The Covid Fertility Issue We Should Be Worried About
F. Perry Wilson, MD, MSCE
Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.
This transcript has been edited for clarity.
Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I’m Dr F. Perry Wilson of the Yale School of Medicine.
There’s a meme flying around the interwebs that COVID vaccines might render young people infertile. Taken on its own, this may seem like run-of-the-mill antivax fearmongering and it is, but this one seems to have some legs. In fact, a UK survey found that one quarter of young women would decline the vaccine, citing concerns about fertility.
This is actually a sort of old vaccine trope. It’s been trotted out without any evidence for the polio vaccine and the HPV vaccine. And I get why it’s so powerful. Fertility is obviously a huge issue, a basic human function. But it also immediately conjures up the long term: Sure, I may be protected from COVID today, but what if I want to have kids 15 years from now and find out I can’t?The Handmaid’s Tale stuff. Disturbing.
So I want to show how this thing got started, but more importantly, I want to make an argument: that if you really want to worry about fertility, you should worry about SARS-CoV-2 more than the SARS-CoV-2 vaccine.
The question: Is syncytin-1 similar enough to the spike protein of coronavirus that cross-reactive antibodies might attack the placenta?
They are dramatically different proteins.
Source: The Human Protein Atlas
Why Covid Vaccines Are Falsely Linked To Infertility
Jan. 12, 2021 — Theres no evidence that the new vaccines against COVID-19 cause infertility, yet thats a worry thats been cited by some health care workers as a reason theyre reluctant to be first in line to get the shots.
Across the country, significant numbers of health care workers have balked at getting the new vaccines.
Ohio Gov. Mike DeWine said in a recent briefing that 60% of Ohios nursing home staffers had declined their shots. In Georgia, an infection prevention nurse who coordinates COVID vaccines for the 30,000 employees in her health system said that so far, fewer than 33% had gotten the shot. The rest had decided to wait and see. The nurse disclosed the numbers on the condition that we not reveal what hospital she worked for, as she was not authorized to speak to reporters.
None of this has surprised Jill Foster, MD, a pediatric infectious disease specialist at the University of Minnesota in Minneapolis who has been studying vaccine hesitancy.
With COVID, it was the perfect storm. With COVID, there was already a bunch of people out there saying theres no such thing as COVID, its no worse than the flu, she says. Many of those people gained substantial followings for themselves on social media. When the vaccines came along, they used those platforms to stir up conspiracy theories.
Where did this infertility myth come from?
A spokesperson for Amazon Studios says the series is pure fiction.
Myth: The Vaccine Contains Scary Ingredients
The vaccines ingredient lists are simple and straightforward, with no ingredients that are considered significant threats to human health, and no aluminum, mercury, or human cells. The ingredient lists for both mRNA vaccines contain just three types of ingredients:
- the mRNA
- lipids with very long names
- sugars, salts, and/or simple chemical buffers
In the Pfizer vaccine, the third category includes potassium chloride, monobasic potassium phosphate, sodium chloride, dibasic sodium phosphate dihydrate, and sucrose. These may sound scientific, but three of them you probably have in your kitchen . Here is the fact sheet for the Pfizer vaccine, which includes the ingredients list.
The Moderna vaccine is formulated with different ingredients, but along the same formula. Besides the mRNA and lipids, it includes tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, and sucrose. Again, these are extremely common, simple ingredients in medical solutions. Tromethamine is just Tris buffer, which you may have used in science class. Acetic acid is the sour component of vinegar. Sucrose is sugar. Here is the fact sheet for the Moderna vaccine.
The Johnson & Johnson vaccine contains the adenovirus with the SARS-CoV-2 spike protein, salts, ethanol , a preservative called polysorbate-80, and a chemical called 2-hydroxypropyl–cyclodextrin that keeps the vaccine components properly mixed. Here is the fact sheet for the Johnson & Johnson vaccine.
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Myth: The Mrna Vaccine Is Not Considered A Vaccine
FACT: mRNA vaccines, such as Pfizer-BioNTech and Moderna, work differently than other types of vaccines, but they still trigger an immune response inside your body.
This type of vaccine is new, but research and development on it has been underway for decades.
The mRNA vaccines do not contain any live virus. Instead, they work by teaching our cells to make a harmless piece of a spike protein, which is found on the surface of the virus that causes COVID-19. After making the protein piece, cells display it on their surface. Our immune system then recognizes that it does not belong there and responds to get rid of it. When an immune response begins, antibodies are produced, creating the same response that happens in a natural infection.
In contrast to mRNA vaccines, many other vaccines use a piece of, or weakened version of, the germ that the vaccine protects against. This is how the measles and flu vaccines work. When a weakened or small part of the virus is introduced to your body, you make antibodies to help protect against future infection.
Learn more about how mRNA COVID-19 vaccines work.
Misinformation About Vaccines And Infertility Is Part Of A Larger Movement Around Wellness Specifically Centered On Women
Conversations around vaccine skepticism and reproductive health have overlapped for years, with many of the same prominent people promoting both anti-vaccine sentiment and a supposedly natural approach to birth control, pregnancy, and parenting.
