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接种新冠疫苗影响生育?无稽之谈

接种新冠疫苗影响生育?无稽之谈

Kat Eschner 2021年11月09日
各项研究表明,影响生育这个荒诞说法是人们不愿意接种新冠疫苗的主要原因。

11月5日,绿湾包装工队(Green Bay Packers)的四分卫阿隆·罗杰斯告诉《帕特·麦卡菲秀》(Pat McAfee Show),他因为担心患上不孕症而拒绝接种新冠疫苗,由此他成为最近公开表示担心新冠疫苗接种和不育症问题的名人。罗杰斯说:“我相信,我人生的下一个重要篇章是成为一名父亲,所以我对这件事情非常重视。”

罗杰斯并不是唯一有这种担忧的人,但这并不意味着他的想法是对的。在这场为期近一年的新冠疫苗接种运动中,新冠疫苗影响生育能力的荒诞说法是持续时间最久的错误观念之一。就在几天前,美国疾病控制与预防中心(CDC)推荐小学生接种辉瑞(Pfizer)的新冠疫苗,现在专家们担心家长因为这种荒诞说法而无法在新冠疫情决胜阶段迈出关键一步。

凯泽家族基金会(Kaiser Family Foundation)在最新的《新冠疫苗监测报告》(COVID-19 Vaccine Monitor)中发布的一项调查显示,在5-11岁孩子的家长中,有三分之二表示他们不让孩子接种新冠疫苗的原因是担心孩子未来的生育能力。除此之外,自去年12月新冠疫苗首次获得紧急使用授权以来,各项研究表明这个荒诞说法是人们不愿意接种新冠疫苗的主要原因。

佛罗里达大学(University of Florida)致力于新冠疫苗接种和妊娠研究的儿科医生兼流行病学家索尼娅·拉斯穆森称:“绝对没有任何证据表明新冠疫苗会导致不孕症。”她表示,已经有数千人在接种新冠疫苗之后怀孕。此外,对接种新冠疫苗者展开的大量研究证明,新冠疫苗接种对女性或男性的生育能力均没有影响。多项研究也表明新冠疫苗对孕妇安全有效。

拉斯穆森毫不犹豫地向28岁的女儿和25岁的儿子推荐新冠疫苗。她说:“现有数据表明,这种新冠疫苗安全有效,年轻人可以接种。如果我担心生育问题或任何长期影响的话,我绝不会在孩子们符合接种条件的那一刻就催促他们去接种新冠疫苗。”

尽管如此,全国各地的医生也从患者那里听到这个荒诞说法。一位密苏里州的家庭医生劳拉·莫里斯已经听过太多次了,现在当有未接种新冠疫苗的患者或未接种新冠疫苗的患者家属前来就诊时,她会主动提起这个荒诞说法。

她表示:“有些患者和家长非常想听听医生的意见。”当她告诉他们这个荒诞说法不是真的后,他们就放心了。其他人则对新冠疫苗的科学原理产生疑问,她会花时间向他们解释清楚。

随着有资格接种新冠疫苗的人群范围扩大到更年轻的患者,莫里斯发现她不得不替不同年龄段的人打消接种顾虑。在新冠疫情初期,向她提问的大部分是女性,但是现在向她请教问题的是青年男女的家长们,他们已经在为要孙子孙女做打算了。

正如每一条被人们所接纳的虚假信息一样,新冠疫苗接种导致不育症这种错误联系始于不确定性。目前在美国获授权的新冠疫苗均未同时在普通人群和孕妇身上进行试验。这很正常:因为孕妇是“药物孤儿”。这个特定术语是指很少参与药物试验的人群。但在此情况下,这就意味着2020年年末,医生和民众要努力在感染新冠肺炎的特定风险(对孕妇而言风险更大)和接种新冠疫苗带来的潜在风险之间进行权衡。

根据绝大多数专家的意见,接种新冠疫苗是正确的选择,数千名怀孕的医护人员选择了接种新冠疫苗。但是,直到2021年4月一项研究表明新冠疫苗对孕妇群体的安全性后,美国食品与药品监督管理局(FDA)才正式推荐孕妇接种新冠疫苗。

