Can the COVID-19 Vaccines Affect My Fertility?

Updated on Jun 30, 2022 | COVID-19, Featured, Men's Health, Vaccines, Women's Health, Your Health

Worried young woman holding pregnancy test

Some men and women may be reluctant to get the COVID-19 vaccination because of concerns about fertility. You may be wondering if any of the vaccines used in the United States can have an effect on your sperm count, or on your eggs, embryo, or the pregnancy itself.

In this Q&A, Alan Copperman, MD, Director of the Division of Reproductive Endocrinology and Infertility and Vice Chair of the Department of Obstetrics, Gynecology, and Reproductive Science at the Mount Sinai Health System, says the evidence shows that the vaccines do not pose a concern.

Update: The Centers for Disease Control and Prevention on September 29, 2021, strongly recommended COVID-19 vaccination either before or during pregnancy because the benefits of vaccination outweigh known or potential risks. Read more from the CDC

Does the COVID-19 vaccine affect my sperm count?

None of the COVID-19 vaccines in use in the United States affect sperm count or the sperm’s  ability to move toward an egg (motility). It is true that contracting a severe case of COVID-19 can lower sperm count for a time. But studies show that the vaccine itself does not affect sperm. In fact, we recently completed a study looking at sperm donors around the country before and after getting the vaccine. We saw no change in count or motility.

Can the vaccine affect my ability to get pregnant and have a baby?

We have found that the COVID-19 vaccinations do not affect a woman’s fertility.  Pregnancy involves a number of steps:

  • Your ovaries release an egg.
  • The egg travels through the fallopian tube to the womb (uterus).
  • Sperm fertilizes the egg as it travels.
  • The fertilized egg attaches to the inside of the uterus (implantation) and grows.

A problem at any one of these steps can lead to infertility. We’ve been studying women who have gone through several fertility cycles to see if any of the COVID-19 vaccines used in the United States affects any of these steps. We have found that:

  • The vaccine does not decrease egg production.
  • It doesn’t affect the ability to make an embryo.
  • It doesn’t affect a chromosomally normal embryo’s ability to grow in the uterus.
Will the COVID-19 vaccine have any effect on my pregnancy?

This is a good question because we’ve found that pregnant women who get COVID-19 tend to become very ill. That’s why we recommend taking the vaccine. As of now, three billion COVID-19 vaccinations have been administered, have of them to women, and we haven’t heard any reports of them affecting a woman’s pregnancy. We have also seen women getting the vaccine while undergoing in vitro fertilization—and it has had no effect on their outcomes. In fact, we have found that the vaccine not only protects the pregnant woman, but it keeps them safe at vulnerable times, such as when they deliver—and the fetus gets some immunity as well. We hypothesize that the vaccine prevents severe illness in these babies.

Should I get the COVID-19 vaccine if I’m planning a pregnancy in the near future?

The best time to get the vaccine is as soon as it becomes available to you. You may feel tired after the shot, and you may have short-term symptoms like fever. Some people have an allergic reaction to the vaccine, but that is very rare. We definitely recommend getting the COVID-19 vaccine to protect you, your pregnancy, and your infant.

If I’m already pregnant should I get the vaccine?

Safety data from around the world shows that women taking the vaccine during pregnancy have seen no effect on their pregnancy. The vaccine has shown itself to be safe and effective. As a result, all the major organizations involved with women’s health care—including the Society for Maternal-Fetal Medicine and the Centers for Disease Control and Prevention—are strongly advocating that people who are pregnant get the vaccine.

Which vaccine is best for a pregnant woman?

There’s no data suggesting that any one of the vaccines is better than any of the others for pregnant women. We know that the effectiveness against preventing disease seems a little bit higher in the mRNA vaccines (Pfizer-BioNTech and Moderna), but all the vaccines that have been authorized by the Food and Drug Administration (FDA) are up to 99 percent effective in preventing severe disease and death. Get whatever vaccine is most readily available to you.

What should I do if I have questions about the vaccine and my fertility?

If you have any questions, ask your health care provider. You can also check the online guidelines from organizations like the World Health Organization and the FDA. There is a lot of great information out there to help us fight back against this pandemic.

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What Can I Do About My Post-COVID Ear, Nose, and Throat Symptoms?

Updated on Jun 30, 2022 | COVID-19, Ear Nose Throat, Your Health

Loss of taste and smell. Persistent cough. Nagging throat clearing. Hearing loss. These are just some of the symptoms experienced by those who were infected with and have since recovered from COVID-19.  Researchers estimate that nearly 10 percent of all patients who have recovered from COVID-19 suffer from prolonged symptoms. Often called post-COVID-19 syndrome, this condition can cause a range of health problems including fatigue, headache, shortness of breath, confusion, forgetfulness, and cardiac complications.

Every day, Sam Huh, MD, Chair of Otolaryngology-Head and Neck Surgery at Mount Sinai Brooklyn, sees at least two of these patients with long COVID for persistent ear, nose, and throat symptoms.

