The ASRM has put together their 2024 guidelines on vaccinations for infertility patients planning pregnancy (by IVF or otherwise), recommending vaccines for COVID-19, influenza, tetanus, and more.
The American Society for Reproductive Medicine (ASRM) is the US authority on reproductive medicine that releases committee opinions on various topics. The latest committee opinion is on the use of vaccines for infertility patients planning a pregnancy (by IVF or otherwise).
Vaccines can help prevent serious illnesses in both the mother and baby. Even though most vaccines are safe during pregnancy, some doctors might hesitate to vaccinate at this time because some people might misattribute a miscarriage to the vaccine. Vaccines that can’t be given during pregnancy include vaccines against MMR, varicella (chickenpox), herpes zoster (shingles) and HPV.
Most of these recommendations come from the CDC, and for more details on scheduling or dosing you can find the CDC’s updated information here.
More information on the immune system can be found in my post The role of the immune system in infertility and IVF.
🔗 Original studies are referenced in this post or within the linked Remembryo posts.
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ASRM recommended vaccines for infertility patients considering pregnancy
Below is a list of vaccines recommended by the ASRM. The ASRM recommends that doctors assess a patient’s immunization history before beginning infertility treatment.
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COVID-19 vaccine:
- Recommended for those pregnant or for infertility patients considering pregnancy due to the increased risk of complications linked with COVID-19 infections during pregnancy.
- Current CDC guidelines should be followed to maintain up-to-date vaccination.
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Influenza vaccine:
- Recommended for those pregnant or for infertility patients considering pregnancy due to the increased risk of complications linked with influenza infections during pregnancy.
- The vaccine should ideally be administered annually between October and November to cover the flu season.
- Some concerns have been raised over the use of influenza vaccines that contain thimerosal (a mercury-based preservative). No evidence has linked thimerosal to adverse outcomes in newborns.
- Vaccines that use live attenuated (weakened) influenza virus should be avoided (intranasal influenza vaccines).
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Tetanus-Diphtheria-Pertussis (Td/Tdap) vaccine:
- Recommended for those pregnant or for infertility patients considering pregnancy (without a previous Td/Tdap vaccine) to protect newborns from pertussis.
- For those pregnant, the Tdap vaccine should be given after 20 weeks gestation (late 2nd or 3rd trimester). If not given during pregnancy, it should be given immediately after delivery.
- The CDC recommends a single Tdap vaccination at each pregnancy, or a booster every 10 years.
-
Varicella (chickenpox) vaccine:
- NOT recommended for those pregnant as this vaccine uses a live attenuated (weakened) virus that could lead to an infection in the baby.
- Adults without immunity or documentation of past infection/vaccination should be vaccinated pre-pregnancy, and should avoid pregnancy for one month following vaccination.
- Two doses are needed one month apart.
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Human papillomavirus (HPV) vaccine:
- Recommended before the age of 26, but NOT recommended for those who are pregnant.
- There’s no evidence that the vaccine can cause complications and no intervention is needed for those who have received the vaccine during pregnancy.
- Two-three doses are needed, depending on age.
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Measles, mumps and rubella (MMR) vaccine:
- NOT recommended for those pregnant as this vaccine uses a live attenuated (weakened) virus that could lead to an infection in the baby.
- Adults without immunity or documentation of past infection/vaccination should be vaccinated pre-pregnancy, and should avoid pregnancy for one month following vaccination.
- No evidence of the MMR vaccine causes congenital malformation or significant intrauterine infection when given during pregnancy, so pregnancy shouldn’t be terminated if the vaccine is received at this time.
- One-two doses are needed.
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Pneumococcal vaccine:
- Recommended before pregnancy for high-risk individuals.
- Two doses are needed.
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Hepatitis A and B vaccines:
- Recommended for high-risk individuals who are pregnant or for infertility patients considering pregnancy. These vaccines pose no known risks to the fetus.
- Two-four doses are needed.
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Meningococcal vaccine:
- Recommended for high-risk individuals who are pregnant or for infertility patients considering pregnancy, although this vaccine should ideally be given before pregnancy due to the lack of data.
- Two-three doses are needed.
The ASRM didn’t cover all possible vaccines, so you can check out the CDC’s recommendations for more complete guidance. Here’s some of the CDC’s recommendations:
- Respiratory syncytial virus vaccine is recommended at 32-36 weeks gestation from September to January in most of the continental US, regardless of previous RSV infection. It’s not recommended for other pregnancies.
- Herpes zoster (shingles/RZV) vaccine has no guidance due to a lack of data, so it the CDC recommends that it’s avoided until after pregnancy.
- The Mpox vaccine is recommended for high-risk individuals, although data on the mpox vaccine and pregnancy are limited, with experiments in animals showing no evidence of harm to the fetus. The CDC recommends that the vaccine be offered to pregnant women or those breastfeeding, but the risks and benefits should be discussed with a doctor before getting the vaccine.
Conclusion
In general, immunization is best performed before infertility treatments start since some vaccines aren’t recommended during pregnancy (ie. live attenuated vaccines). Doctors should assess a patient’s immunization history before treatment.
For those pregnant or for infertility patients considering pregnancy, the ASRM recommends immunization against:
💉 COVID-19
💉 Influenza (the flu)
💉 Tetanus-Diphtheria-Pertussis (Td/Tdap) (Td ideally before pregnancy, with Tdap in third/late second trimester)
For patients considering pregnancy and without preexisting immunity, the ASRM recommends that individuals are vaccinated before pregnancy against:
💉 Varicella (chickenpox)
💉 Measles, mumps and rubella (MMR)
For high-risk individuals considering pregnancy, the ASRM recommends immunization against:
💉 Pneumococcal disease
💉 Hepatitis A and B
💉 Meningococcal disease
Reference
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About Embryoman
Embryoman (Sean Lauber) is a former embryologist and the founder of Remembryo, an IVF research and fertility education website. After working in an IVF lab in the US, he returned to Canada and now focuses on making fertility research more accessible. He holds a Master’s in Immunology and launched Remembryo in 2018 to help patients and professionals make sense of IVF research. Sean shares weekly study updates on Facebook, Instagram, and Reddit regularly. He also answers questions on Reddit or in his private Facebook group.
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