在此期间的几个月时间内,一场关于辉瑞前副总裁变成反疫苗人士的谣言堪称火上浇油。直到2011年,辉瑞德国公司过敏和呼吸研究部门的副总裁迈克尔·伊登声称,疫苗靶向的SARS-CoV-2刺突蛋白与在人类胚胎中发现的一种蛋白具有微小的相似性,当接种新冠疫苗者的身体对胎盘产生排斥反应,可能会导致流产。他和一位同事于2020年12月1日致信欧洲药品管理局(European Medicines Agency),他们在信中要求该机构停止新冠疫苗试验,因为这将“导致接种新冠疫苗的妇女基本失去生育能力”。

他的说法已经被揭穿。拉斯穆森说:“虽然有极小的一片区域相似,但这片区域的面积很小,小到人们肯定不会认为它会对生育能力产生任何影响。”

迈阿密大学(University of Miami)的生殖泌尿科医生兰吉特·拉马萨米表示,辉瑞公司和Moderna公司的原始试验均未对生殖毒性进行评估,这又额外造成了一些不确定性。拉马萨米曾经研究新冠肺炎和不孕症之间的联系。同样不足为奇的是:这些研究通常要到临床试验的第三阶段才会进行,即使到那时,也只有在预期孕妇会接种新冠疫苗的情况下才能够进行。

但对这些新冠疫苗可能导致不孕症的猜想,从来不存在任何科学依据。现在我们可以肯定新冠疫苗不会导致不孕症。促使美国疾病控制与预防中心对孕妇提出建议的研究只是世界各地正在开展的众多研究之一,没有一项研究表明新冠疫苗接种与流产或不孕症之间存在任何联系。对接种新冠疫苗后男性的研究,包括拉马萨米撰写的一项研究,也取得了同样的结果。

尽管如此,这个荒诞说法仍然留存了下来并传播开来。拉马萨米的研究发现,在2020年12月美国疾病控制与预防中心紧急授权使用辉瑞-BioNTech的新冠疫苗后,谷歌(Google)上“新冠疫苗生育能力”等词的搜索量在一个半月内飙升了700%。

具有讽刺意味的是,虽然从未有人发现新冠疫苗对生育能力有影响,但人们已经发现感染新冠肺炎对男性生育能力有显著影响,尽管这方面仍然存在许多问题尚未解答。感染新冠肺炎对孕妇来说也危险得多,并且与新冠病毒携带者和胚胎的一系列负面结果有关,包括流产和早产。

肯塔基大学(University of Kentucky)妇产科专业的雷切尔·桑德斯说:“人们担心不孕不育。”她表示,对生育能力感到担忧是很正常的,这可能是这种荒诞的说法留存下来的原因之一。

匹兹堡大学医学院(University of Pittsburgh School of Medicine)的医生兼内科教授埃洛霍·乌福马塔说:“感到害怕没有错。忧虑和担忧没有错。”但是她指出:“我们了解有数十万人接种了新冠疫苗,并且成功怀孕。”

2020年12月底,处于妊娠第三期(一期为三个月)的乌福马塔在接种了新冠疫苗后,把这一消息发布到了社交媒体上。最近在打了新冠疫苗加强针后,她又发了一次动态,鼓励她的粉丝如果有问题,可以和她取得联系。

她收到并对何时接种新冠疫苗、流产风险和生育能力等问题进行了回答。她说:“作为一名黑人医生和一名黑人妇女,我知道由于系统性的不公正,黑人妇女不信任医疗体系。我认为有某个值得信任的人与他们进行这些对话真的很重要,尤其是在怀孕期间。”

乌福马塔认为,把孕妇从新冠疫苗的试验中排除的做法是错误的。她说:“它让许多阴谋论大行其道,因为人们无法回答这些问题。根据小道消息或没有数据支持,医生和科学家都不愿意回答这些问题。”