One such person is Mayim Bialik, whose past statements started getting renewed scrutiny when she was selected as a Jeopardy co-host earlier this summer. She said in 2009 that hers was a non-vaccinating family. She has also endorsed skepticism around hormonal birth control, calling it a powerful drug with a lot of side effects. As E.J. Dickson reports at Rolling Stone, Bialik is also a home birth advocate who said in a 2010 interview that there are those among us who believe that if the baby cant survive a home labor, it is OK for it to pass peacefully. While Bialik said she herself did not subscribe to this view, she said that some feel that if a baby cannot make it through birth, it is not favored evolutionarily.
Bialik has since on vaccines, saying that while her family delayed vaccinations for reasons you dont necessarily get to know about, her children have had vaccines and she has been vaccinated against Covid-19. And a spokesperson for Bialik told Vox that she believes in the science behind vaccines and traditional medicine. But Bialik is just one of many celebrities and influencers to question vaccines as part of a larger, allegedly holistic or wellness-based ethos around reproductive and family health.
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Can I Get Pregnant After Receiving The Covid
- Can I get Pregnant after Receiving the COVID-19 Vaccine? Does the Vaccine Affect a Mans Fertility?
In December 2020, Tieg Beazer, M.D. was eligible to receive the COVID vaccine. She was getting married the following spring, and she and her partner knew they wanted to have a family.
When it was her turn to sign up for the shot, she admits she was hesitant. The vaccine was so new, and she didnt want to compromise her fertility. But Beazer, an OB/GYN fellow at the University of Rochester Medical Center, was comforted when she saw data from the vaccine clinical trials: many women who participated in the studies conceived between their first and second dose. She signed up and got the shot.
Now 14 weeks pregnant, Baezer is eager to quell the fears of others in similar situations.
This vaccine is safe, and anyone who is trying to become pregnant or who is already pregnant should get the shot, says Baezer, who had a normal first trimester and is feeling good in the beginning of her second. I understand why people are scared and uncertain, but if you want to be around for your baby, the shot is what will help you do that.
Beazer also has a view that many in the community do not: shes admitted many pregnant women who were not vaccinated and got COVID into the intensive care unit at Strong Memorial Hospital. Some need to be on a breathing tube for weeks at a time, and others delivery very early, leaving mom and baby in the ICU.
How The False Claim That Vaccines Cause Infertility Came About
Myths around Covid-19 vaccines and infertility follow a few different patterns.
First, there are misconceptions around the vaccine and peoples menstrual cycles. Some people have reported unusually heavy periods after getting the Covid-19 shot, which isnt necessarily surprising there is definitely a connection between your immune system and your menstrual cycle, Gounder said. But these effects, if someone experiences them at all, should be short-lived. You can have a change in your menstrual cycle, but that does not affect your fertility, Gounder said.
Then theres the idea that your vaccine could harm someone elses reproductive system. This myth is often connected to the idea of vaccine shedding, in which a person sheds parts of an inoculation from the body after receiving a shot. The idea is that these shed components could potentially throw off other peoples menstrual cycles or otherwise harm their reproductive systems. One viral article, for example, makes the false claim that young girls and postmenopausal women are suddenly getting periods, sometimes with grapefruit-sized blood clots, just from being near vaccinated people.
Indeed, the main way your vaccine can impact someone else is by protecting them: When youre vaccinated,youre less likely to give that person Covid-19, Gounder added.
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Myth: The Vaccines Contain Microchips Or Something Magnetic
The idea that vaccines contain microchips is just flat-earth-caliber wrong. A whole conspiracy theory was whipped up from thin air about microchips in vaccines, and throughout 2020 it was shared in groups that discuss Qanon conspiracies and anti-vaccine propaganda. It is not based on any real-world truths whatsoever.
There are injectable microchips in this world, and your pet can get them at any vets office. Sometimes pets get their microchip at the same appointment where they get a vaccine. Maybe thats where the rumor started?
If youve ever seen a microchip injected, youll know that theyre a little bigger than a grain of rice, and the needle that delivers them is sized to match. In other words, the inside of the needle is big enough to fit a grain of rice. Meanwhile, the needles that deliver vaccines are extremely thin, less than 1 millimeter wide. Here is Vice President Pence getting his COVID shot in front of news cameras. You can see the needle is normal sized. Theres no microchip in there.
Theres a related rumor going around TikTok where people supposedly demonstrate that their arms are magnetic after getting the vaccine. I heard this rumor just as I hit the two-week mark, when I was considered fully vaccinated, so I ran down to the kitchen and tried to stick a bunch of magnets to my arm. Thats the video you see above. None of the magnets stuck.
Myth : Vaccines Spike Protein Attacks The Placenta
Likewise, Dr Staci E. Pollack, a fertility doctor and professor at Montefiore-Einstein in New York City, was keen to debunk conspiracies contributing to vaccine hesitancy.
One rumor published on a blog was the bogus claim the vaccine’s spike protein “trained” the female body to attack the protein Syncytin-1, which is vital for placenta development because they are too alike but Pollack pointed out that the proteins are not actually similar.
