Dr. Rosen interviewed Dr. Bar Ze'ev in February, so this was before the widespread use of the vaccine in women of reproductive age and doesn't mention menstrual irregularities. There has been more reassuring data since then indicating that the vaccine is safe for pregnant and breastfeeding women, so it's possible he's modified his advice. Here's the section of the transcript on fertility.
https://covid19ch.blogspot.com/WAS THE VACCINE STUDIED IN PREGNANT WOMEN?
DR. BAR-ZEEV: Pregnant women were not included in the clinical trials. By definition -- well it's normal that that happens. Because of unknown risks that occur before clinical trials, you know, the trials are there to determine risk. We usually first do these trials in healthy adults and in this case we also included older adults in people with other conditions. But we want to know, we want to establish that the vaccines are safe in that population before we move on to put at risk women who are pregnant and their unborn child. So at this point those trials are starting and are underway and pregnant women are going to be recruited to trials and we will know more as time goes on.
However, we also know by now that COVID disease does pose an increased risk for women who are pregnant compared to women who are not pregnant. Not to the same degree as influenza does, influenza is a major cause of issues particularly in the pandemic but also -- in pandemic influenza, 2001 but not just in pandemic also in seasonal influenza. Perhaps not to that degree but still COVID poses an increased risk to women in pregnancy. That's a real risk. Okay. And so their question is how do we best balance those risks?
With an RNA vaccine that from biological plausibility point of view is unlikely to cause specific and major issues for women who are pregnant, it caused no major toxicity in the animal studies of pregnant animals, and I know that animals are not humans but some of those animals were nonhuman primates so, you know, biologically not very dissimilar to humans at least in terms of the Guf [body] if not in the Neshama [soul]. And, you know, that was reassuring. We will be more reassured once we have the trials that have demonstrated safety in pregnant women. There is no question about that.
But now we're facing the situation of what should be done now, what's the best approach for women now? The current recommendations in the United States is that if a women is eligible to receive the vaccine because she has comorbid conditions for example, other medical conditions and it obviously doesn't apply to the elderly, or because she's a health care worker and is at risk of being exposed and potentially getting a greater risk of large exposures, the patient coughs right in the face and so on, then the suggestion is, the recommendation is at the moment that they should go ahead and receive vaccine but there is this ability or this recommendation to discuss it with their practitioner if they want to, to think about it, to discuss it with their practitioner. They don't have to discuss it with their practitioner. If they want to go ahead and do it, they can do it and it's currently recommended that women who are pregnant can go ahead and do it. Women who are breast feeding, there's in my mind as a pediatrician, as an immunologist, as a vaccine scientist, I just do not see any issue really with that and, you know, clearly there will be women who are lactating and breast feeding who will be included in some of these trials going forward but from a first principles point of view I'm happy to be very reassuring about that.
Obviously I don't know and I obviously I could be wrong but I think on the balance of probabilities, you know, you want that child to have a healthy mother and you want that child to remain with a mother who is free from COVID and the uncertainty that there might be around breast feeding and vaccination is far outweighed by the risks of COVID. Even in a young woman. Okay. So that's on the issue of pregnancy and breast feeding.
DOES THE VACCINE AFFECT FERTILITY?
[54:09] Fertility, I'm going to divide my comments on fertility into two.
Okay. The first is talking to women who may be undergoing fertility treatment, women on IVF and so on. There's nothing known about that situation. So I'm very cautious about making any specific recommendations. I've heard that some clinicians argue potentially against receiving the vaccine. The vaccine as I said does cause quite a lot of local side effects, quite commonly and it causes fever quite commonly and I've heard some practitioners say that because it could cause fever even if you take Tylenol or acetaminophen, whatever, you shouldn't take Advil if are you pregnant, but, you know, if you are IVF and a fever may be an issue for you discuss it with your practitioner, discuss with your gynecologist, with your obstetrician, with your family physician. If there's ever a question about those kinds of issues don't just look at the guidance for everybody, it's a personal issue, speak to your practitioner. Okay. I am not going to tell you to rush and go get vaccinated, I think it's important in special cases to discuss it with a practitioner. So that's the end of what I know about that. I don't know much more to say about that.
This other issue is this thing that's been circulating particularly in the Chareidi [religious] community. I don't know in the Chabad community maybe also. I mean Chabad is Chareidi but, you know, what I mean, sorry. I should be careful what I say. But about this issue of syncytium one, placental protein, this argument that there is sequence homology, in other words that the protein looks similar to the receptor binding domain on COVID and so on, that by having vaccine, you develop antibodies against the SARS-CoV-2 spike protein and that might act against placental adhesion to the endometrium, all these kinds of things.
I've seen materials that have been circulated on this that look very advanced, that look very scientific, that look very convincing, they look very frightening. And particularly for, you know, our community where fertility is such an important part of our life and, you know, in every regard. Like, you know, it's so important for us. It's a frightening issue.
The facts are as follows. There is no sequence homology between syncytium one and the receptor binding domain. That's not the case. Okay.
And just rationally thinking for a minute, millions of people around the world including millions of young women have been infected with COVID-19. And we've heard lots of things emerging from COVID-19, most of them are mild disease but we've heard things emerging. We've not heard any -- and it's been a year, okay, we've not heard of this sudden drop-off in fertility globally. That's not the case. That's not happened. And if the vaccine was to induce antibodies against the receptor binding domain or the spike protein obviously so does infection. That's what the immune response to infection is against. So the logic of it would say that if there's reason to doubt that the vaccine -- if there's reason to be concerned that the vaccine might cause infertility, Lo Alainu, [G-d forbid] then the very same logic would argue that natural infection should cause infertility, but we've had millions of cases of COVID around the world and we have not seen drop-off in fertility or any of that kind of situation. And it just is not a rational argument, it doesn't make sense, it doesn't make sense biologically, it has no basis biologically, it's been hyped up, it's been dressed up. But it's false. Okay. So I just want to just set that aside. If it was true it would be really important and I'm not taking it lightly and I'm not brushing it off, but it's false. Okay. So that's really important.