Krissy considers herself someone who is “very pro-vaxx.” With her 3-year-old daughter, she followed the Centers for Disease Control and Prevention’s childhood vaccination schedule, and she was “excited” to get vaccinated against COVID-19 as soon as she was eligible.
Krissy, 37, who lives in the Atlanta-area and asked for her last name to be withheld for privacy, said she had no side effects after her first Moderna dose. But two days after her second dose she got her period — and after that period ended, she got another eight days later. This cycle continued for a few weeks, at which point she went to her gynecologist for advice. After a course of oral progesterone failed to restart her regular menstrual cycle, she went back to her doctor, who told her that it seemed like she had stopped ovulating.
She hadn’t planned on having any more children, but now is worried that the choice may have been made for her. Krissy is concerned that the vaccine is to blame, and what this might mean for her daughter’s fertility should she get vaccinated when she becomes eligible in the coming months.
“I want her to be safe and healthy, but I don’t know what the long-term ramifications are,” Krissy said.
Research published at the end of June in the medical journal Fertility and Sterility concluded that the COVID vaccine does not cause sterility. The research also determined that nothing in the vaccine impacts embryo implantation or pregnancy development.
Dr. Hina Talib, a pediatrician, adolescent medicine specialist and spokesperson for the American Academy of Pediatrics, emphasized that there is “no biological mechanism for future fertility to be impacted by the COVID vaccine or any other vaccine to date, which should be reassuring given the long history of world populations with vaccinations.”
“I think this is the one thing I hear most commonly as a question from parents: Does this impact their puberty, their sexual development, their future fertility?” Talib said about the COVID-19 vaccine.
“We’re living in strange times where there is so much misinformation that spreads so quickly and it preys on the fears of parents. Parents get caught up and become the middlemen of these national movements that are political in nature.”
But Talib said she understands where parents like Krissy are coming from.
“It’s been a very long 16 months, and especially so for parents of children who really felt the effects of social isolation and disruption in their lives. Right now, parents are preoccupied with the health and wellbeing of their children in a way that is unique to any time from ever before,” she said. This newness, she added, “can feel like a burden on top of a year that was already so different.”
As Jennifer Reich, a professor of sociology at the University of Colorado Denver and author of “Calling the Shots: Why Parents Reject Vaccines” explained, vaccine hesitancy isn’t new. Even before COVID, 25 to 30 percent of American parents were having their children skip vaccines, spacing out vaccines, coming up with their own vaccination schedules, or committing to some — but not all — vaccines. In her research, Reich heard from parents who felt that, ultimately, they were best qualified to determine the risks and benefits.
“As parents, they feel like experts on their own children,” Reich said to The 19th. “And that was pre-COVID.”
She pointed out that over the past three decades, vaccines have increasingly become seen as an individual, consumer decision and not a public health one.
“We download apps and count calories and count steps and undergo genetic testing for any potential underlying risks,” Reich said. “These aren’t public health strategies, though. Even our public health agencies are focusing their messaging on personal responsibility, telling people, ‘don’t smoke’ and ‘go for a walk.’ Implicit in this is that you can personally manage disease — which is scientifically untrue.”
Most disease, she said, results from environmental or genetic factors, not choices that are “personally malleable.” But in this moment in particular, what it means to be a parent — and, more specifically, a “good mother” — is often defined by the perception that you are making informed decisions about your own child, and your own child only.
Talib echoed the sentiment.
“People look at the rates of vaccination in their area, their school — but these numbers don’t fully account for all children. Maybe they account for your children or some children, but we need to look out for those who are only speaking out for their own children and remind them that their health and vaccine privilege are what allow them to make statements about what other families should do with regards to this vaccine.”
Given the low mortality and hospitalization rates for children who contract COVID, “it’s not entirely irrational to say you don’t want to vaccinate your child because they are young and at low-risk of infection,” Reich said. The COVID vaccine is the first new vaccine approved in about 15 years — the Gardasil vaccine for HPV was approved by the Food and Drug Administration (FDA) in 2006, before many of today’s parents had children — which means parents might have questions about what it means to reasonably evaluate this choice.
