Aa COVID-19 vaccines become available to Canadians across the country, the SOGC (The Society of Obstetricians and Gynaecologists of Canada) has just released long-awaited recommendations about vaccination and pregnancy and planning conception. These guidelines are also endorsed by the CFAS (Canadian Fertility and Andrology Society). TRIO’s medical team has reviewed the guidelines and supports them in principle. But each case should be considered on an individual basis. Therefore, please make sure you speak with your TRIO physician about the specific risks and benefits for you.
The SOGC consensus statement states:
For individuals who are at high risk of infection and or/morbidity from COVID-19, it is the SOGC’s position that the documented risk of not getting the COVID-19 vaccine outweighs the theorized and undescribed risk of being vaccinated during pregnancy or while breastfeeding and vaccination should be offered.
For individuals planning pregnancy (fertility patients):
It is recommended to complete the entire COVID-19 vaccination series (where possible) to achieve maximal vaccine efficacy ahead of pregnancy. It is not known whether an individual should delay pregnancy following receipt of the vaccine. Patients need to consider their own health status risk and the exposure risks to decide whether or not to proceed with vaccination.
Based on the above guidelines, we recommend having a discussion with your TRIO physician about the specific risks and benefits of the COVID-19 vaccine for you.
What are the risks of developing a severe case of COVID-19 while pregnant?
- Many pregnant women who contract COVID-19 have mild symptoms, or are asymptomatic
- However, 8-11% of pregnant women with COVID-19 will require hospitalization, and 2-4% of those will require ICU admission
- Pregnant women with severe cases are at increased risk of needing invasive ventilation
- Risk factors for severe infection in pregnancy: age >35 yrs, asthma, obesity, pre-existing diabetes, pre-existing hypertension, heart disease
Is there a difference among the various types of COVID-19 Vaccines?
- The Pfizer-BioNTech COVID-19 Vaccine and the Moderna vaccine have both been approved by Health Canada
- The Pfizer vaccine is administered as 2 intramuscular injections 21-28 days apart
- Safety and efficacy have been demonstrated for adults over 16 yrs of age, preventing symptommatic COVID-19 cases at an efficacy rate of 94.6% at least 7 days after the 2nd dose
- Safety data has been published about 2 months following vaccination, however data collection is ongoing and will continue for 2 years
- Pregnant and breastfeeding women were excluded from vaccine trials
- However, 23 women who received the vaccine conceived shortly thereafter. They are being monitored and so far show no untoward effects from the vaccine
- Worldwide ongoing data collection will no doubt lead to more numbers and data about vaccine use immediately before and during pregnancy
How do I know if it’s safe for me to receive a vaccine for COVID-19 while trying to conceive?
- Because of the lack of data so far, there have been recommendations made that COVID-19 vaccination should not be offered to patient populations that have been excluded from the clinical trials, however there are special considerations to be made in the time of a global pandemic: Essentially, the unknown risks of the vaccine have to be weighed against the risk of exposure and outcome to the mother and fetus of severe disease
- The discussion and assessment of individual risk should be taken into consideration on a case by case basis, and include:
- Local epidemiology and risk of community acquisition of COVID-19
- Workplace situation and risk of work-related acquisition of COVID-19
- Individual risk for COVID-19 related morbidity as listed above
- Gestational age of pregnancy
- Available data related to the safety of and efficacy of the vaccine for pregnant and breastfeeding women (as it is published)
- Individual beliefs and personal risk assessment of the available data