“As far as we know in 2021, there’s no basis for those fears,” Pollack told The Sun, citing a June 2021 study of participants who were undergoing fertility treatments.
Data published in the ASRM Journal Fertility & Sterility found no difference between women who had the vaccine, who previously had Covid, or who had neither in terms of getting pregnant and maintaining that pregnancy.
“Vaccinations and Covid infections do not impact embryo implantation or early pregnancy development,” Pollack concluded, before addressing the threat Covid poses to unvaccinated pregnant women.
“We only know what we know: there was information that we knew yesterday, there’s information that we know today, and there’s information that we will know tomorrow,” the fertility doctor said.
“I know that if you happen to be pregnant and get … there’s a higher chance that you’re going to get admitted to the ICU intubated with a tube down your throat.”
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Myth: Receiving A Covid
FACT: Receiving a COVID-19 vaccine will not make you magnetic, including at the site of vaccination which is usually your arm.
COVID-19 vaccines do not contain ingredients that can produce an electromagnetic field at the site of your injection. All COVID-19 vaccines are free from metals.
Learn more about the ingredients in the COVID-19 vaccinations authorized for use in the United States.
Mcmaster University Developing Inhaled Aerosol Covid
CanSino had the same idea for an inhaled COVID-19 vaccine and the company appears to be way ahead of McMaster. Its inhaled vaccine is now in Phase 2 and 3 human trials.
Last April, CNBC reported on CanSino’s innovative inhaled COVID-19 vaccine and interviewed Yu.
“Actually we have run the TB human trials in Canada,” Yu told the U.S. news network.
Yu was apparently referencing the McMaster trials, which the university says it conducted on its own with funding from the Canadian government.
Last fall, Yu told The Fifth Estate that CanSino’s inhaled COVID-19 vaccine is based on “commercially available technology” and that he was not aware that McMaster has been developing its own inhaled vaccine. “I haven’t really had a conversation lately with McMaster University. I’m so busy with COVID-19 this last year,” he said.
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The Covid Vaccine Doesnt Cause Infertility But The Disease Might
Worries that the Covid-19 vaccine could cause infertility are among the reasons people give for avoiding vaccination. While theres no evidence any of the Covid vaccines cause problems with fertility, becoming severely ill from the disease has the potential to do so, reproduction experts say, making vaccination all the more important.
There is evidence to suggest that infection with SARS-CoV-2 has the potential to impact both male fertility, female fertility, and certainly the health of a pregnancy of someone infected, said Dr. Jennifer Kawwass, a reproductive endocrinologist and associate professor at the Emory University School of Medicine in Atlanta. And there is simultaneously no evidence that the vaccine has any negative impact on male or female fertility.
Why Should Children And Teens Get The Covid19 Vaccine
While children and teens are at lower risk of severe illness from COVID19, they are not immune from the virus. Vaccinating children and teens not only protects them and your immediate family from getting sick, but also helps the community.
In addition, getting vaccinated is an important step in helping us return to regular activities and routines.
“This pandemic has taken a real emotional toll on kids,” says Dr. DeSilva. “To decrease mental health concerns and to get our children back to the lives they want to live, it’s really important for them to get vaccinated.”
Vaccination is also backed by science including major medical organizations, from the American Academy of Pediatrics to the North American Society of Pediatric and Adolescent Gynecology and the American College of Obstetricians and Gynecologists.
“This is not a recommendation that multiple medical societies would make lightly if there were a true concern about reproductive health,” says Dr. DeSilva.
Dr. DeSilva recommends talking to your kids about their feelings about getting the vaccine. They may not be getting accurate information about the vaccine, so you need to help them learn about the evidence.
“Our teenagers are old enough that they could be part of this decision,” says Dr. DeSilva “This is an age where we start to allow them to take responsibility with their health care, and this is a great opportunity to allow them to do so.”
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Myth : The Vaccine Makes You Sterile
The Sun contacted J& J and Moderna for comment and did not receive a response at the time of publication.
A Pfizer spokesperson confirmed their vaccine “has not been found to cause infertility” and like Pallock, debunked the sterilization theory.
“It has been incorrectly suggested that Covid-19 vaccines will cause infertility because of a shared amino acid sequence in the spike protein of SARS-CoV-2 and a placental protein,” the company said.
“The sequence, however, is too short to plausibly give rise to autoimmunity. Additionally, a cohort study comparing the outcomes of pregnancies with and without intercurrent SARS-CoV-2 infection shows no difference in outcomes, further debunking the theory.”
Pfizer’s Phase 3 clinical trial includes more than 44,000 people who will be monitored for two years after their second dose the company noted that although expectant mothers weren’t included, some women fell pregnant during the trial.
CDC spokesperson Martha Sharan said there is currently “no evidence that any vaccines, including Covid-19 vaccines, cause female or male fertility problems problems getting pregnant.”
“The CDC does not recommend routine pregnancy testing before COVID-19 vaccination. If you are trying to become pregnant, you do not need to avoid pregnancy after receiving a COVID-19 vaccine,” Sharan said.
It has been incorrectly suggested that Covid-19 vaccines will cause infertility because of a shared amino acid sequence.