Patient Management and Clinical Recommendations During The Coronavirus (COVID-19) Pandemic

ASRM COVID-19 Task Force Update #17

COVID-19 Vaccination and Vaccination Hesitancy

• As of August 18, 2021, the 7-day moving average of daily new cases of COVID-19 (114,190) in the United States (U.S.) increased by 18.4% compared with the previous 7-day moving average (96,454). ¹ The Delta variant continues to contribute to most new cases. ¹
   
• The “pandemic of the unvaccinated” continues to prevail in the U.S.² Only 50.9% of the U.S. population is fully vaccinated, and only 59.9% have had at least one vaccination. ¹
   
• Vaccine hesitancy has emerged as an important obstacle to fighting the COVID-19 pandemic.
   
• Research on causes of and solutions for vaccine hesitancy has lagged compared with that on vaccination and treatment efficacy. Vaccine hesitancy research should be prioritized, and studies should include pregnant persons and people who are trying to conceive.
   
• The ASRM Task Force supports clinics that mandate COVID-19 vaccination for all employees, including administrative staff and medical providers.
   
• While all women should be strongly encouraged to receive COVID-19 vaccination when pregnant or attempting pregnancy, clinics should strongly consider requiring vaccination for gestational carriers and advise intended parents to include requirement of vaccination of gestational carriers in their contracts. 
   
• Health care providers are instrumental in encouraging both patients who are pregnant or attempting to conceive, and their partners, to obtain vaccination against COVID-19.
   
• Discussions should occur at every opportunity to establish an ongoing dialogue with patients who have questions or concerns about COVID-19 vaccine safety and efficacy. Obstetrician Gynecologists and Reproductive Endocrinologists are particularly essential in this effort as they see patients both pre-conceptually and during pregnancy.
   
• For some patients, conveying evidence-based scientific information will not be enough to provide reassurance of the importance of vaccination. Appealing to patients with empathy and personal reassurance can go a long way towards allaying their fears and encouraging them to be vaccinated.

Suggestions to initiate a conversation with patients regarding vaccination include:

• Explaining that every person has a right to be protected and that vaccination is an important way of exercising ones right to be healthy and to maximize the chance of a healthy pregnancy.
   
• Expressing to patients that they care about them and their health and want to ensure that they do all they can to stay healthy.
   
• Personalizing the discussion by using phrases such as: 
  • “If it were me…”
  • “If you were my relative…”
  • “Let me speak personally…”
  • “It was important for me to get the vaccine because…”
  • “Let me take my “doctor hat” off for a minute and speak frankly…”
  • “If I were in your shoes, I would worry about my risk of…”

The Task Force continues to recommend that practices utilize the ASRM Mental Health Professional Group as a resource for referrals and staff support. 

REFERENCES

1. Centers for Disease Control and Prevention. COVID Data Tracker Weekly Review. Available at https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html, last accessed August 18, 2021.
   
   
2. Rochelle Walensky. July 16,2021 Press Briefing by White House COVID-19 Response Team and Public Health Officials. Accessible at https://www.whitehouse.gov/briefing-room/press-briefings/2021/07/16/press-briefing-by-white-house-covid-19-response-team-and-public-health-officials-45/, last accessed July 2021.

Read the Full Text Recommendations:

• Update #17 - published August 20, 2021
• Update #16 - published July 23, 2021
• Update #15 - published May, 20, 2021
• Update #14 - published March, 23, 2021
• Update #13 - published February 22, 2021
• Update #12 - published January 19, 2021
• Update #11 - published December 16, 2020
• Update #10 - published November 17, 2020
• Update #9 - published October 12, 2020
• Update #8 - published September 8, 2020
• Update #7 - published August 10, 2020
• Update #6 - published July 10, 2020
• Update #5 - published June 8, 2020
• Update #4 - published May 11, 2020
• Update #3 - published April 24, 2020
• Update #2 - published April 13, 2020
• Update #1 - published March 30, 2020
• Patient Management and Clinical Recommendations During The Coronavirus (COVID-19) Pandemic - published March 17, 2020