Addressing Vaccine Hesitancy in Surrogates

Dr. Gad Lavy

Medical Director and Founder of New England Fertility

For a third-party reproduction specialist like myself, the sharp rise in surrogacy inquiries in the past year is gratifying. The demand for gestational carriers is so high it can hardly keep up with supply. Most of the intended parents who come to our clinic, however, want a vaccinated carrier — and therein lies the problem: A fair percentage of surrogates don’t want the COVID-19 vaccine.

With the Delta variant of COVID-19 spreading rapidly and showing no signs of slowing down, the human cost of remaining unvaccinated is greater than ever. We’ve seen that the variant is far more easily spread than previous strains, and for those who are unvaccinated and infected with the variant, hospitalization (or worse) is far more likely.

Unfortunately, the news becomes even more dire: Without curbing the current rate of infection, we could soon be looking at a vaccine-resistant strain of COVID. According to Dr. Vaughn Cooper from the American Society for Microbiology, “The more infections, the more chance that mutations will occur.”

Fortunately, the CDC has now released data to support the safety of COVID-19 vaccines in pregnant people and is recommending that everyone over the age of 12 get vaccinated against COVID-19. In spite of such compelling evidence, it’s clear from speaking daily with surrogates (and hearing the stories from surrogacy agencies) that vaccine hesitation is fueled by misinformation. Whether you’re an intended parent or a surrogate yourself, you should have a few facts:

  • Pregnant women are more likely than non-pregnant women to become severely ill from COVID-19. They are more likely to be admitted to an ICU, be put on a ventilator, or, most tragically, not survive. They are also more likely to suffer complications such as preterm labor.
  • Pregnant women in any trimester can safely receive the vaccine. Data so far shows no adverse effects on carriers or the babies they’re carrying. The vaccine is even safe for lactating women and beneficial because their breast milk will carry the antibodies.
  • The vaccine helps protect the fetus by providing it with antibodies. While the virus rarely crosses the placenta to infect the fetus, and there’s been no evidence that it causes birth defects, the antibodies may continue to protect the baby after the birth.
  • There’s no evidence showing that the vaccine affects fertility in men or women, so if you personally are looking to become pregnant, don’t hesitate to get the vaccine.
  • While the COVID-19 vaccines are new, mRNA technology is not. Research to develop mRNA vaccines has been in progress for more than 20 years.
  • mRNA vaccines (Pfizer and Moderna) do not alter your DNA. mRNA stimulates your body’s own immune response to produce antibodies but doesn’t enter the nucleus of your cells, so it won’t affect your DNA.
  • The Johnson & Johnson vaccine is also shown to be safe for pregnant women and those trying to become pregnant. The concept of the J&J vaccine is more traditional: It uses adenovirus (which doesn’t contain a live virus) to instruct your cells to produce antibodies.
  • The vaccines do not seem to affect pregnancy outcomes. There’s no evidence to support a higher incidence of outcomes such as premature birth, congenital defects, pregnancy loss, or gestational diabetes.
  • The vaccine offers greater protection than previous COVID-19 infection. Antibody levels are higher in vaccinated people than in those who’ve previously been infected.

It’s only natural that anyone looking to carry a pregnancy or planning to become a parent through surrogacy would want to be careful. But we now have evidence to support the safety of the vaccine. Studies are ongoing but thus far there’s no indication, in human or animal studies, that the vaccine can cause pregnancy complications or birth defects.

Acceptance of the vaccine isn’t just about the availability of gestational carriers; it’s about the health of your community and the world around you.