这种荒诞说法的传播没有减缓的迹象,名噪一时的误传者的言论肯定无济于事。针对这一说法,接受采访的专家感到担忧,尤其是为孕妇或可能怀孕的人以及儿童和青少年感到担忧。

桑德斯说:“我们未看到接种新冠疫苗和不孕症之间存在任何关联,但我们确实看到感染新冠肺炎对孕妇造成了非常大的负面影响。”

拉马萨米从他的病人那里得知,其他医生正在建议他们或他们的伴侣怀孕后再接种新冠疫苗,这让他感到担忧。他说:“医生在接种新冠疫苗方面不应该迟疑不决。”(财富中文网)

翻译:李亚男

审校:汪皓

11月5日,绿湾包装工队(Green Bay Packers)的四分卫阿隆·罗杰斯告诉《帕特·麦卡菲秀》(Pat McAfee Show),他因为担心患上不孕症而拒绝接种新冠疫苗,由此他成为最近公开表示担心新冠疫苗接种和不育症问题的名人。罗杰斯说:“我相信,我人生的下一个重要篇章是成为一名父亲,所以我对这件事情非常重视。”

罗杰斯并不是唯一有这种担忧的人,但这并不意味着他的想法是对的。在这场为期近一年的新冠疫苗接种运动中,新冠疫苗影响生育能力的荒诞说法是持续时间最久的错误观念之一。就在几天前,美国疾病控制与预防中心(CDC)推荐小学生接种辉瑞(Pfizer)的新冠疫苗,现在专家们担心家长因为这种荒诞说法而无法在新冠疫情决胜阶段迈出关键一步。

凯泽家族基金会(Kaiser Family Foundation)在最新的《新冠疫苗监测报告》(COVID-19 Vaccine Monitor)中发布的一项调查显示,在5-11岁孩子的家长中,有三分之二表示他们不让孩子接种新冠疫苗的原因是担心孩子未来的生育能力。除此之外,自去年12月新冠疫苗首次获得紧急使用授权以来,各项研究表明这个荒诞说法是人们不愿意接种新冠疫苗的主要原因。

佛罗里达大学(University of Florida)致力于新冠疫苗接种和妊娠研究的儿科医生兼流行病学家索尼娅·拉斯穆森称:“绝对没有任何证据表明新冠疫苗会导致不孕症。”她表示,已经有数千人在接种新冠疫苗之后怀孕。此外,对接种新冠疫苗者展开的大量研究证明,新冠疫苗接种对女性或男性的生育能力均没有影响。多项研究也表明新冠疫苗对孕妇安全有效。

拉斯穆森毫不犹豫地向28岁的女儿和25岁的儿子推荐新冠疫苗。她说:“现有数据表明,这种新冠疫苗安全有效,年轻人可以接种。如果我担心生育问题或任何长期影响的话,我绝不会在孩子们符合接种条件的那一刻就催促他们去接种新冠疫苗。”

尽管如此,全国各地的医生也从患者那里听到这个荒诞说法。一位密苏里州的家庭医生劳拉·莫里斯已经听过太多次了,现在当有未接种新冠疫苗的患者或未接种新冠疫苗的患者家属前来就诊时,她会主动提起这个荒诞说法。

她表示:“有些患者和家长非常想听听医生的意见。”当她告诉他们这个荒诞说法不是真的后,他们就放心了。其他人则对新冠疫苗的科学原理产生疑问,她会花时间向他们解释清楚。

随着有资格接种新冠疫苗的人群范围扩大到更年轻的患者,莫里斯发现她不得不替不同年龄段的人打消接种顾虑。在新冠疫情初期,向她提问的大部分是女性,但是现在向她请教问题的是青年男女的家长们,他们已经在为要孙子孙女做打算了。

正如每一条被人们所接纳的虚假信息一样,新冠疫苗接种导致不育症这种错误联系始于不确定性。目前在美国获授权的新冠疫苗均未同时在普通人群和孕妇身上进行试验。这很正常:因为孕妇是“药物孤儿”。这个特定术语是指很少参与药物试验的人群。但在此情况下,这就意味着2020年年末,医生和民众要努力在感染新冠肺炎的特定风险(对孕妇而言风险更大)和接种新冠疫苗带来的潜在风险之间进行权衡。

