By: Dr. Ed Coats
As the Covid-19 pandemic grumbles on into its second year so much has changed. There have been more than 100,000 coronavirus associated deaths and we are in yet another national lockdown. The UK has led the way in the development and approval of Covid-19 vaccines and over 10 million people have received their first dose.
It has been a challenging 12 months though for patients needing fertility treatments and for clinics trying to work through the crisis. Due to the wider pressures on the NHS from Covid-19, several IVF clinics located on NHS sites have had to temporarily close their doors to patients, who have had to pause their treatments. We all hope the option of vaccination will help steer things back towards normal.
There are currently three different Covid-19 vaccines approved for use in the UK by the Medicines and Healthcare Products Regulatory Agency (MHRA). The first to be approved was the Pfizer-BioNTech vaccine in December. The first woman in the world to receive this vaccine was Margaret Keegan who is 91 years old and living in Northern Ireland. Once the roll out of vaccines began the Oxford-Astra Zeneca vaccine was next to be approved for use and more recently the Moderna vaccine too.
Vaccine development and approval has moved at record pace in an effort to stop a global pandemic in its tracks. Never before has vaccine development been accelerated in this way, leaving many scrutinising the data and in particular the efficacy and safety of vaccines use. It is becoming clearer as the days pass though that vaccination appears to be safe, and it is not the testing but the vaccinating that will steer us out of this awful Coronavirus pandemic.
The schedule for both the Pfizer-BioNTech and AstraZeneca vaccine is to receive two doses. Whilst there is some evidence to support short term immunity with a single dose the recommended schedule is to have two doses of these vaccines. The Royal College of Obstetricians and Gynaecologists (RCOG) and the Joint Committee on Vaccination and immunisation (JCVI) have published recommendations and advice for patients who are pregnant or trying to conceive.
The vast majority of patients undergoing fertility treatment tend to be young and not vulnerable but there are many front line key workers juggling work commitments and potential exposure to coronavirus and infection with the need to have fertility treatment. These early vaccines do not contain live organisms that can multiply and infect a baby developing in the womb.
The data available to interpret the safety of the vaccines in pregnancy is limited as there has been no clinical studies yet in pregnancy. So until the time that more information is available the current data must be cautiously interpreted. There have to date though been no concerns raised with the Pfizer-BioNTech and Astra Zeneca vaccines.
There is currently no evidence to avoid pregnancy once vaccinated against Covid-19. However, if you do fall pregnant you should only be vaccinated if you are in a high risk group. If you happen to have received the first dose of the vaccine and fall pregnant you should discuss the need for a second dose of the vaccine with your Obstetrician and only proceed if you are in a highly vulnerable group. If you are not at high risk then it may be better to delay a second Covid-19 vaccination dose until after pregnancy.
There are potential vaccination benefits for some high risk patients but always discuss these with your fertility expert or Obstetrician. If you are breastfeeding it is recommended that it is safe to receive the vaccine in line with recommendations from the World Health Organisation. In general the Covid-19 vaccines in the UK have been shown to be effective and seem to have a good safety profile.
Further information can be found at The Royal College of Obstetricians and Gynaecologists
By: Dr. Ed Coats