The question of how the COVID vaccine may impact their children’s fertility is a perfect distillation of this dynamic. As Reich explains, early in the COVID vaccine’s initial release period, there was an unfounded theory circulating around the Internet that the genetic code for the COVID vaccine was similar to that used in placental development during pregnancy. There was concern among this theory’s proponents that the vaccine could potentially disrupt a placenta’s ability to successfully grow a fetus to term. Reich said when she contacted scientists who work in perinatal and reproductive health about this claim, they explained to her that because there are only so many combinations of letters available in discussing genetic sequences, the sequencing for the vaccine and for placental development look superficially similar, but that any overlap ends there.
“It’s like me thinking that I know I can call you because I know you have a ‘7’ in your phone number,” Reich said.
Concerns about children’s future fertility persist, though. Talib says she hears about fertility from mothers most often, specifically in regards to daughters — which she says isn’t surprising.
“Mothers don’t need to do the mental gymnastics themselves on that unfortunate piece of misinformation,” about COVID and placental disruption, “because many of them already feel done with trying to have a family. But with their kids, they think their fertility is ahead of them, not behind them.”
Talib noted that there have been “anecdotal reports of periods fluctuating after receiving the COVID vaccine,” but notes that any time there is stress on the body — including but not limited to weight changes, emotional stress, illness and malnutrition — menstruation may be impacted. So it’s not unusual if people’s menstrual cycles seem off for several cycles following vaccination.
Even Krissy found this to ultimately be true: After two months of irregular cycles, her period seems to have resumed normally. Talib added that there are new and ongoing studies now looking closely at the impact of the COVID vaccine on menstruation in adult women.
But researchers may have a long road ahead to winning some women’s trust. “Women’s issues are often overlooked,” says Krissy of her experiences with the health care system to date. “Maybe they just don’t care. Maybe if something like this were impacting sperm counts, it would be researched to the nines. But doctors think, ‘Oh women — their cycles are irregular anyways.’”
Talib says she has come to better understand the importance of her voice in discussing the vaccine with patients and their families.
“I feel like I’m on autopilot sometimes and saying the same thing over and over again, but saying it out loud in a clinical visit is quite powerful,” she said. “You’re not going to change everybody’s mind in every clinical encounter, but that’s not the goal. The goal is just to share evidence-based information about the COVID-19 vaccine and keep the conversation going.”
Reich says that it isn’t surprising that this is something parents, especially mothers, are discussing among themselves: “Mothers always talk to each other about their children’s health, schools, activities.” She added that when it comes to vaccine hesitancy clusters, it isn’t that these peer groups are self-selecting, but rather that the more people a mother knows who won’t vaccinate, the more likely she is to not vaccinate her children too to maintain the norms of their own social networks.
Talib added that an important part of any conversation with vaccine-hesitant parents is the reminder that “vaccines end pandemics — and children deserve to be protected just as adults are.” The risks to otherwise low-risk children go beyond severe illness and hospitalization, she said, and also include things that can impact their mental health like having to quarantine away from school and activities, constant testing, and the risk of infecting other adults who may be higher risk. Children who are immunocompromised or have other COVID-19 risk factors need to be accounted for, too.
“We need to center these children and their families as well and not forget about them,” Talib said. “These families are counting down the days until their children can get the vaccine and I don’t want to discount their experiences and fears.”
Reich said the stakes could feel especially high for mothers. “Part of that is that everything that happens to children tends to be linked back to mothers’ decisions,” she said. “I don’t think you have to subscribe to conspiracies to think that you want to feel like you have thought this through and feel certain in your decisions. It’s been an anxiety-provoking year, and vaccines are a new form of anxiety.”
For some, she said, “Waiting and seeing feels safer, even if it isn’t safer.”