根据绝大多数专家的意见,接种新冠疫苗是正确的选择,数千名怀孕的医护人员选择了接种新冠疫苗。但是,直到2021年4月一项研究表明新冠疫苗对孕妇群体的安全性后,美国食品与药品监督管理局(FDA)才正式推荐孕妇接种新冠疫苗。

在此期间的几个月时间内,一场关于辉瑞前副总裁变成反疫苗人士的谣言堪称火上浇油。直到2011年,辉瑞德国公司过敏和呼吸研究部门的副总裁迈克尔·伊登声称,疫苗靶向的SARS-CoV-2刺突蛋白与在人类胚胎中发现的一种蛋白具有微小的相似性,当接种新冠疫苗者的身体对胎盘产生排斥反应,可能会导致流产。他和一位同事于2020年12月1日致信欧洲药品管理局(European Medicines Agency),他们在信中要求该机构停止新冠疫苗试验,因为这将“导致接种新冠疫苗的妇女基本失去生育能力”。

他的说法已经被揭穿。拉斯穆森说:“虽然有极小的一片区域相似,但这片区域的面积很小,小到人们肯定不会认为它会对生育能力产生任何影响。”

迈阿密大学(University of Miami)的生殖泌尿科医生兰吉特·拉马萨米表示,辉瑞公司和Moderna公司的原始试验均未对生殖毒性进行评估,这又额外造成了一些不确定性。拉马萨米曾经研究新冠肺炎和不孕症之间的联系。同样不足为奇的是:这些研究通常要到临床试验的第三阶段才会进行,即使到那时,也只有在预期孕妇会接种新冠疫苗的情况下才能够进行。

但对这些新冠疫苗可能导致不孕症的猜想,从来不存在任何科学依据。现在我们可以肯定新冠疫苗不会导致不孕症。促使美国疾病控制与预防中心对孕妇提出建议的研究只是世界各地正在开展的众多研究之一,没有一项研究表明新冠疫苗接种与流产或不孕症之间存在任何联系。对接种新冠疫苗后男性的研究,包括拉马萨米撰写的一项研究,也取得了同样的结果。

尽管如此,这个荒诞说法仍然留存了下来并传播开来。拉马萨米的研究发现,在2020年12月美国疾病控制与预防中心紧急授权使用辉瑞-BioNTech的新冠疫苗后,谷歌(Google)上“新冠疫苗生育能力”等词的搜索量在一个半月内飙升了700%。

具有讽刺意味的是,虽然从未有人发现新冠疫苗对生育能力有影响,但人们已经发现感染新冠肺炎对男性生育能力有显著影响,尽管这方面仍然存在许多问题尚未解答。感染新冠肺炎对孕妇来说也危险得多,并且与新冠病毒携带者和胚胎的一系列负面结果有关,包括流产和早产。

肯塔基大学(University of Kentucky)妇产科专业的雷切尔·桑德斯说:“人们担心不孕不育。”她表示,对生育能力感到担忧是很正常的,这可能是这种荒诞的说法留存下来的原因之一。

匹兹堡大学医学院(University of Pittsburgh School of Medicine)的医生兼内科教授埃洛霍·乌福马塔说:“感到害怕没有错。忧虑和担忧没有错。”但是她指出:“我们了解有数十万人接种了新冠疫苗,并且成功怀孕。”

2020年12月底,处于妊娠第三期(一期为三个月)的乌福马塔在接种了新冠疫苗后,把这一消息发布到了社交媒体上。最近在打了新冠疫苗加强针后,她又发了一次动态,鼓励她的粉丝如果有问题,可以和她取得联系。

她收到并对何时接种新冠疫苗、流产风险和生育能力等问题进行了回答。她说:“作为一名黑人医生和一名黑人妇女,我知道由于系统性的不公正,黑人妇女不信任医疗体系。我认为有某个值得信任的人与他们进行这些对话真的很重要,尤其是在怀孕期间。”

