Should surrogates get the COVID Vaccine?

Last year, the coronavirus brought fertility clinics to a halt and drastically changed procedures for fertility treatments, birth, and more. Now as the Delta variant prompts new preparations and conversations about safety, more hopeful parents and surrogates alike have COVID vaccine questions.

When it comes to third-party fertility, intended parents are getting a helping hand in having a child. This can get tricky when complicated subjects like vaccination come up, and there are multiple opinions at play. How do you navigate COVID vaccination during surrogacy? Should surrogates get the COVID vaccine? Is the COVID vaccine safe for pregnancy? We’re answering your questions.

Some surrogates are concerned about vaccination
Surrogates are providing a huge gift to intended parents by carrying their child, and none of them take the responsibility lightly. Surrogacy requires in-depth health information, strict screenings, frequent doctor’s visits, and legal contracts. Every woman who moves forward as a surrogate is committed to the process.

We’ve encountered several surrogates who do not want the COVID vaccine. Some of them are concerned that it may affect their health. Many are concerned that it could affect the health of the baby they are carrying. Carrying someone else’s baby is a big responsibility, and we understand why surrogates may be cautious of anything that could affect that process. Meanwhile, many intended parents prefer a vaccinated woman to carry their child, because they don’t want their surrogate to fall seriously ill.

COVID-19 risks and pregnancy
According to the CDC, COVID-19 infection presents a danger to pregnant women. “Pregnant and recently pregnant women are at an increased risk for severe illness from COVID-19 compared to nonpregnant women,” says the report. “Additionally, pregnant women with COVID-19 are at increased risk for preterm birth and might have an increased risk of other adverse pregnancy outcomes.”

These risks are the reason why many intended parents hope to find a vaccinated surrogate – for her safety and the safety of the child. Luckily, these dangers are preventable, thanks to the COVID vaccine.

The COVID vaccine and reproduction
But does the vaccine have an effect on pregnancy or reproductive health? According to experts, there is “no plausible reason — no medical or scientific mechanism — for this vaccine to interact with a woman’s reproductive organs or have any interaction with an egg that’s been released or fertilized.” The American Society of Reproductive Medicine (ASRM), “remains steadfast” and committed to vaccination, stating that “COVID-19 vaccination is recommended for women who are contemplating pregnancy or who are pregnant to minimize risks to themselves and their pregnancy. ASRM also released a recent study confirming that there is no indication that the Covid-19 vaccine could cause female sterility.

Here at Donor Concierge, we continue to encounter surrogates and intended parents who are concerned about the safety of the COVID-19 vaccines. So where did this worry come from? According to experts at Johns Hopkins, misinformation spread that confused the COVID spike protein and a protein involved in placenta growth. This “false report said that getting the COVID-19 vaccine would cause a woman’s body to fight this different spike protein and affect her fertility.” However, the experts explained that the Coronavirus spike protein and the spike protein involved in placenta development during pregnancy "are completely different, and getting the COVID-19 vaccine will not affect the fertility of women who are seeking to become pregnant, including through in vitro fertilization methods.”

The COVID vaccine and pregnancy
Information on vaccine safety for pregnant women has been harder to find than for the general population. According to the CDC, the way the vaccines work in the body means they “are unlikely to pose a risk for people who are pregnant.” The CDC also noted “limited data on the safety of COVID-19 vaccines in pregnant people.”

This limited data was due to the fact that pregnant women were excluded from initial clinical trials of the COVID vaccine. Since then, though, more data has become available around COVID vaccines and pregnant women. Over 130,000 women in the U.S. who received the COVID-19 vaccine while pregnant or breastfeeding have joined the V-safe registry. Initial findings from that registry show no safety concerns from the vaccine.

How to talk about vaccination
The COVID-19 pandemic has been devastating, and we understand why there is fear and tension around the subject. When it comes to tricky topics like this, communication is key. Your surrogate’s agency and your Donor Concierge case manager will act as a liaison for this discussion, so that both sides can voice their opinions.

“We are seeing a lot of surrogate candidates who do not want to get vaccinated,” says Gloria Li, Program Director. Meanwhile, many intended parents are requesting that they match with a gestational carrier who HAS had the vaccine. "Our goal is to make sure everyone is on the same page," Gloria continued, "which means that it may take a little longer to find a good fit." Intended parents can’t make a surrogate get vaccinated, obviously – it is a personal decision that each individual must make.

The COVID vaccine and surrogacy contracts
Lila Seif, attorney at New Family Fertility Law, weighed in on the legal decisions involved in surrogacy and COVID vaccines. “If a Gestational Carrier does not wish to receive the vaccine, she cannot be forced to do so,” Lila said. “However, Intended Parents can absolutely require that they only match with a vaccinated Gestational Carrier, and this is a critical factor to consider when matching the parties. If a Gestational Carrier agreed in the contract to receive the vaccine and later refused, this again could not be forced upon her. However, to the extent that her breach of that term caused damage, she theoretically would be responsible. For this reason, it's recommended that if vaccination is important to a particular Intended Parent, they should be matched with a Gestational Carrier who is in fact already vaccinated.”

As for the contracts? While both parties are reviewing contracts, Lila recommends “to be very clear with the matching agency on their position regarding Covid lifestyle issues, including vaccination status, social distancing considerations, and other relevant factors.” She walks her clients through concerns, and asks them to “discuss the medical risks with their trusted physician so they can better explain their position and concerns with a matching agency.” With her gestational carrier clients, she also “reviews the contract in detail about these issues to be sure they are comfortable.”

Remember it’s a team effort
In the surrogacy process, the pregnancy becomes a team effort. So intended parents and surrogates need to be on the same team! Both of you are bringing this child into the world, and everyone’s opinion matters. Knowing where you stand on key issues like vaccination will help you decide whether a candidate would be the right surrogate for you. Lila agrees with this, explaining that the goal with surrogacy contracts is to “come to a fair agreement that makes all parties comfortable.”

We hope this helped as you navigate through surrogacy during the time of COVID-19. Remember to listen openly, communicate clearly, and keep in mind that your surrogacy journey needs to be a team effort. Good luck!