As a seasoned Nurse-Midwife and digital health coach, I’ve spoken to many people who are working to expand their families. Maternity and early parenthood are incredibly magical times in someone’s life, but can also be riddled with uncertainties and anxiety. Which is why I feel so called to help. My goal as a health professional, and Ovia Health’s goal as a company, is to help women and families at this pivotal point make informed decisions about their health. Today, this means ensuring families have the information they need from trusted sources like the American College of Obstetricians and Gynecologists (ACOG).
In my recent conversations with women who are trying to conceive, women who are pregnant, and women who are breastfeeding, many have asked questions about the COVID-19 vaccine, and whether or not it is safe for them. This uncertainty is understandable as there’s so much information out there about the COVID vaccines and so little time to sort out what’s true and what isn’t.
As of today, ACOG’s recommendation is that the vaccine should not be withheld from this population due to the heightened risks that we have seen in pregnant people who have been infected with COVID.
To help provide education around the vaccine, our clinical team has created a COVID vaccine guide to help people understand how the COVID vaccine could impact their reproductive health. Available today, My COVID-19 Vaccine Guide can help you get answers to questions about the COVID vaccine, whether you’re trying to get pregnant, are pregnant, or are deciding for your child. You can download the apps to access the guide.
In addition to this new tool, I’ve also put together a list of the most common questions I’ve heard while talking to patients and provided some answers you can share with your employees.
What’s driving this specific misinformation?
In this country, we all have the right to informed consent. Vaccines are no exception! So some questioning of whether or not a new treatment is safe is very reasonable and responsible. Some of the questions have come out of how quickly these vaccines were developed. The general public knows that this type of coronavirus was new in late 2019 because we’ve all lived through the pandemic. However, vaccine science is not widespread knowledge. Vaccine developers are a very small portion of the population and how vaccines and our immune systems work are not common knowledge in general. So the lay-person sees this highly technical intervention come out very quickly and it is natural to question if corners were cut or steps were skipped.
In addition, the internet has put a lot of information at our fingertips, but with no guarantee of accuracy. It is so important to choose your information sources wisely, but not everyone knows how to do that. Even some reputable sites will misinterpret scientific studies unintentionally. The scientific process is a very dependable source of information, but data can be misinterpreted by really smart people who are not trained to see the flaws in study designs or the further need for studies to rule out alternative reasons for the associations brought up by a single study.
For example, there could be a study done that shows more balding men have heart attacks than those with a full head of hair. One might say losing your hair increases your risk of heart attack.
However, if you look at the population of men, those who have heart attacks are typically older. Those who are older are also more likely to be balding. Thus, you have a correlation without causation. This is a very simplistic example. But it illustrates how misinterpretation of data can suggest that something false is supported by evidence.
Why is it such a persistent myth?
Social media continues to be an enormous, influential source of misinformation. In this age where everyone has a platform to share their opinions, it’s really difficult to discern what is truth and what is opinion. And in the case of COVID-19 where we are learning something new every day, it is really hard to keep up with the most current accurate information. This is directly contributing to the persistence of misinformation.
Fear is powerful and can certainly cloud one’s judgement. One specific fear (with no evidence to support it) is the relationship between COVID-19 vaccines and fertility. The idea that protecting myself from this potentially deadly virus could cause me to not be able to have a child is a very emotionally-loaded concept. Even without information behind why those two things could possibly be linked, the fear is real. What if that was true? I might never forgive myself for getting the vaccine. And once even the possibility of that outcome takes hold, it can be hard to eliminate, even when information about the lack of data on that topic is presented.
How did it come about?
Early on, there was a misinformation social media frenzy around the COVID-19 vaccine causing infertility. To understand how the (false) idea of getting a vaccine could be linked to problems conceiving, it’s important to understand how the vaccine works.