乌福马塔认为,把孕妇从新冠疫苗的试验中排除的做法是错误的。她说:“它让许多阴谋论大行其道,因为人们无法回答这些问题。根据小道消息或没有数据支持,医生和科学家都不愿意回答这些问题。”

这种荒诞说法的传播没有减缓的迹象,名噪一时的误传者的言论肯定无济于事。针对这一说法,接受采访的专家感到担忧,尤其是为孕妇或可能怀孕的人以及儿童和青少年感到担忧。

桑德斯说:“我们未看到接种新冠疫苗和不孕症之间存在任何关联,但我们确实看到感染新冠肺炎对孕妇造成了非常大的负面影响。”

拉马萨米从他的病人那里得知,其他医生正在建议他们或他们的伴侣怀孕后再接种新冠疫苗,这让他感到担忧。他说:“医生在接种新冠疫苗方面不应该迟疑不决。”(财富中文网)

翻译:李亚男

审校:汪皓

On November 5, Green Bay Packers quarterback Aaron Rodgers became the latest celebrity to express concern about COVID-19 vaccination and infertility, when he told the Pat McAfee Show that he avoided the vaccine because of worries over sterility. “The next great chapter of my life, I believe, is being a father and it’s something that I care about a lot,” Rodgers said.

Rodgers isn’t alone in his worries, but that doesn’t mean he’s right. The fertility myth has been one of the most persistent misconceptions dogging this almost year-long vaccination campaign. Now, just days after Pfizer’s vaccine was recommended by the CDC for elementary-aged children, experts are concerned that the myth will prevent parents from taking this crucial step in ending the pandemic.

Two thirds of parents of 5 to 11 year olds cited concerns about their children’s future fertility as reasons for not vaccinating, in a survey published in the Kaiser Family Foundation’s most recent COVID-19 Vaccine Monitor. In addition, studies since the vaccines were first granted Emergency Use Authorization last December have shown that this myth has been a key motivator for people to not get vaccinated.

“There’s absolutely no evidence that the vaccines cause infertility,” says Sonja Rasmussen, a University of Florida pediatrician and epidemiologist who studies COVID-19 vaccination and pregnancy. Thousands of people have gotten pregnant since being vaccinated, she says. In addition, numerous studies of vaccinated people have demonstrated that COVID-19 vaccination has no impact on either female or male fertility. Multiple studies have shown that the vaccine is safe and effective in pregnant people.

Rasmussen had no hesitation in recommending the vaccine to her own 28-year-old daughter and 25-year-old son. “The data we have right now has shown that young people can receive this vaccine, that it’s safe, and that it is effective,” she says. “There’s no way, if I had concerns about fertility or any long term effects, that I’d have pushed my kids to get the vaccine the minute they were eligible.”

Still, doctors around the country are encountering this myth among their patients. Laura Morris, a family physician who practices in Missouri, has heard about it so many times that she now proactively brings it up when unvaccinated patients or their unvaccinated family members come in.

“There’s a group of patients and parents that really want to hear from their doctor,” she says. Once they’ve heard from her that there’s no reality to this myth, they’re reassured. Others have questions about the science behind the vaccine, and she spends time explaining it to them.

As vaccine eligibility has been expanded to ever-younger patients, Morris finds herself having to address concerns about vaccination for people at different stages of life. Earlier in the pandemic most of her questions came from women, but she’s now talking to parents of young boys and girls who are already thinking about grandchildren.

As with every successful piece of false information, the untrue link between vaccination and infertility began with uncertainty. None of the COVID-19 vaccines currently authorized in the United States were trialed on pregnant people at the same time as the general population. That’s normal: pregnant people are “drug orphans,” a term of art for populations who are rarely part of drug trials. But in this case, it did mean that at the end of 2020 doctors and the public found themselves trying to weigh the certain risk of getting COVID-19, which is more severe for pregnant people, against the possible risk of a vaccine.