“There are many of these patients suffering from a variety of symptoms that last approximately three months or longer after infection,” explains Dr. Huh. “They can be quite debilitating and have a significant impact on their quality of life and ability to return to normal.”

While some of Dr. Huh’s patients had severe COVID-19 infection, others were asymptomatic. “Many patients who come to me were never officially diagnosed with the virus but have symptoms of post-COVID syndrome. However, when I run an antibody test, it often comes back positive for a prior infection,” he says.

Fortunately, many of the ear, nose, and throat symptoms experienced by those with long COVID are reversible.

Loss of smell and taste may return organically, or with training

One of the most common post-COVID symptoms is the loss of smell and taste, also known as anosmia and ageusia. Additionally, on their way to recovery, some patients develop an altered sense of smell and taste called parosmia and dysgeusia. For these patients, nothing smells or tastes like what it should. It is not clear why this happens, but it can cause much distress among the sufferers.

“Smell and taste are linked together,” says Dr. Huh. “If you lose smell, taste often goes with it. Most of these patients get better on their own in a month or so, but others may have issues for up to eight months.”

There are two potential culprits for these altered senses. In some patients, post-infection inflammation and swelling in the nasal tissues prevents odor from reaching the olfactory nerve, which is instrumental for the sense of smell. For others, the COVID-19  virus has damaged the area surrounding the nerve, affecting their sense of smell and taste.

To address this problem, it is important to identify anything in the patient’s medical history that is contributing to the problem, such as abnormal nasal anatomy or allergies. When inflammation is the contributing factor, Dr. Huh recommends using saline rinses to irrigate the nasal passageways, topical or oral steroids, and antihistamines. If the problem is damage around the nerve, Dr. Huh advises olfactory smell training. Research shows that patients can retrain the nose by smelling five strong scents—such as cinnamon, citrus, garlic, rose, or lavender—three times a day.

Your post-COVID cough might be post-nasal drip

Many people who have long COVID struggle with a prolonged cough that lasts for months.

Lung damage is one of the more serious causes of this symptom. Patients experiencing shortness of breath or who are becoming winded when walking up the stairs should seek medical attention immediately. Consult a lung specialist if your symptoms are mild and, if they are severe, head to the emergency room.

The majority of post-COVID patients with chronic cough do not have shortness of breath. Instead, they experience an irritating, nagging tickle in their throat from post-nasal drip caused by post-viral inflammation of the nasal passages. This causes them to cough incessantly. For these patients, Dr. Huh usually prescribes saline rinses, topical or oral steroids, and antihistamines.

A dietary change may help with chronic throat clearing

Post-COVID patients often describe that they feel as though something is stuck in their throat. This feeling causes them to repeatedly try to open their airway by coughing and throat clearing.

“These individuals typically had an awful cough during the symptomatic period when they had COVID-19,” explains Dr. Huh. “The constant coughing caused pressure to rise in their stomach, acid to build up, and reflux to occur.”

Known as laryngopharyngeal reflux, this condition occurs when stomach acid and an enzyme called pepsin travel up to the throat. Thankfully, once the reflux is addressed, patients tend to feel better.

Unlike with the more common gastroesophageal reflux disease, antacids typically do not alleviate these symptoms. However, Dr. Huh has had success with low-protein, plant-based diets, which reduce stomach acid. He also advises that patients drink at least eight cups of water a day.

Extreme post-COVID pain is rare, but treatable

An uncommon post-COVID complication is neuralgia, a severe stabbing pain that can develop after being infected with a virus. This debilitating condition is caused by an inflamed or damaged nerve. Dr. Huh has seen a handful of patients with neuralgia in the throat who experience extreme pain or even incontinence when they cough. These patients are typically treated with neuroleptics, a class of medication normally used to treat psychosis, which research has shown to be beneficial in the treatment of nerve pain.

Post-COVID hearing loss is an unusual side effect that is not fully understood

Another unusual ear, nose, and throat complication is post-viral hearing loss. Dr. Huh estimates seeing one of these patients approximately every month. Physicians are not entirely sure what causes this symptom to develop. They suspect the virus triggers an immune response that may be damaging the tiny vessels inside the ear. Since COVID-19 is associated with blood clots, it is also possible that these vessels become clogged. These patients are typically treated with steroids. However, Dr. Huh says the medication is not always effective in restoring hearing loss. But, some patients can recover their hearing spontaneously.

“Most people recover fairly well when we give them these supportive treatments,” says Dr. Huh. “So, if you are suffering, please know there is hope. I encourage anyone with symptoms to make an appointment because there is probably something we can do to make you feel better.”

Dr. Huh and his colleagues evaluate and treat patients who have symptoms related to the ear, nose, and throat at Mount Sinai Brooklyn. For complications that affect vital organs including the lung, heart, or brain, he advises patients to visit the Center for Post-COVID Care at Mount Sinai.

