Some women who are pregnant or planning to enlarge their families are still worried about vaccinating against COVID-19. The question arises as to whether vaccines can affect fertility or damage the fetus? What is known on this subject, Dr. Jacek Tulimowski, obstetrician, PhD, told Medonet.
- Dr. Jacek Tulimowski emphasizes that pregnant women are many times more likely to be at risk of severe COVID-19
- The Polish Vakcynological Society emphasizes that vaccines against COVID-19 do not increase the risk of infertility, and there is no need to delay pregnancy after vaccination
- There is no evidence that the COVID-19 vaccine harms the unborn child
- More information can be found on the Onet homepage.
For many years he was associated with the Clinic of Tumors of the Female Genital Organs of the Oncology Center in Warsaw. Currently, the place of work are private clinics “Tulimowski & Sterlińska”. In addition to professional work, he has been promoting medical knowledge in the media for many years: he is the editor-in-chief of the “Nowy Gynecological Gynecological” bimonthly, the creator of the “Dr Tulimowski Press Workshops” – training courses for journalists dealing with health issues, a consultant and expert of the Association “Journalists for Health” , television and radio programs about health. In 2020, honored with the title of Media Friend.
Monika Mikołajska / Medonet: Let me ask directly: a pregnant woman can get vaccinated against COVID-19? This issue is often raised in discussions about vaccines today. There are women who fear this. Let us remind you why there are so many doubts related to this
Dr. Jacek Tulimowski, obstetrician gynecologist, editor-in-chief of the “New Gynecological Cabinet”: Poles do not like vaccinations, it results from fear and lack of reliable knowledge about vaccinations. In relation to vaccination against COVID-19 in pregnant women and the concerns related to it – in my opinion this topic is outstanding, because so far there are reports in the media that pregnant women contract COVID-19 asymptomatically. This data is the result of preliminary analyzes carried out in March last year in Wuhan. We now know that it is completely different. Pregnant women are many times more likely to be at risk of severe COVID-19, and that is now certain.
What are the consequences of COVID-19 for the pregnant woman and her baby?
It is estimated that 15 percent. infected pregnant women have a severe course of COVID-19 and require oxygen therapy, in the remaining 5% the use of a ventilator and ECMO is necessary. As for other complications, it has been confirmed that the risk of miscarriage and preterm labor is increasing. About 10 percent the risk of having a baby with IUGR (low birth weight) syndrome increases. There have been reports of maternal kidney damage following SARS-CoV-2 infection. If a high fever occurs at the beginning of the first trimester, and we know that it is 19-38 degrees with COVID-40, the risk of malformations in the child increases. Moreover, according to recent studies, maintaining high temperature at 38-39 degrees may cause concentration disorders in children due to hyperthermic damage to midbrain neurons. The risk of pneumonia also increases in the developing fetus. After what I said, I would like to ask: get vaccinated or not vaccinate against COVID-19?
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Of course, it is not advised against, but rather encourages pregnant women to get vaccinated. On April 26, the Polish Society of Gynecologists and Obstetricians issued a position in favor of the opinions presented, among others Of the American College of Obstetricians and Gynecologists that COVID-19 vaccines should be offered to pregnant and lactating women.
In medicine, the procedure is based on facts and on the law. Each drug has a so-called SmPC – Summary of Product Characteristics. If any drug is administered contrary to the SPC and causes toxic side effects, a physician who has prescribed such a preparation by a different route of administration or for a different medical indication may have serious legal problems. So at the moment there is no official document saying that the COVID-19 vaccine can be administered to pregnant women. Importantly, all scientific societies agree that pregnant women must not be forbidden to receive the vaccine.
What about women who are planning or are trying to become pregnant?
In December 2020, the Polish Vakcynological Society issued a position on this matter. PTW recommends vaccination against COVID-19 to women planning or applying for pregnancy who belong to the priority groups (i.e. those who are vaccinated at that time in the zero group, i.e. those working in the health service). The Society emphasizes that they do not increase the risk of infertility, and there is no need to delay pregnancy after vaccination. That is women who get vaccinated now and want to plan motherhood can do so.
If a woman becomes pregnant after receiving the first dose of the vaccine, the next one should be given by the date specified by the manufacturer. As there is no documented risk of harm to the fetus due to administration of the vaccine, it is not necessary to perform a pregnancy test prior to administration of the vaccine. The Polish Society of Reproductive Medicine and Embryology also points out that there is no information on the possible effects of vaccination on eggs, sperm, and early stages of pregnancy.
Again, there is no evidence that the COVID-19 vaccine harms the fetus.
There isn’t. Moreover, the American Advisory Committee on Immunization Practices points out that pregnant women should be among the groups that should be vaccinated against COVID-19.
Worldwide organizations emphasize that a woman expecting a baby should be able to make a decision about vaccination, which also means access to information that will make it easier for her. In other words, the doctor should fully explain what is currently known about pregnancy vaccinations.
Where do we get this information from? We know that pregnant women do not participate in clinical trials
Yes, I would like to emphasize that no clinical trials of drugs or any vaccines have tested pregnant women. No ethics committee will issue a license to vaccinate pregnant women with anything. The exception is the situation when pregnant women volunteer for clinical trialsby signing all legal documents. So it will be a voluntary test.
Coming back to your question, all the data we have on vaccination against COVID-19 in pregnant women is based on retrospective studies conducted around the world. They apply to women who have been vaccinated when planning a pregnancy while pregnant and at the end of pregnancy. I use this data. In the United Kingdom, there is currently work on the development of a special register of data related to vaccination of pregnant women. This will allow the collection of additional information on vaccination safety in this group.
Are there any situations in which it would be advisable to postpone or discontinue vaccination in pregnant women?
Last December, the American College of Obstetricians and Gynecologists (ACOG) stressed that there is currently no data to suggest that vaccination against COVID-19 should be contraindicated in pregnant women.
As of today, however, there is no scientific consensus as to whether every pregnant woman should get the COVID-19 vaccine at the start. This means that I, as a doctor, have to do one thing: if a patient asks about a vaccine, I carefully analyze her condition. I take into account everything – previous pregnancies, the course of births, the course of the current pregnancy, comorbidities. Only on this basis can I say why I recommend or advise against vaccinating her. But what’s important: the decision is up to the woman.
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