Event Review: The Effects of SARS-CoV2 Infection and Vaccine Safety on Fertility and Pregnancy

While viruses and vaccines are not typical topics for a a genetics and assisted reproduction newsletter, the past two years have seen a shift in BioNews coverage to include various COVID-19-related developments.

mRNA vaccines have proved to be an exciting development, but the conspiracy theories that emerged surrounding the vaccines and infertility have been less enjoyable to cover (see BioNews 1104). Therefore it was with a heavy heart that we saw COVID-19 vaccines and infertility were trending again on Twitter recently, due in part to recirculated early clinical trial data from Pfizer and outdated Medicines and Healthcare products Regulatory Agency warnings to not give the Pfizer vaccine to pregnant or breastfeeding women.

It was just as well that Imperial College London's Dr Viki Male had delivered the Queens University Toronto's latest development and reproduction lecture on the effects of SARS-CoV2 infection and vaccine safety on fertility and pregnancy that week. Dr Male has been outspoken about the problems that have arisen due to pharmaceutical companies' failure to include pregnant women in their trials and of subsequent messaging from the NHS and other bodies around the safety and importance of the COVID-19 vaccine for this group. She pointed out that of course, women became pregnant on the trials anyway and subsequent enrollment of pregnant frontline workers in Israel and the United States had demonstrated the safety of the vaccine in pregnancy.

To emphasise the problematic ethics employed to justify the denial of vaccines to pregnant women she used the example of the ebola vaccine trials in 2016, where she said pregnant women who were excluded from them said they felt 'protected to death'. Guidelines had then been developed in 2019 to include pregnant women in those vaccine trials which had resulted in greatly increased survival rates for them and their babies. It was these guidelines that could have been used to help develop the COVID-19 vaccine trials in early 2020, said Dr Male.

She continued to critique the male-normative approach taken by pharmaceutical companies and researchers with a look at the failure to collect data on the impact of the new vaccines on periods. I had actually become aware of Dr Male's work on the issue by seeing it referenced by Caroline Criado Perez in her newsletter. Criado Perez has been outspoken about her desire for greater information about the impact of the vaccine on periods as she tried to conceive. Therefore, it was great to listen to Dr Male provide a personal narrative of how and why she had decided to carry out her own research into the impact of COVID-19 vaccines on the menstrual cycle, on what she described as 'a shoestring, basically, in my own time at night'. They had discovered a 'hint of a tint' of an effect with her own study she said, but outlined the reporting and recruitment biases which make this kind of research challenging.

I had hoped that Dr Male would confront the myth that the COVID-19 vaccines cause infertility in her lecture, and she didn't disappoint. In fact she deep-dived into the subject and explored the origins of what she called a conspiracy theory. She outlined how the theory had arisen over the mistaken idea that mRNA vaccines target placental synticil-1, a protein needed to maintain a pregnancy (see BioNews 1095). Her own outrage about the subject was palpable as she told the audience at the time she had thought: 'I work on immune responses to the placenta. And I thought, well, if I won't stand up and explain why this isn't true, then who will?'

The most important source of data for disproving this conspiracy theory came from trials undertaken on people who had undergone fertility treatment during the pandemic, she said. This was as the highly medicalised nature of fertility treatment meant that the pregnancies that resulted from them took place in a controlled, measurable and reportable system. We now know of course that numerous trials done with participants undergoing fertility treatment have shown that COVID-19 vaccines did not harm male or female fertility (see BioNews 1100 and 1101).

Attending a lecture from such a respected researcher in the field, which scrutinised the assumptions and indeed ethics of other researchers over their approach to protecting women during the COVID-19 pandemic was a breath of fresh air. Both as science editor of BioNews, and in general, I have repeatedly butted up against the idea that poor uptake of the vaccine among pregnant women was due to poorly informed women sharing silly ideas on social media and Mumsnet. Or even that it would have been impossible to provide women and those undergoing fertility treatment with better care and that to expect otherwise is unreasonable, even unscientific.

To hear a scientist so forensically take down the poorly-evidenced justifications often used for these positions was a deeply validating experience. I can only hope her attitudes prevail and that far fewer people will be left behind by outdated assumptions in future.