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April 20th, 2021 – Latest statement from ASRM COVID 19 Task Force
Latest Statement & Information from ASRM:
Podcast: ASRM Today: Update #14 from the ASRM COVID-19 Task Force with Dr. Alan Penzias
Given the known risks and severity of COVID-19 disease during pregnancy, vaccination of pregnant women or women attempting pregnancy is recommended, including by the World Health Organization (WHO), the American College of Obstetricians and Gynecologists (ACOG), the Society for Maternal-Fetal Medicine (SMFM), and the ASRM, as first recommended by this Task Force.
COVID-19 VACCINATION AND PREGNANCY • While pregnant women were not included in the initial COVID-19 vaccine trials, there is growing data involving pregnant individuals who have received the Pfizer-BioNTech or Moderna vaccines. As stated in Task Force Update #13, there is convincing evidence that pregnant individuals are at increased risk of more severe complications from COVID19. As such, the theoretical risk of COVID-19 vaccination to periconception and pregnant women is significantly less than the real risk of acquiring COVID-19. • V-safe is a smartphone-based tool that collects voluntary data using text messaging and web surveys from individuals who have received the COVID-19 vaccine.
V-safe includes a Pregnancy Registry that collects additional information from individuals that report vaccination in the periconception period or during pregnancy. • For those interested in contributing to the data surrounding COVID-19 and pregnancy, enrollment in the V-safe registry is highly encouraged. Individuals are eligible to participate in the study if COVID-19 vaccination occurred in the periconception period (within 30 days before the last menstrual period) or during pregnancy. More information regarding the V-safe Pregnancy Registry and enrollment can be found here and the full V-safe protocol can be found here. •
As of March 8, 2021, more than 44,000 V-safe participants had indicated they were pregnant at the time they received their COVID-19 vaccination. The CDC presented preliminary data at the Advisory Committee of Immunization Practices (ACIP) meeting on March 1st, 2021 and intends to share more data regarding COVID-19 vaccination and pregnancy as it becomes available. That data indicated that: o
As of February 16, 2021, a total of 30,494 patients with pregnancies had been reported to V-safe, of which 16,039 and 14,455 had received the Pfizer-BioNTech and Moderna vaccines, respectively. o For both the Pfizer-BioNTech and Moderna vaccines, there were no concerning differences between pregnant and non-pregnant women in the incidence of reported local reactions (such as pain, swelling, redness, or itching) or systemic reactions (fatigue, headache, myalgia, chills, nausea, fever) after both doses of the Pfizer-BioNTech and after the first dose of the Moderna vaccine. o The V-safe Pregnancy Registry outcomes of interest include miscarriage and still birth, pregnancy complications, maternal ICU admission, adverse birth outcomes, neonatal death, infant hospitalizations, and birth defects. As of February 19, 2021, the V-safe Pregnancy Registry included 1,815 enrolled participants of which 275 had completed pregnancies resulting in 232 live births. The rates of miscarriage, still birth, gestational diabetes, preeclampsia or gestational hypertension, eclampsia, and intrauterine growth restriction were lower in the V-safe pregnancy registry compared to background rates.
The ASRM COVID-19 Task Force statement emphasizes the importance of shared decision making between patients and their physicians but is very clear that, “The Task Force does not recommend withholding the vaccine from patients who are planning to conceive, who are currently pregnant, or who are breastfeeding (1,2,3) and encourages patients undergoing fertility treatment to receive vaccination based on current eligibility criteria.”
The report also states that virus mitigation strategies, such as universal masking, physical distancing and reducing social interactions must be followed even though some people now have access to a vaccine.
In addition, the statement addresses head-on a piece of misinformation which has been circulated by antivaccine ideologues and states that the mRNA vaccines “are not thought to cause an increased risk of infertility, first or second trimester loss, stillbirth, or congenital anomalies.”
ASRM also joined with the American College of OB/GYNs, the International Federation of Fertility Societies (IFFS), the Society for Maternal Fetal Medicine, the Society for Gynecological Oncology and the AAGL in a joint statement from the OB/GYN community. It too emphasizes access to the vaccine for pregnant and lactating women and the importance of decisions about the vaccine being made by patients and their physicians.