Expert opinion overwhelmingly suggested that vaccination was the right choice, and the case built as thousands of pregnant healthcare workers opted to be vaccinated. But it wasn’t until April 2021 that the FDA formally recommended the vaccine for pregnant people after a study demonstrated its safety in that population.

In the intervening months, a rumor began by an ex-Pfizer VP turned anti-vaxxer helped to stoke a wildfire. Michael Yeadon, who was the vice president of the German company’s allergy and respiratory research division until 2011, claimed that a tiny similarity between the SARS-CoV-2 spike protein that the vaccines target and a protein found in the human placenta could result in vaccinated people having miscarriages when their body attacked the placenta. This would “result in vaccinated women essentially becoming infertile,” he and a colleague wrote in a December 1, 2020 letter to the European Medicines Agency that asked it to stop trialing the vaccines.

His claims have been debunked. “There is a little tiny area that’s similar,” Rasmussen says, “but certainly not any amount that would make you think it would have any effect on fertility.”

An additional piece of uncertainty was caused by the fact that neither Pfizer nor Moderna’s original trials evaluated reproductive toxicity, says Ranjith Ramasamy, a University of Miami reproductive urologist who has studied the links between COVID-19 and infertility. Again, that’s not unusual: These studies are normally not conducted until Phase 3 of clinical trials, and even then only if it’s expected that pregnant women will be taking the vaccine.

But there was never any scientific reason to suspect that these vaccines could cause infertility. Now we know for sure that they don’t. The study that prompted the CDC to make its recommendation for pregnant women is just one of many going on around the world, none of which have shown there to be any link between COVID-19 vaccination and pregnancy loss or infertility. Studies of men after vaccination, including one authored by Ramasamy, have found the same.

Still, the myth persisted and spread. Google searches for terms like “COVID vaccine fertility” spiked by as much as 700% in the month and a half following the CDC’s emergency authorization for the Pfizer-BioNTech vaccine in December 2020, Ramasamy’s research found.

The irony here is that while the vaccines have never been found to impact fertility, COVID-19 infection has been found to significantly impact male fertility, although there are still many unanswered questions. A COVID-19 infection is also much, much more dangerous for pregnant people, and is associated with a host of negative outcomes for both carrier and fetus, including miscarriage and preterm birth.

“Infertility is something people worry about anyways,” says Rachel Saunders, a University of Kentucky OBGYN. It’s very normal to have concerns about fertility, she says, and that may be one of the reasons why this myth has stuck around.

“It’s not wrong to feel scared,” says Eloho Ufomata, a doctor and professor of internal medicine at the University of Pittsburgh School of Medicine. “It’s not wrong to have concerns and worries.” But “we know that hundreds of thousands of people have gotten vaccinated and have had successful pregnancies,” she says.

Ufomata, who is in her third trimester, posted on social media when she got vaccinated at the end of December 2020—and again recently when she received her booster shot—encouraging her followers to get in touch if they have questions.

She has fielded questions about when to get vaccinated, the risk of pregnancy loss, and fertility. “As a Black physician and as a Black woman, I know about the distrust of the medical system that Black women have due to systemic injustices,” she says. “I think it’s really important, especially during pregnancy, to have someone you trust, and to have these conversations with them.”

Ufomata feels it was a mistake to not include pregnant women in trials of the COVID-19 vaccines. “It allowed a lot of conspiracy theories to flourish, because there was no way to answer those questions,” she says. “And physicians and scientists are very hesitant to answer questions anecdotally or without data.”

This myth shows no signs of slowing its spread and remarks by prominent misinformers are certainly not helping. The experts interviewed for this story are concerned, especially for pregnant people or those who might get pregnant and for children and teens.

“We don’t see any correlation between getting the vaccine and having issues with infertility,” Saunders says, “but we do see very negative effects for pregnant people getting COVID-19.”

Ramasamy is also concerned by reports from his patients that other physicians are counseling them or their partner to wait on COVID-19 vaccination until after pregnancy. “There should be no hesitancy on the physician’s part,” he says.

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