The facts about COVID vaccines, pregnancy and fertility

Pregnant women are at increased risk of developing severe illness and dying from COVID, warns the province's science advisory table.

Yet, they are less likely than other high-risk populations to be vaccinated.

Vaccination is an important strategy to minimize morbidity and mortality in this vulnerable group," the Ontario COVID-19 Science Advisory Table said in a brief published Monday, pointing out low uptake."

The Ontario Medical Association also highlighted the risk to pregnant women and the importance of reliable information at a briefing Sep. 9.

What we're seeing now is still hesitancy about getting the vaccine into the arms of pregnant women," said Dr. Constance Nasello, president of the Ontario Society of Obstetricians and Gynaecologists.

What is the risk?

The consequences of getting a COVID infection during pregnancy are magnified about five times what it would be if you are not pregnant," said Nasello. That's because pregnancy itself is an immune deficient state."

The science table concluded the rate of infection in pregnancy doesn't appear to be higher.

But there is an increased risk of ending up in the intensive care unit, needing mechanical ventilation or being put on a last-ditch and risky treatment called extracorporeal membrane oxygenation (ECMO) that involves pumping blood out of the body, bringing oxygen to it and sending it back.

In addition, pregnant women have higher COVID death rates.

COVID also results in a higher frequency of pre-eclampsia, Cesarean delivery, and a higher rate of preterm birth.

Why the hesitancy to get a COVID shot?

Vaccine hesitancy is, in part, driven by the failure to include pregnant individuals in initial vaccine trials," concludes the science table.

It has left each woman having to consider for herself the data on the safety of vaccines, said Nasello.

We all know they were not tested in pregnant women," she said. And that is a defect in the vaccination testing programs that obstetricians and gynecologists and our various societies around the world have been trying desperately to change."

Are the vaccines safe in pregnancy?

It is safe," said Nasello. The vaccinations do not cause miscarriage ... It can be given at any gestational age of pregnancy."

Nasello recommends the mRNA vaccines like Pfizer and Moderna, which are being administered in Ontario.

What is different about the mRNA vaccines ... is that there is no virus," she said. The messenger RNA is like sending your cell an email" that gives it instructions.

The science table also calls vaccines safe and effective for pregnant women.

In addition, the province's chief medical officer of health said in August that he was paying very close attention" to the data provided by 40,000 Ontario women vaccinated during pregnancy.

There has been no evidence of increased risk to the health of the mother or infant from vaccination," said Dr. Kieran Moore. These findings are consistent with evidence from other jurisdictions, which show vaccination in pregnancy is safe and effective."

Do the vaccines benefit the baby?

Women who received the COVID vaccines actually transferred antibodies through the umbilical cord to their babies," said Nasello. Those antibodies ... will protect the infant."

In addition, vaccinated mothers pass antibodies to their babies through their breast milk.

It's very important for newborns to have that protection until they can get a vaccine themselves," said Nasello.

Will a COVID shot harm fertility?

There is no effect of the vaccine on fertility," said Nasello. It does not affect menstrual cycles."

She points out that many other things can affect menstrual cycles and sperm counts such as stress or illness.

Ontario's chief medical officer of health also addressed misinformation around fertility and vaccines in a briefing in August.

I know that the relationship between COVID-19 vaccines and fertility is a worry and has been tracking on social media for sometime," said Moore. This is something we've been monitoring and we've consulted the Society of Obstetricians and Gynecologists of Canada. To date, we have found no evidence that points to increased risk to either male or female fertility following vaccination."

Why is there misinformation?

You have to take a lot of what you hear on social media with a grain of salt," said Nasello. The people who have been talking about these things have been using science-y sounding words that actually don't mean anything ... It is very easy to go down a rabbit hole."

Joanna Frketich is a Hamilton-based reporter covering health for The Spectator. Reach her via email: jfrketich@thespec.com