On December 16, 2020, the American Society for Reproductive
Medicine (ASRM) released
a statement for people who are pregnant or who are planning to get pregnant
regarding the COVID-19 vaccine. This has significant meaning for gestational surrogates
and intended parents, who were previously in a wait-and-see holding pattern.
The statement says that pregnant people, and anyone planning to get pregnant, cango ahead and get vaccinated — as long as your health provider gives you the OK to do so.
Ultimately, you’re free to choose whether or not you get
vaccinated. It’s a discussion that intended parents and gestational surrogates
should have, along with their American Surrogacy specialist.
If you’re (understandably) nervous about COVID or about
getting the COVID-19 vaccine, this guide will help gestational surrogates and
intended parents to make a decision on what’s best for them, and for the baby. Please note: You should still talk to your
doctor first! They can offer you medical advice based on your individual
COVID-19 Vaccine Basics
Here’s a brief introductory lesson on the COVID-19 vaccine,
considerations for surrogates and intended parents:
- As you probably know, pregnant women are
at a greater risk for becoming seriously sick as a result of COVID-19.
- Two different pharmaceutical companies, Moderna
and Pfizer, have produced COVID-19
vaccines — both
are about 95% effective. You probably won’t be able to choose which one you
- More vaccines are on the way, and they will also
probably be safe for pregnant women.
- The vaccine requires two doses, administered
21-28 days apart, depending on which vaccine you receive.
- You will need to receive both doses of the
vaccine in order for it to be effective.
- The first shot is a primer and then the second
is a booster shot.
- The vaccine does not contain the live virus
itself, and cannot give you COVID-19.
- You will need to continue wearing your mask,
practicing good hand-washing and hygiene habits and social distancing even
after you’ve received both doses of the vaccine.
- Common side effects include injection site pain,
fatigue, headache, muscle and join pain. A handful of people have experienced
fevers or allergic reactions. You may want to consider taking a day off to rest
up after receiving the booster dose — some recipients say they feel a bit tired
and achy for a day or two.
- Vaccine side effects are a sign that your immune
system is working as it should, not a sign that a vaccine isn’t working or that
something is wrong. However, monitor how you feel after receiving the vaccine,
and call your doctor if you’re worried.
- If you’ve had a severe allergic reaction to a
vaccine in the past, you should check with your doctor before getting the COVID
- Pregnant people were
not included in the testing groups for the vaccine, which was why health
organizations were initially wary to conclusively state that the vaccine was
safe for pregnant women. However, so far there have been no harmful effects for
pregnant women or for fetuses, and these organizations have concluded that the
likely benefits outweigh the unlikely risks. Because the vaccine does not
include the live virus, experts have little reason to believe that the vaccine
would be harmful to pregnant women or to unborn babies. But, we understand the
lack of data may be too great a worry for you.
- There are still some
unknowns, like how long the vaccine protects you, whether it can protect
you against an asymptomatic infection, or if you can transmit the virus if you
do become infected and are asymptomatic.
Ultimately, when weighing the potential pros and cons, experts say that it’s fine to get the vaccine when it’s available to you. That being said, you should always consult with your doctor before getting vaccinated, especially if you are pregnant or are planning to get pregnant as a gestational surrogate!
Gestational surrogates and intended parents should also talk
about the choice to get vaccinated with their American Surrogacy specialist.
It’s important for you all to be on the same page.
What the ASRM Says About Pregnancy and the Vaccine
In the statement released December 16 of 2020, the American
Society for Reproductive had this to say to anyone who is pregnant (or plans to
- “The Task Force does not recommend withholding
the vaccine from patients who are planning to conceive, who are currently pregnant,
or who are lactating. These recommendations are in line with those of the
Advisory Committee for Immunization Practices (ACIP) of the U.S. Centers for
Disease Prevention and Control (CDC), the American College of Obstetricians and
Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine (SMFM).”
What that means for you: The general consensus among professionals who are responsible for the health of pregnant women and fetuses is that the vaccine can be administered to surrogates.
- “Patients undergoing fertility treatment and
pregnant patients should be encouraged to receive vaccination based on
eligibility criteria. Since the vaccine is not a live virus, there is no reason
to delay pregnancy attempts because of vaccination administration or to defer
treatment until the second dose has been administered.”
