Viki Male

Large study finds COVID-19 shots don’t affect fertility

Among almost 60,000 women aged 18 - 45 in one Swedish county, #Covid #Vaccination did not affect the chance of getting or staying #pregnant.

I know of at least a dozen studies that have shown this, but this is by far the biggest! I spoke to @lizszabo.bsky.social

Lovely to finally meet you IRL too!

Thank you so much for inviting me! It was great to chat to so many inspiring scientists!

British Society for Immunology MIG seminar, Dr Victoria Male, Imperial College London: "The immune and reproductive systems: a fertile conversation." Thursday 29th January 12 pm Michael Smith Lecture Theatre Lydia Becker Institute of Immunology and Inflammation

Dr. Victoria Male @vikilovesfacs.bsky.social joins us from @imperialcollegeldn.bsky.social tomorrow to discuss "The immune and reproductive systems: a fertile conversation."

📆 Thursday 29th Jan
🕛 12:00 PM
📍 Michael Smith Lecture Theatre

@britsocimm.bsky.social #ImmunoSky

Explainer on COVID19 vaccine and fertility.docx Explainer on COVID vaccination, fertility, pregnancy and breastfeeding Viki Male, Associate Professor in Reproductive Immunology at Imperial College London v.male@imperial.ac.uk @VikiLovesFACS Last ...

So this reports on the combined effect on fertility and pregnancy - none. If we want to know those effects separately, we have to look elsewhere... 3/3

But you have to hunt in the supplementary for it.

Important also to realise that this approach effectively looks at effects on pregnancy on the left side of the curve (where ppl vaccinated are already pregnant) and on fertility on the right (vaccination before pregnancy). 2/

A Kaplan Meier curve displaying time to childbirth by COVID vaccination status. There is no difference between the two groups.

I actually reviewed this one! I was satisfied with the methods but I do felt it struggled for the extremely short format the journal required.

To my mind, the most important finding is the Cox proportional hazards model, showing no difference in time to childbirth by vaccination status... 1/

Tylenol during pregnancy is safe without increased risk of autism, ADHD, or intellectual disability of offspring
A new review of the evidence just out
www.thelancet.com/journals/lan...

Thanks! We hope people find it useful!

Thanks to the IMPRINT network for supporting this project, @ukri.org for funding and colleagues @drbethholder.bsky.social and Sara Barnett. You've all been great to work with!

We've also curated a collection of resources for midwives and other healthcare professionals, to help make conversations about this important topic easier and more impactful.

Please take a look and share with your patients and colleagues! 2/

Vaccines in Pregnancy, UK | Learn More About Vaccination Today Comprehensive guide to vaccines during pregnancy in the UK, including timing and locations for vaccination. Essential information for expectant parents and healthcare providers.

Vaccination against whooping cough, RSV and flu during pregnancy saves babies lives, but expectant parents are sometimes unsure.

How do I know it's safe? Will it protect my baby?

To answer these questions, we've created www.vaccinesinpregnancy.org

#ObGynSky #MedSky #ImmunoSky

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@scientisttess.bsky.social Sorry to miss your talk (and indeed the drinks!) My train was cancelled so I had to leave in time to get the one before.

…it means we can’t tell what is due to infection and what is due to other factors relating to the pandemic. They had 65 pandemic-era but (apparently) uninfected pregnancies that I don’t see them reporting on. I would really have liked to know how these babies were! 2/2

I am thank you!

Just read this. One thing that annoys me is that they only compare babies born following infection to pre-pandemic babies. I see the logic in that (you can’t be sure that people who weren’t infected in the pandemic really weren’t infected!) but… 1/

I tried but never really got into things here! I think I never got my notifications set up quite right, but got one for this. Certainly something that’s worth keeping an eye on. Thanks for sharing.

Until very recently, the CDC was doing this, but specifically focused on the risk of COVID in babies, rather than obstetric outcomes. With their remit being curtailed, rather than extended, I don’t see us having answers to this anytime soon. 2/2

To my knowledge, no. One big challenge is that we no longer have the testing infrastructure to know who has or hasn’t had COVID and follow up outcomes. Another way to approach the question would be to look at outcomes in vaccinated vs unvaccinated pregnancies. 1/

But these stats on their own don’t convince me we’re seeing problems of repeat COVID infection in these services, and also don’t chime with what we’re seeing on the ground: business pretty much as usual, albeit that services are underfunded and understaffed (so… business as usual!) 12/12

Formal analyses of HES can be done, and this is one of the ways we found that COVID vaccination was safe in pregnancy, and put a numerical value on the harm of infection at the height of the pandemic. As I’ve said, I’d like to see an updated analysis. 11/11

So from all of this, I will say the same as I did when people were using HES to try and claim an increase in certain obs and gynae problems due to COVID vaccination.

So much goes into HES that you can’t use the raw figures to test these kinds of ideas. 10/

There’s also increased awareness about endometriosis, which is great! And longer waiting lists to see the gynae service - I am hearing years in some trusts - which is not. But both of these will cause an increase in HES. 9/

So these would not show up in the gynae HES. And many of those gynae conditions are ones that you live with for years before getting to hospital. For endometriosis, it’s 8 on average. People being seen in hospital now, on average, first visited their GP about it before the pandemic. 8/

Associations Among Menstrual Cycle Length, Coronavirus Disease 2019 (COVID-19), and Vaccination - PubMed Experiencing COVID-19 is associated with a small change in cycle length similar to COVID-19 vaccination. These changes resolve quickly within the next cycle.

Acute COVID outside of pregnancy can cause temporary changes to menstrual cycles, but these rapidly resolve. 7/

pubmed.ncbi.nlm.nih.gov/37562052/

14 NHS trusts the focus of national maternity investigation Government announces 14 hospital trusts to be looked at in a national investigation.

Similarly, there have been a string of dreadful outcomes in labour recently and a number of maternity services are currently under investigation. My colleagues say that are practicing much more defensively in this climate, and this may well be playing into HES numbers. 6/

www.gov.uk/government/n...

The diagnosis of ectopic pregnancy An estimated 12,000 women experience an ectopic pregnancy each year in the UK. Ectopic pregnancy occurs when the fertilised egg implants outside the uterus, usually in the Fallopian tube. If it’s left...

The investigation into this came out in 2020. The guidance hadn’t yet been updated, but understandably people are being much more cautious about referring and admitting, which may well be causing that increase. 5/

www.hssib.org.uk/patient-safe...

Some important context here is that obstetrics and gynaecology in the NHS are in a bit of a state at the moment. In 2018 there was a high profile case in which someone attended for (what it turned out was) an ectopic pregnancy, was sent home and it ruptured… 4/

We just aren’t seeing COVID preterm births and stillbirths anymore. So the harm of infection in pregnancy now, if there is any, is subtle. Way more subtle than those increases in hospital attendance. 3/

But how bad is COVID in pregnancy now that people are no longer catching it for the first time? We don’t have formal studies on this (I wish we did! It would help us make decisions about whether it would be worth extending the vaccine offer) but, from the ground… 2/

SARS-CoV-2 infection and COVID-19 vaccination in pregnancy - Nature Reviews Immunology In this Progress article, Male summarizes our current understanding of the risks associated with SARS-CoV-2 infection in pregnancy. Importantly, the article highlights the now substantial body of evid...

First, it’s important to acknowledge that COVID can cause preterm birth and stillbirth when unvaccinated people catch it for the first time. This was a big problem in obstetrics during the pandemic, and the main reason we offered pregnant people vaccines. 1/

www.nature.com/articles/s41...