVID-19 infection itself. The vaccine’s mRNA fragment and resulting protein are tiny and non-functional compared to anything produced by the placenta or any other reproductive tissue, so this vaccine is not expected to cause infertility nor miscarriages. Since the virus infection causes known problems with pregnancy and since the way that the vaccine is made seems to be safe, pregnant women who are at risk of contracting the virus are encouraged to get the vaccine, just as they are encouraged to receive the influenza vaccine. Since the vaccine is cleared away from the body very quickly, patients seeking to become pregnant don’t necessarily need to delay conceiving following the vaccine. They might want to wait before embarking on a fertility treatment cycle simply to see how they are feeling physically post-vaccination, but not from any particular safety concerns.
Vaccine-based immunity seems to be long lasting, at least several months, and possibly longer (more information will come as the time goes by). Side effects with the vaccine typically resolve within three days of vaccination and seem to be like those with the flu vaccine including injection site irritation, fatigue, headache, chills, muscle or joint pain. Occasionally, more severe allergic reactions can occur. Interestingly, the immunity with the vaccine seems to more powerful than the immunity following infection with the virus itself, so a patient who has contracted the virus or the COVID-19 illness previously can still consider becoming vaccinated.
Until most of the population is immunized, it remains possible for virus to spread despite the vaccine. Therefore, people who receive the vaccine are still encouraged to follow all the recommendations we’ve had during the pandemic including social distancing and masking. Hopefully, that will be temporary, and things will get back more to normal at some point.
Sending you hugs (virtually for now),
Dr Aubuchon and Dr. Ahlering
And the entire MCRM Team