COVID 19 VACCINATION UPDATE 1/25/22
The Center for Disease Control (CDC) recently reported a significant increase in COVID 19 cases in the USA due to the emergence of the Omicron COVID 19 variant. It also noted that those infected with the Omicron or Delta variants who have received the COVID 19 vaccination booster have an 82-94% decreased chance of emergency room/urgent care visits and/or hospitalizations. Accordingly, the CDC recommends that anyone over the age of >12 years old, who medically qualifies, should receive the COVID- 19 booster dose at least 5 months after completing their initial vaccination series.
As of December, 2021, the Omicron variant has surpassed the Delta variant as the predominant strain in the USA. Although the current COVID 19 vaccinations available in the USA are less effective against the Omicron variant, there is a 90% effectiveness against Omicron >14 days after a booster dose is administered. The net result is a significant decrease in both emergency room visits and hospital/ICU admissions thereby lessening the impact on an already strained hospital system.
The CDC reports that as of December 2021, only 61% of the eligible USA population is vaccinated. Despite recommendations by the CDC, only 35 % of pregnant woman are vaccinated and 27% of all adults have received the booster. Multiple studies have reported that pregnant woman who contract COVID 19 are at greater risk of hospitalization, ICU admission and intubation. Many of the notable medical societies in the USA including The American Society for Reproductive Medicine (ASRM), the Society of Maternal Fetal Medicine (SMFM) and The American College of Obstetrics and Gynecology (ACOG) have therefore recommended that woman trying to conceive, those that are already pregnant, and lactating woman be fully vaccinated and receive the COVID 19 booster.
Further information regarding COVID vaccination is available on the CDC website (www.CDC.gov) . Recommendations by the above listed medical societies can be found at:
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IMPACT OF COVID-19 ON FERTILITY TREATMENTS
Written by: Dr. Althea O’Shaughnessy
Worldwide impact of COVID-19 is undeniable and devastating with almost 3 million cases reported and over 200,000 deaths globally. Most states in the United States have imposed a state of emergency and mandated stay-at-home orders. These mandates also apply to “non-essential” medical procedures. Only New York State has specifically published a guidance document clarifying sexual and reproductive health as “essential services”. Such services include infertility treatment and procedures, leaving it up to the provider and patient to determine whether their infertility services should be delayed.
The American Society for Reproductive Medicine (ASRM), an organization dedicated to provider and patient education in the field of Reproductive Medicine and Infertility, has convened a task force addressing the issues surrounding fertility treatment in the face of the COVID-19 pandemic. There have been two publications from ASRM outlining recommendations related to infertility patient management given the currently COVID outbreak. The second publication dated April 13 through April 24, 2020, did not change any of their initial recommendations which include the following: suspension of new fertility treatment cycles including intrauterine insemination; ovulation induction cycles; IVF (including oocyte retrievals, embryo transfers, frozen embryo transfers and non-urgent oocyte cryopreservation), suspending elective surgical procedures and providing telehealth for patient consultations. ASRM task force also recommends continued fertility treatment for patients with urgent fertility needs such as those with cancer who are awaiting chemotherapy. On April 24, 2020, the task force published new recommendations for gradual “re-initiation of care” taking into account “time sensitive fertility treatments” which may include women with advanced reproductive age, diminished ovarian reserve and those with endometriosis. These recommendations will also consider differences in COVID-19 regulations/mandates by federal, state and local governments. Differences in level of care provided by fertility centers are based on their ability to safely provide treatment. Considerations are their location, size, staffing and local COVID-19 case data. ASRM recommendations also reviewed the need for each fertility practice to implement risk assessment and risk mitigation protocols that satisfy their individual clinic’s needs. The publication also stressed the need for professional training and staff education regarding these protocols and other related COVID-19 issues.
An infertility diagnosis is difficult to navigate and can be associated with anxiety and depression; the stress of the current COVID-19 pandemic makes this even more challenging. The effect of COVID-19 on early pregnancy still remains unknown and this is why some Reproductive Endocrinologists remain hesitant to recommend complete re-initiation of fertility care. Both providers and patients need to weigh the risks and the benefits of continued treatment in these uncertain times. As more information about COVID-19 and its effects on pregnancy becomes available, changes will be implemented. Staying safe and healthy should be everyone’s top priority. We all must accept that this pandemic will continue to unfold and recommendations from reputable local, state and federal sources will constantly be adjusted to meet societal needs.