COVID-19 vaccine when TTC… is it safe to have it?

It is incredible how much our lives have changed in so little time! The words COVID, pandemic, social distancing and now vaccine are everywhere in the news and social media, making us even more anxious. In this uncertain world, there is a lot of information, but sometimes it is difficult to understand, and at other times there is no good evidence behind.

First of all, vaccines have been used for decades, and millions of people receive them every year. The latest COVID-19 vaccines have not appeared by chance. An incredible amount of work is behind them with extensive and rigorous testing to ensure safety and efficacy before they can be introduced in a country's vaccine programme.

In terms of safety in pregnancy, as you might imagine, there is not much research on this at the moment, and therefore recommendations and guidelines are limited. That said multiple scientific societies in the UK, Europe and America have given their advice regarding the recently developed COVID-19 vaccines.

In this Q&A, we have tried to summarise the latest evidence and recommendations around COVID-19 vaccines and TTC, pregnancy and breastfeeding.

Should I try for a baby during the Coronavirus pandemic?

The Royal College of Obstetricians and Gynaecologists (RCOG) says that this is a personal choice as the current evidence suggests that if you become pregnant and infected, it is unlikely to cause problems with your baby's development. But of course, there might be more things to consider with this decision nowadays. 

Should I get vaccinated if I am trying for a baby?

The good news is you can receive the vaccine and keep trying. This was a bit controversial at the beginning, but now societies have agreed on this question. They say that women who are trying to conceive and have benefitted from the vaccine do not need to avoid pregnancy or treatment after receiving the immunisation. This was stated by both The Joint Committee on Vaccination and Immunisation (JCVI) in their latest advice on 30^th December 2020 and The British Fertility Society (BFS) on 14^th January 2021.

I am about to start Assisted Reproductive Treatment, should I get vaccinated before I do?

If you are in this position, The European Society of Human Reproduction and Embryology (ESHRE) published a recent statement on 12^th January. They say that it seems prudent to postpone the start of the treatment as we do not know the effect of the COVID-19 vaccine on eggs, sperm, embryos and early stages of pregnancy. However, the BFS has said there is no need to delay treatment after vaccination. Once again, this will be a personal choice.

Is the COVID-19 vaccine recommended in pregnancy?

According to the JCVI, there is not enough data to recommend routine use of COVID-19 vaccine during pregnancy. Therefore, most scientific societies and countries are being cautious with recommendations, and this should be discussed on an individual basis. If you are in a clinically extremely vulnerable group or a healthcare worker, discuss it with your doctor or team members.

What if I find out I am pregnant after the first dose, should I have the second one? 

The Public Health England guidance on COVID-19 vaccination recommended in November 2020 that women who have had the first dose and find out they are pregnant should complete pregnancy before getting the second dose. If you receive a dose of the vaccine before finding out you are pregnant, you should be reassured that it will not affect the vaccine’s success and the risk of harm to your baby is low. 

What about someone who is breastfeeding? Is it recommended?

The JCVI says there is no known risk in giving COVID-19 vaccine to breastfeeding women. However, women should be advised that there is a lack of safety data for these specific vaccinations in breastfeeding.

Key points:

• Evidence is limited as there is no research on the COVID-19 vaccine and pregnancy and breastfeeding so far.
• Although there is no safety data for COVID-19 vaccinations in pregnancy, there is no known risk from other non-live vaccines in pregnant women.
• Recommendations may be different according to societies and countries – always check your national or local guidelines.
• Recommendations might change as research and publications could be released later in the year.
• If you are not sure about getting vaccinated, discuss it with your doctor for further advice.