Based on ASRM’s recommendations issued on April 24, we are resuming all treatments at all CCRM Fertility locations, including egg retrievals, frozen and fresh embryo transfers (FETs) and intrauterine inseminations (IUIs).
Your health and safety remain our top priority. In order to continue to provide industry-leading care while limiting social exposure and virus transmission, we are controlling the number of patients onsite each day and we have implemented the safety measures listed below.
CCRM New York Patient Advisory: New York State, along with Connecticut and New Jersey, have issued a travel advisory effective midnight June 25, 2020, which requires that all individuals traveling from states with significant community spread of COVID-19 quarantine for a 14-day period from the time of last contact within the identified state. This quarantine applies to any person arriving from a state with a positive test rate higher than 10 per 100,000 residents over a 7-day rolling average or a state with a 10% or higher positivity rate over a 7-day rolling average. Click here to learn the positivity rate in your state.
COVID-19 Vaccine FAQ
In agreement with the American College of Obstetrics and Gynecology (ACOG), American Society for Reproductive Medicine (ASRM), and Society for Maternal Fetal Medicine (SMFM), CCRM Fertility recommends that the Pfizer-BioNTech and Moderna mRNA COVID-19 vaccines should not be withheld from patients attempting pregnancy, pregnant or nursing. The vaccine should be provided to these women based on eligibility criteria.
Since pregnant women were not included in vaccine trials, we do not have any definitive information on their safety for mom or baby. However, since 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.
If there is no data in pregnancy or experience with this vaccine platform, what are reasons to think its risks outweigh its benefits in pregnancy?
- While rapid in its development no “corners were cut” in achieving FDA-approved emergency use authorization (EUA)
- mRNA vaccines are not live virus vaccines and do not cause infection, nor do they enter the cell’s nucleus
- mRNA is rapidly degraded in the body. Even with the lipid nanoparticle carrier, the mRNA is likely gone within 5 hours.
- Increased risks of COVID-19 in pregnancy include severe illness (ICU admission, need for mechanical ventilation and death), as well as adverse pregnancy outcomes (e.g. preterm birth)
- It is important to understand that there may be risks of the vaccine pregnancy, or in women who are trying to conceive that have not yet been demonstrated. You must weigh these theoretic risks against the benefit of decreasing the risk of infection
What are other considerations when making decisions about vaccination?
- Local COVID-19 transmission and risk of acquisition
- Personal risk of contracting COVID-19
- Risks of COVID-19 to her and potential risks to fetus
- Efficacy of the vaccine and known side effects
- Lack of data about the vaccine during pregnancy
CCRM believes the vaccine should be provided to women trying to achieve pregnancy.
What should I do if I am in the middle of fertility treatment or trying to conceive?
It should be noted, that while there is no reproductive or developmental toxicology data yet available, there does not currently exist reasonable, scientific doubt to compel a recommendation to delay, stop or alter fertility treatment or attempts at conception for those individuals eligible for vaccination in early phase vaccination allocations. Those patients, after discussion with their provider, who elect to defer attempts at conception during the initial vaccine series, can reasonably return to attempts at conception after the second dose. Out of an abundance of caution, it would be reasonable to discuss with your physician the potential to delay treatments that would directly lead to pregnancy (e.g. embryo transfer) until after the window in which side effects such as fever or flu-like symptoms could occur.
Will CCRM Fertility administer the COVID-19 vaccine to patients?
We will not administer the vaccines in our offices. Your primary care doctor may be administering the and the national program rollout will include administration of the vaccine at Walgreens, CVS, and other locations that have the capacity to store and determine eligibility.
What should I do if I have a fever after vaccination?
Pregnant women who experience fever following vaccination (more common after second dose in non-pregnant trial participants) should take fever reducing medication like acetaminophen due to associated risks of fever with adverse pregnancy outcomes.
What happens if I can’t get the second dose in the time prescribed?
The second dose of the Pfizer vaccine should be administered within 17-21 days of the first dose and the second dose of the Moderna vaccine should be administered within 28 days of the first dose. If more than this interval has passed the second dose should be administered at earliest opportunity. No doses will need to be repeated. It is important to understand that newer vaccines may have different dosing intervals.
Will I mount an immune response if I only get the first shot?
Getting both doses is necessary for the highest level of protection. Vaccine efficacy is lower and less durable after only one shot with 52% efficacy after the first injection.
I had COVID-19 before I got pregnant. Now that I am pregnant, do I get the vaccine?
Vaccination should be offered to eligible persons regardless of history of prior symptomatic or asymptomatic COVID infection. Viral or serologic testing for acute or prior infection is not recommended for vaccine decision making purposes.
Do I need to get a pregnancy test before getting the COVID-19 vaccine?
Routine testing for pregnancy prior to either vaccination dose is not recommended.
What is known about the first trimester of pregnancy and COVID-19?
At this time, there is limited data available. Of 458 pregnant women with that were hospitalized with COVID-19, 10 had a pregnancy loss, with 4 losses (0.9%) occurring in pregnancies less than 20 weeks.
What is the risk of fever in pregnancy?
Fever in pregnancy (particularly the first trimester) is associated with an increased risk of neural tube defects, however a recent study demonstrated the association no longer remained significant if the patient is taking more than 400 mcg of folic acid. Another large Danish cohort study did not demonstrate any increased risk of congenital anomalies of those who reported fever in the first trimester. The most common symptom (83-99%) of COVID-19 infection is fever. As mentioned above, it would not be unreasonable to defer an embryo transfer until after the window for these side-effects from the vaccine has passed.
Can I get the vaccine if I am breastfeeding?
Yes, people who are breastfeeding can choose to get vaccinated. Though there is no specific information at this time on safety of breastfeeding, important facts are that the vaccine does not contain live virus and should not be a risk to infants. People who are breastfeeding should weigh their person exposure risk and consider vaccination.
Could all of this guidance change?
Yes. As vaccine capacity expands, and safety data accumulates, recommendations and guidance will be updated. We will update this site as recommendations evolve. We encourage you to discuss any questions or concerns regarding vaccination with your healthcare provider.
CDC ACIP COVID-19 Vaccines Work Group
Safety and Efficacy of the BNT162b2 mRNA COVID Vaccine (NEJM)
FDA Fact Sheet for Vaccination Providers
FDA Fact Sheet for Recipients and Caregivers
Covid Vaccines in Pregnancy (AJOG)
Patient Protocols After Receiving the COVID-19 Vaccine
Given the currently limited information on how much the mRNA COVID-19 vaccines may reduce transmission in the general population and how long protection lasts, vaccinated persons should continue to follow all current CDC guidelines to protect themselves and others. This includes wearing a mask, staying at least 6 feet away from others, avoiding crowds, washing hands often, screening for symptoms and following CDC travel guidance, following quarantine guidance after an exposure to someone with COVID-19, and following any applicable workplace or school guidance, including guidance related to personal protective equipment use or SARS-CoV-2 testing.
Since there is no data that supports that vaccination eliminates the potential that patients can still carry the virus and/or be infectious to others, we will continue to require COVID-19 testing for our patients at this time.