Are COVID-19 vaccines safe in pregnancy?

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As the COVID-19 vaccination programme starts to be rolled out, many young women are hesitant to accept the vaccine, citing concerns about fertility. Meanwhile, those offered the vaccine during pregnancy must decide whether they will accept, even though pregnant people were excluded from the clinical trials. Data on accidental pregnancies that occurred during the trials and, increasingly, outcomes in pregnant people who receive the vaccine can help these groups to make informed decisions.

In December 2020, a blog post appeared online claiming, falsely, that a senior employee at Pfizer was concerned that antibodies elicited by COVID-19 vaccines could attack the placenta. The post was quickly removed but the rumours that it started continue to spread and a survey carried out by ‘Find Out Now’ found that more than a quarter of young women in the United Kingdom would decline the vaccine, citing concerns about its effect on fertility. This is not the first time that unfounded rumours about vaccines causing infertility have circulated. In 2003, such concerns resulted in a boycott of polio vaccination in northern Nigeria; more recently, they have contributed to hesitance in accepting the human papillomavirus vaccine. It is understandable that people are apprehensive, especially about a new vaccine: the vast majority of adverse events can be ruled out in clinical trials, but the short time frame during which these take place, especially for COVID-19, means that events that could potentially occur decades into the future are harder to discount. Indeed, many people are hesitant specifically about receiving an mRNA vaccine, as this is a relatively new platform. With respect to these concerns, it is worth noting that the first human trials of mRNA vaccines began in 2006, so there have been 15 years during which any long-term problems arising from the platform itself could have come to light1.