What that means for
you: Getting vaccinated is still likely safe for surrogates who are
currently undergoing, or are planning to undergo fertility treatments, IVF, embryo
transfers and pregnancy. It’s also probably safe for intended parents planning
to harvest their gametes for the surrogacy journey. Wherever you’re at in your
surrogacy journey, that journey will not be affected or delayed if you choose
to receive a COVID vaccine.
- “Recent studies have suggested that pregnancy is
a risk factor for severe COVID-19 disease. Furthermore, many women who are
pregnant or contemplating pregnancy have additional risk factors such as
obesity, hypertension or diabetes which may further increase the chance of
severe disease from COVID-19 infection. These considerations should be included
in decisions regarding vaccination.”
What that means for you: As you probably know, pregnant women have a higher risk of experiencing severe COVID-19 symptoms. This will be a factor in the conversation with your doctor about getting vaccinated.
- “Because COVID-19 mRNA vaccines are not composed
of live virus, they are not thought to cause an increased risk of infertility,
first or second trimester loss, stillbirth, or congenital anomalies. It should
be noted that pregnant and lactating women were excluded from the initial phase
III trials of these two vaccines, so specific safety data in these populations
are not yet available and further studies are planned. However, the mechanism
of action of mRNA vaccines and existing safety data provide reassurance
regarding the safety of COVID-19 mRNA vaccines during pregnancy. The FDA EUA
letter permits the vaccination of pregnant and breastfeeding individuals with a
requirement that the company engage in post-authorization observational studies
What that means for you: Even though pregnant women weren’t included in the original trials of the vaccine, this type of vaccine has been extensively studied and is generally considered safe for pregnant women and for the pregnancy itself. However, we understand the lack of data may give you pause.
- “While COVID-19 vaccination can cause fever in
some patients (up to 16% of those vaccinated and mostly after the second dose),
this risk should not be a concern when deciding whether to vaccinate a pregnant
individual or a patient desiring pregnancy. While fever in pregnancy
(particularly the 1st trimester) has been associated with an increased risk of
neural tube defects, a recent study demonstrated the association no longer
remained significant if the patient is taking >400 mcg of folic acid daily.
Another large Danish cohort study did not demonstrate any increased risk of
congenital anomalies of those who reported fever in the first trimester.
Additionally, the most common symptom of COVID-19 infection itself is fever
(83-99% of affected patients). Patients who experience fever following
vaccination should take an antipyretic medication, like acetaminophen.”
What that means for
you: Even if a gestational surrogate experiences vaccine side effects like
a fever, it shouldn’t
harm the surrogate or the pregnancy, especially if you’re taking your
recommended folic acid.
- “Patients who conceive in the window between the
first and second dose of the vaccine should be offered the second dose of the
vaccine at the appropriate interval.”
What that means for
you: It’s OK if you become pregnant in between your first and second dose.
Go ahead and get your second vaccine dose as scheduled.
- “Physicians should promote vaccination to
patients, their communities, and to the public. Preliminary data suggests that
those populations at greatest risk of severe disease from COVID-19 may also be
the most hesitant to be vaccinated, and specific efforts to increase vaccine
uptake in these communities should be undertaken.”
What that means for you: We know you’re worried about the health and safety of this pregnancy, as well as your own safety. But, after checking in with your doctor, you’re free to schedule your COVID vaccine as soon as it’s available to you. The benefits may outweigh the risks.
What American Surrogacy Recommends
We know that if you’re a gestational surrogate or an
intended parent, or if you’re thinking about starting your surrogacy journey as
a surrogate or parent, you’re probably worried about how COVID-19 affects your
surrogacy journey. During a surrogacy journey, the gestational surrogate and
intended parents worry about everything that goes into the surrogate’s body —
everyone’s priority is the health and safety of the surrogate and baby.
With that top priority in mind, and with the recommendations of trusted health organizations, American Surrogacy joins in recommending that gestational surrogates can receive the COVID-19 vaccine, as long as the surrogate, the intended parents and the surrogate’s doctor are all comfortable with this. However, a COVID-19 vaccine is not currently required for our surrogates — the decision to receive the vaccine is still at the discretion of the surrogate, the intended parents and the surrogate’s doctor.
Wherever you’re currently at in your surrogacy journey, we suggest
speaking to your doctor about getting
vaccinated. Ask your doctor when a COVID-19 vaccine might be available to
you, and ask if they think you might have any health conditions or risk factors
that would make the vaccine inadvisable in your situation.
As long as your doctor and your surrogacy partners agree with this choice, you’re free to get the vaccine when it’s available to you. But, when in doubt, consult your American Surrogacy specialist!