With the start of the corona vaccination, there are a lot of open questions about the desire to have children, pregnancy, and the vaccination of small children. We asked two experts to find out more.
Corona vaccination: This is what the experts say about the Covid 19 vaccine, pregnancy, and the desire to have children
In early December, 90-year-old Margaret Keenan became the first person in the world to receive the Covid-19 vaccine from Pfizer / BioNTech in the UK. It was the start of mass vaccination to end the ongoing pandemic. At the time, the government (in the UK) advised pregnant women not to get the Covid-19 vaccine if they are pregnant or trying to become pregnant within the next three months. Shortly thereafter, on December 30th, the Oxford vaccine was approved.
In 2021, Public Health England's recommendations for action changed to say: "The early Covid-19 vaccines do not contain organisms that can reproduce in the body so they cannot infect an unborn baby in the womb." It is important that the UK health authority MHRA (Medicines and Healthcare products Regulatory Agency) has raised no concerns about the safety of the vaccine. And the Joint Committee on Vaccination and Immunization (JCVI) recognizes the importance of getting the vaccine at high risk for pregnant women.
We spoke to two experts - Dr. Victoria Male, Lecturer in Reproductive Immunology at Imperial College London, and Professor Beate Kampmann, Head of the Department of Pediatric Infections and Immunity at the London School of Hygiene & Tropical Medicine - on the current guidelines and why women shouldn't worry.
"Pregnant women were not included in the first round of the trial. When the UK government approved the vaccine, they initially advised that the same measures be taken when it continues to roll out," explains Dr. Times. "However, following the release of data on unwanted pregnancy and animal safety, as well as pressure from pregnant workers on the front lines who should not be deprived of protection from the virus, the government changed its advice in late December."
"The current guideline says the vaccine should be offered to pregnant women who are at high risk of contracting the virus (those who are on the front line), or with underlying diseases that are at high risk of serious complications if they catch the virus, "says Dr. Times. "For these women, the benefits of protection outweigh the small possibility that some risks will emerge in the future." As Professor Kampmann emphasizes, "women should discuss with their midwife or doctor how great the risk of Covid-19 is for them and weigh up the risks and benefits."
The most likely relevant groups of pregnant women are recipients of solid organ transplants; those with severe respiratory diseases, including cystic fibrosis and severe asthma; those who have homozygous sickle cell disease; those receiving immunosuppressive therapies that significantly increase the risk of infection; those on dialysis or who have chronic kidney disease (stage 5); and those with significant congenital or acquired heart disease. "There is no known risk associated with giving other non-live vaccines to pregnant women, and we regularly vaccinate pregnant women in the UK against flu and whooping cough," says Professor Kampmann.
"There is no evidence that the Covid vaccine reduces a woman's chances of getting pregnant and some evidence that it doesn't," explains Dr. Times. "Although pregnant women were not included in the first round of the study and participants were asked to avoid pregnancy, 23 women in the Pfizer vaccine study and 13 women in the Moderna study became pregnant by chance. These women had no problems with their pregnancy reports. This tells us that the vaccine does not prevent women from getting pregnant and that it does not cause problems with pregnancy. "
Professor Kampmann believes that women shouldn't have to worry that the vaccine will affect their chances of having a child. "The studies on pregnant animals (so-called reproductive toxicology studies) have shown no danger," she says. "And there is no biological reason why the vaccines should affect fertility or cause harm because they don't change the genetic code - that's a total myth that needs to be dispelled. RNA is different from DNA (which is the genetic code), and RNA cannot alter the genetic code because it cannot get into the germ cells, and it also degrades very quickly after vaccination (Pfizer's vaccine is RNA-based), and the vector virus used in the AstraZeneca vaccine can become infected do not replicate in the human body and therefore do not affect fertility or early pregnancy. "
Of course, being pregnant during a pandemic can be unsettling for mothers-to-be - especially since some people get long-term Covid. "Women who contract Covid-19 in the first trimester of pregnancy appear to have normal pregnancies - although this is actively monitored to ensure there is no impact on the baby's health after birth," explains Dr. Times. "Although most women who develop Covid-19 later in pregnancy are also healthy, the virus puts a lot of pressure on the heart and lungs, which are already under pressure from pregnancy. In order to save the mother, they decide the doctors sometimes for a premature baby. "
"There is also some evidence that Covid-19 infection is linked to early rupture of the amniotic sac," continues Dr. Repeat. "For these two reasons, if a woman gets Covid-19 late in pregnancy, there is a risk that her baby will be born prematurely. That is why pregnant frontline workers were so keen on being offered the vaccine It is also a reason why it is a good idea for women planning pregnancy to get vaccinated. "
Professor Kampmann is of the opinion that "with regard to Covid and the vaccine, we should generally be very positive about the pregnancy results". "While we have to be honest and say that not many pregnant women have received the Covid vaccine, that is changing fast and studies are starting to take pregnant women in and give them the vaccine or a placebo and look into it more closely to prove that there really is no risk, ”she explains. "In the meantime, pregnant women with high-risk factors should consider it [the vaccination]. If I were in her place I would put it off until after the first trimester, as many early pregnancies can naturally end in spontaneous abortions, and then the woman herself blames herself or the vaccine, although neither is responsible. If the risk is low, I would even wait until after the 20-week exam - but that's my personal opinion, not an official recommendation - it is just comforting to know that everything is fine with the developing fetus and that everything is in your head. The Covid virus is not transmitted to the baby during pregnancy or through breastfeeding - if it is transmitted it is usually after or around the birth because the mother has active Covid."
As it stands, children are not on the priority list to be vaccinated. "The current program prioritizes people who are seriously ill with Covid - with a few exceptions, children have no or very mild symptoms," explains Professor Kampmann. "Children were not included in clinical trials because the disease is most severe in adults, and studies in children are only just beginning as children are known to be able to transmit the virus, so if we should aim for high herd immunity they too are vaccinated - but more to protect those around them than to protect themselves."