Though this is in line with what we expect, I was surprised to see such clear results in a single study - albeit a big one. Is there a bias here?
In this cohort the vaccinated are generally healthier and wealthier, but the authors adjust for this. 2/
They also restrict the sample to ppl for whom weeks 20-43 following LMP fall entirely within the study period, to avoid fixed cohort bias. 3/
They do a subgroup analysis showing that *even if you catch COVID*, being vaccinated ⬇️ preterm birth, though numbers too low to adjust for covariates in this subgroup). 4
My one beef is that they do a sensitivity analysis on congenital abnormalities in only those vaccinated <20 weeks. I believe <12 weeks would have been more appropriate here since this is the critical period for development. 5/
But overall, I think this is a really carefully done study, which should give us confidence in these results, even though at first glance I thought they were too good to be true! 6/6
PS! With thanks to @John_P_Topham who brought this one to my attention!
PPS! Have just found the author of this study here on Twitter. Nice study @LisaHui4!
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@beverleyturner Morning Bev! We've discussed before how female fertility measures were including in the clinical trials. You can find a summary of the outcomes to November 2020 here... 1/
@beverleyturner And of course we now also have very extensive data on female fertility following COVID-19 vaccination from the general rollout, with no sign of any harm to fertility in either IVF patients or those trying to conceive through intercourse. 3/
@SwaledaleMutton@AGreenroyd1958@Amber84280581@NathanaelYoung@somethingsummit@DavidTYork … At that point, around 48,000 people had been vaccinated in pregnancy. Most didn’t make any report because nothing worth reporting happened. You are looking only at the people who *did* make a report, who are naturally enriched for those who experienced a bad outcome…
@JoelCraig1 The meta analysis we’re talking about included 23 studies and 117,552 people vaccinated in pregnancy. So if you are looking for evidence, that’s a good place to start.
Link again since sounds like you haven’t looked at it yet… 1/
@JoelCraig1 Some studies didn’t meet the strict predefined inclusion criteria for SR/MA. So you can find more in my own review, published in @NatRevImmunol in March. At the time we had studies on 185,309 ppl vaccinated in pregnancy with no problems appearing. 2/
@JoelCraig1@NatRevImmunol But of course more has been done since March! @UKHSA has updated their data and there’s been a new study published by Rudermann. So the evidence base now stands at 239,760 ppl vaccinated in pregnancy, in formal studies, with no problem appearing. 3/
@BerryTartlet@DrLoupis Yes, this is quite an old document. A timeline of UK policy on this might help you.
8 - 31 Dec 2020. Vaccines approved, but using the same exclusions as the trials - no-one who is or could be pregnant. That’s the document you’re looking at there. 1/
@BerryTartlet@DrLoupis Also worth noting that even at that point, there’s nothing saying it’s not safe, only pointing out that we don’t have any evidence yet. 2/
@BerryTartlet@DrLoupis 31 Dec 2020 to 18 April 2021. No requirement to prove you are not pregnant in order to be vaccinated, and vaccines offered to those at particularly high risk due to their profession or medical history. 3/
@jtmayes3@kevinault Let’s begin by taking the 172,000 number at face value. About 190,000 ppl have been vaccinated during pregnancy in the US. So if that were true it’s a miscarriage rate of 90%…
@jtmayes3@kevinault Quite apart from being not plausible, it’s straight up impossible. Miscarriages by definition happen before 20 weeks and about half of those vaccinated were vaccinated after 20 weeks. It was too late for them to have a miscarriage. 2/
@jtmayes3@kevinault So even if *every single person* who received the vaccine before 20 weeks miscarried, and we somehow failed to notice, that’s still an overestimate of the rare by at least 2x.
(Spoiler alert: Obviously it’s a bigger than 2x overestimate…) 3/
The finding that #CovidVaccination does not affect #fertility mirrors what we have already seen in IVF settings, but it is good (if unsurprising!) to see it confirmed among those #TryingToConceive the old fashioned way! 2/