Two of the vaccines currently available in the US are mRNA vaccines (Moderna and Pfizer). They do not contain the virus itself (dead or alive) and therefore, cannot cause infection. What they do contain is the mRNA (think blueprint or recipe) that codes for the spike protein found on the surface of the COVID-19 virus. Our bodies respond to the presence of the mRNA by reading the “recipe” or “blueprint” and then creating copies of the spike protein. The protein on its own is harmless in our bodies. However, it is a foreign protein that is not otherwise found in the human body. Because it is foreign, our immune system (specifically our B-lymphocytes and T-lymphocytes) learns how to fight the virus by recognizing the spike protein, creating antibodies to it, and deactivating it. Thus, if the COVID-19 virus were to enter a vaccinated person’s body, the spike proteins on its surface would be familiar and our immune cells would remember how to quickly create antibodies that bind to the virus and stop it from invading the cells of the body.
While the protein coded for by the mRNA in the COVID-19 vaccines is commonly called a “spike protein,” this does not mean it is identical to all so-called “spike proteins.” For example, there is a spike protein involved in the placenta’s attachment to the uterus during conception and development of a pregnancy called Syncytin-1. The Syncytin-1 protein is an essential part of the type of cells that create the connection and exchange of blood between the mother and the fetus. Without it, a healthy pregnancy would not be possible.
However, the theory that once we develop antibodies to the COVID-19 spike protein, those same antibodies can disable all spike proteins is absolutely false. As an analogy, if the syncytin-1 protein’s recipe is 1 page long, the COVID-19 protein’s recipe is 18 pages long. They are totally different in size and makeup. The antibodies we form are very specific to the antigen they disable. So getting the COVID-19 vaccine absolutely does not cause infertility.
How are doctors combating it? Is there evidence that vaccines impact fertility?
By sharing this information. Patient education is so powerful. This goes back to informed consent. We have a right to know the risks and benefits to the treatments we are getting. It is the healthcare provider’s responsibility to educate their patients on these things. Your provider is trained to understand how vaccinations work and how scientific studies need to be interpreted by experts. Part of their training is to sift through misinformation and spread the information that is evidence-based and trustworthy.
Can you explain how the body expels genetic material after vaccinations?
mRNA specifically uses a part of the cell called the ribosome (like a 3-d printer) to make the spike protein. Our ribosomes are within our cells, but are outside of the nucleus (where our human DNA is stored). Thus, mRNA vaccines do not have the ability to alter our DNA. They never come into contact with one another. Additionally, mRNA doesn’t live in the cell very long at all. Our body has chemicals called enzymes that break down the mRNA and dispose of it. The fragile nature of the mRNA is actually what makes distribution of this vaccine difficult because it has to be encased in a shell that requires it to be stored at very low temperatures.
What advice do you have for teens/parents who are concerned the vaccine could impact fertility/menstruation.
There is zero animal or human evidence that the COVID-19 vaccine causes infertility or changes our DNA. In fact, many people who were vaccinated have since become pregnant, and many people who were pregnant while vaccinated have since delivered healthy babies. The choice to be vaccinated is personal and should be made alongside your healthcare provider so you have the opportunity to ask questions and get solid, trustworthy information. For each individual, there will always be risks and benefits to be considered. This is the perfect opportunity to help your teenager make an informed decision using the resources available to them (with your help, of course).
What can we do to support employees as they return to in-person work settings?
Allowing for open dialogue with concerned employees is essential to demonstrate empathy for these challenging decisions. Empowering them with tools that provide decision-support and an avenue for clinical questions is key to help individuals make informed decisions. As you consider return to office policies, or vaccine mandates for your organization, ensure upfront conversations for those trying to conceive or pregnant are addressed to avoid alienating these team members . Expressing the intent for health and safety of all employees speaks volumes to demonstrate a culture of inclusion during this challenging time
To support employers and managers, we’re actively updating resources like this interview with the science lead for the COVID Project, Jessica Malaty Rivera, the Ovia My COVID-19 Vaccine Guide, and referring to this CDC resource hub to support teams with up-to-date, easy to understand guidance, delivered in a way that is relatable for women and families.
With access to verified information, each employee can make an informed decision about their health, and proactively engage their healthcare providers to share in decision making with full consideration of their risk factors.