Discussions all Intended Parents need to have with their Gestational Carrier
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The relationship between intended parents and their surrogate, or gestational carrier, is like no other. The parties work together to bring a new life into the world and expand the intended parents’ family. Although the surrogate is fairly compensated, it is undeniable that her work involves personal sacrifice; she is committing to carry a pregnancy, making sacrifices of her time, energy, and comfort in order to give birth to a healthy child for another family. What happens when the intended parents and the gestational carrier disagree about an action the surrogate should, or should not take, during the pregnancy? One potential source of disagreement is the COVID vaccine for pregnant women.
People tend to feel very strongly one way or another about the COVID-19 vaccine. Understandably, many people are concerned about the newness of the vaccine and its potential long-term effects. And unlike giving up caffeine or smoking during a pregnancy, receiving a vaccine is not a temporary decision that can be reversed once the pregnancy is over.
Initially, there was little data on the COVID vaccine for pregnant women, because pregnant women were excluded from the first clinical trials. But over the more than 18 months that the pandemic has dragged on, more data has become available, and it overwhelmingly supports the use of the COVID vaccine for pregnant women.
Is the COVID Vaccine Safe for Pregnant Women?
To some people, it is almost miraculous that multiple highly effective vaccines have been developed and brought to market. To others, the speed with which the vaccines became available is a source of concern. (The reason that the vaccine was able to be created so quickly is that the technology had been in the works for decades.)
To some people, it is almost miraculous that multiple highly effective vaccines have been developed and brought to market. To others, the speed with which the vaccines became available is a source of concern. (The reason that the vaccine was able to be created so quickly is that the technology had been in the works for decades.)
Gestational carriers who are hesitant about getting the COVID vaccine deserve to have their concerns heard and addressed. Unfortunately, information about the safety of the COVID vaccine for pregnant women and others has come from many sources, and unfortunately, much of it has been unreliable. It is important to get information from established, trustworthy sources. In the United States, the best information we have about the safety of COVID vaccines in pregnancy comes from the Centers for Disease Control (CDC).
Here are things that we now know about COVID-19, vaccines, and pregnancy from the CDC:
The CDC recommends the COVID vaccine for all people 12 and older, including those who are pregnant, breastfeeding, trying to become pregnant, or who intend to get pregnant at a later date.
The growing body of data suggests that the benefits of getting a COVID vaccine outweighs any known or potential risks of getting vaccinated before or during pregnancy.
None of the COVID vaccines contains live virus, and there is no risk of anyone, including pregnant women, becoming infected with the virus through vaccination.
Animal studies for the three major vaccines in the U.S. (Moderna, Pfizer-BioNTech, and Johnson & Johnson) showed no adverse effects in pregnant animals or their babies.
Previous clinical trials that used the same vaccine platform (viral vector) as the Johnson & Johnson vaccines showed no adverse pregnancy-related outcomes. (It’s not that there have been adverse pregnancy-related outcomes for the Pfizer-BioNTech and Moderna vaccines; there have not been previous clinical trials using the same mRNA platform.)
Early data on the safety of mRNA vaccines during pregnancy is reassuring, and suggests that the vaccines reduce the risk of infection with COVID-19 without any safety concerns for pregnant individuals or their babies.
There is no evidence that the use of the COVID vaccine causes fertility in women or men.
A report of individuals enrolled in the CDC’s v-safe pregnancy registry found no increased risk of miscarriage from the mRNA vaccines.
Pregnant people, and people who have recently been pregnant, are more likely to get severely ill from COVID-19 than non-pregnant people.
The CDC is not the only trusted organization that strongly recommends the use of COVID vaccines for pregnant women. The American Society for Reproductive Medicine (ASRM) has also issued a position paper in favor of the vaccine. The American College of Obstetricians and Gynecologists (ACOG) encourages its members to “enthusiastically recommend” the vaccine to their patients. In other words, these respected medical groups are not simply saying that pregnant individuals may get the vaccine; they are stating unequivocally that they should.
Deciding to Vaccinate as a Gestational Carrier
Despite the increasing data suggesting the safety and benefit of the COVID vaccine for pregnant women, some people argue that even the most favorable data on the issue is still new; why take a risk on as-yet unknown potential long-term side effects?
There’s a simple and straightforward answer to concerns about the long-term side-effects of the COVID vaccine: the virus itself is new, and we don’t yet know the long-term effects of having been infected, either. We do know, however, that there is a long and worrisome list of symptoms associated with post-COVID conditions. That list is likely to grow as more is known.
For surrogates deciding to vaccinate, it is recommended that their spouse and all of their eligible household members be vaccinated as well. Obviously, intended parents have no control over the vaccination status of anyone in a gestational carrier’s household, including the gestational carrier herself. However, the increased likelihood of infection from unvaccinated household members could cause some surrogacy contracts to be put on hold.
We understand that this is a sensitive issue, and that it may be difficult, though essential, to discuss with your surrogate.