COVID-19 Vaccination and Pregnancy: Expert Analysis of Risks and Safety

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• Infertility Myth Debunked
• COVID-19 Vaccine Safety in Pregnancy
• Delta Variant and Placental Damage
• SARS-CoV-2 Receptors in the Fetus
• Managing Pregnancy After COVID-19
• Full Transcript

Infertility Myth Debunked

Dr. Yves Ville, MD, directly addresses the false claim that COVID-19 vaccination affects fertility. He categorically states there is no evidence to support this myth. Dr. Ville describes this misinformation as classic fake news, which persists specifically because it cannot be rationally disproven with a single study. The assertion is built on nothing, making it impossible to provide a definitive counter-demonstration. Dr. Anton Titov, MD, facilitates this crucial clarification from a leading authority.

COVID-19 Vaccine Safety in Pregnancy

Dr. Yves Ville, MD, strongly advocates for vaccinating pregnant women against COVID-19. He emphasizes that pregnant women deserve the same standard of care and protection as anyone else. Vaccination, especially in the first trimester, is safe and highly recommended. Dr. Ville references a massive US registry of over 35,000 women who received the COVID-19 vaccine during pregnancy. This data shows no increased risk of adverse outcomes. He argues that the perceived risks of early pregnancy interventions are often overstated and not supported by evidence.

Delta Variant and Placental Damage

The conversation with Dr. Anton Titov, MD, highlights the extreme danger the Delta variant poses to the placenta. Dr. Yves Ville, MD, explains that even a mild maternal COVID-19 infection can have devastating consequences weeks later. The virus can travel to the placenta and cause severe destruction. This damage can result in catastrophic outcomes like intrauterine fetal death and acute fetal distress during the third trimester. This placental toxicity makes the risk of COVID-19 infection far greater than any theoretical risk from vaccination.

SARS-CoV-2 Receptors in the Fetus

Dr. Yves Ville, MD, discusses his research into where the SARS-CoV-2 virus can bind in the developing fetus. His team found the ACE2 receptors necessary for viral entry primarily in the placenta, fetal kidneys, and gut. Later in pregnancy, receptors were also identified in the lungs. Dr. Ville finds this distribution reassuring regarding the risk of congenital malformations. These organs are less likely to be permanently damaged by the virus. However, the presence of receptors in the placenta from the earliest stages confirms it is a prime target for infection.

Managing Pregnancy After COVID-19

For women who contract SARS-CoV-2 during pregnancy, Dr. Yves Ville, MD, advises careful and vigilant follow-up. Even after recovery, the virus may have compromised the placenta's function. This damage can impair its ability to provide adequate oxygen and nutrients to the fetus. Consequently, a key concern is the risk of restricted fetal growth. Dr. Ville stresses the importance of increased monitoring for signs of fetal distress in these patients. This proactive management is essential for ensuring the best possible outcome.

Full Transcript

Dr. Yves Ville, MD: Perhaps while we're discussing pregnancy and COVID-19 and vaccination, there is a persistent myth that keeps circulating about the fact that COVID-19 vaccination before pregnancy could affect a woman achieving pregnancy in the first place.

The characteristic of that kind of question is the characteristic of fake news. When you get fake news, the definition is that you have no answer. Otherwise, they wouldn't put it forward. This is put forward because there is no answer to that.

There is no evidence whatsoever—not the slightest evidence—that COVID-19 vaccination could affect fertility. There is not the slightest evidence even in the most elaborate theories. So the simple answer is no.

But what demonstration can you bring? Nothing. You can't bring any demonstration to fake news. It's based on nothing. So obviously, there is no rational answer to that.

Dr. Anton Titov, MD: That's very important to hear from a real expert, as you are the expert. A pregnant woman could be infected with the COVID-19 virus, but perinatal COVID-19 infection during pregnancy is not frequent.

What is important to know about COVID-19 infections and pregnancy? What is the risk of congenital malformations in an unborn child due to COVID-19 infection in the mother?

Dr. Yves Ville, MD: Well, this question is current. If you had asked it only eight months ago, answers would have probably been different. Now, what is important is to be insisting on the fact that pregnant women should be treated like anyone else—not less treated, not less considered.

There is no benefit to prevent or not expose women to the COVID-19 vaccine. Pregnant women should be vaccinated against COVID-19. The earlier, the better. First-trimester vaccination.

Pregnant women in the world are the individuals that are the least well looked after. When a hairdresser knows that a client is pregnant, the hairdresser is calling the obstetrician: "Can I give her a hair dye?" Yeah, why not? She's pregnant.

A dentist asks, "Can I treat a tooth while she's pregnant?" Yeah, well, you better. I mean, pregnant women in the first trimester are the kind of people with whom you should not interact. Why is that?

Because a pregnant woman in the first trimester has a one in four risk of losing the pregnancy. Whatever she does—she opens the windows and she breathes the air from the mountain—she has the same risk as going to the hairdresser, the dentist, and vaccination with COVID-19 vaccine.

COVID-19 vaccine doesn't increase the risk of anything. And there is now the biggest registry from the US: over 35,000 women vaccinated at once against COVID-19, and there is no increased risk of anything.

So the risk for the pregnant woman is actually to get COVID-19. This risk is not only for yourself. Especially it could be very severe if she's well advanced in the pregnancy.

But with this COVID-19 strain, the latest strain, the Delta variant, what we've observed is extreme toxicity to the placenta. So even in women with a mild COVID-19, a couple of weeks later, we've seen intrauterine death. We've seen acute fetal distress in the third trimester.

And when you look at the placenta, the placenta is essentially destroyed by the COVID-19 virus. So there is much more risk not to be vaccinated and get COVID than not.

And people should be aware that with this latest Delta strain—the next one will be even worse, hopefully not—even if the woman is not very symptomatic herself, within two or three weeks after that, the COVID-19 Delta virus can get to the placenta at the time of the acute infection and gradually destroy the placenta.

What we've looked at: we've looked at the receptor of SARS-CoV-2 in the placenta, trophoblast in the first trimester. And we looked at organs from specimens from the pathology, organs from different stages of development of the fetus.

The receptor of SARS-CoV-2 we found only in the kidneys, in the gut, and the placenta. And late in the pregnancy, SARS-CoV-2 receptor was found in the lungs. This, to us, is very reassuring in terms of malformation risk, because these are very unlikely to be destroyed or damaged by the SARS-CoV-2 virus.

At the same time, a placenta has SARS-CoV-2 receptors from very early on. The placenta could be affected and destroyed at any time. So vaccination is the answer for pregnant women even more than for people who are not pregnant.

And if women get SARS-CoV-2, they recover. They should be very careful in the follow-up for fetal growth. Because if the placenta is hit by the virus and it is not lethal, it could affect fetal growth. And one should be very, very aware of the risk of fetal distress.