Make an appointment with Dr. Huh at the following locations:

Mount Sinai Brooklyn
125 St. Nicholas Avenue
Brooklyn, NY 11237

718-756-9025
9 am to 5 pm

Mount Sinai Otolaryngology Faculty Practice
3131 Kings Highway
Suite C1
Brooklyn, NY 11234

718-756-9025

9 am to 5 pm (Wednesdays only)

Mount Sinai Doctors Manhasset
1155 Northern Boulevard
Manhasset, NY 11030

516-370-3434
9 am to 1 pm

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Mount Sinai Awarded $42 Million to Prepare for Future Pandemics and Advance Influenza Research

May 25, 2021 | COVID-19, Featured, Research

Adolfo García-Sastre, PhD, left, and Shashank Tripathi, PhD, Assistant Professor of Microbiology. File photo

The National Institute of Allergy and Infectious Diseases (NIAID) has awarded the Icahn School of Medicine at Mount Sinai a seven-year contract valued at more than $42 million to advance basic research into influenza and COVID-19, and prepare for future pandemics.

This marks the third time Mount Sinai has received a seven-year NIAID contract under the leadership of Adolfo García-Sastre, PhD, Director of the Global Health and Emerging Pathogens Institute and Irene and Dr. Arthur M. Fishberg Professor of Medicine, who serves as Principal Investigator. Florian Krammer, PhD, Mount Sinai Professor in Vaccinology; and Viviana Simon, MD, PhD, Professor of Microbiology, Pathology, and Medicine (Infectious Diseases), will serve as the contract’s co-investigators.

“This contract represents 21 years of continuity in conducting research that leads to better treatments, better vaccines, better disease management, and better prevention of pandemics,” says Dr. García-Sastre.

The team’s work will lay the foundation for diagnostics, therapeutics, and clinical trials, but will not include the actual implementation of the clinical trials. The contract also calls for the surveillance of emerging pathogens, risk assessment studies on as many as 15 respiratory viruses each year, and training of postdoctoral fellows and graduate students. “Training is part of the fight against infectious diseases. You need the people and the weapons,” says Dr. García-Sastre.

Mount Sinai’s previous NIAID contracts have led to many advances. In response to the 2009 H1N1 flu pandemic, Dr. García-Sastre; Peter Palese, PhD, Chair of the Department of Microbiology; and Dr. Krammer launched their seminal work in developing a universal influenza vaccine. The vaccine— administered only once or twice in an individual’s life, rather than each year—has now undergone two phase 1 clinical trials and is expected to move toward a human challenge trial.

Since COVID-19, like influenza, will probably remain within the human population, Dr. García-Sastre says there may be a need to develop a universal COVID vaccine as well.

The new NIAID contract calls for funding of $6 million per year over seven years, but Dr. García-Sastre expects there will be room for additional funding. “The last contract did not have a specific amount of money for COVID-19 because there was no COVID-19 at the time,” he says, so when the pandemic started the government provided extra funding to study and find treatments for the new disease.

In fact, Mount Sinai’s research in influenza allowed the team to respond quickly to COVID-19. “Through this initiative we were able to develop and respond with diagnostics, treatments, and a vaccine,” Dr. García-Sastre says. “We were able to screen compounds that had potential for treatments and by testing COVID-19 proteins we identified targets and inhibitors of these targets.”

Work led by Dr. Palese, in collaboration with the University of Texas at Austin, produced a low-cost COVID-19 vaccine that is currently being tested in humans in Vietnam and Thailand, with clinical trials expected to begin in Brazil.

The team has also identified a promising small-molecule drug, plitidepsin, which appears to be particularly effective in stopping the replication of SARS-CoV-2, the virus that causes COVID-19. Clinical trials of plitidepsin are about to start in the United Kingdom, and the Spanish drug maker, PharmaMar, is negotiating with the U.S. Food and Drug Administration to begin clinical trials in this country as well.

While the new NIAID contract calls for Mount Sinai’s team to take a proactive response to future pandemics, they will also continue to focus on influenza, which remains a major international health concern. Influenza pandemics arise periodically, and according to the World Health Organization, the seasonal viruses infect as many as one billion individuals a year and lead to 650,000 deaths. There is much more to discover about how the human body responds to influenza, says Dr. García-Sastre, and the NIAID contract will support that important work.

I Have Long COVID. How Do I Get Back to Physical Activity?

May 19, 2021 | COVID-19, Rehab Medicine, Your Health

Older woman on work out bench lifting free weights

Millions of people across the United States have contracted and overcome a COVID-19 diagnosis. However, for some, the road to recovery has been difficult. Known as ‘long COVID,’ some patients continue to experience symptoms of COVID-19 weeks to months after their initial diagnosis.

While experts are unsure of its prevalence, the number of people with long COVID is significant and has prompted the creation of programs like the Mount Sinai Center for Post-COVID Care where patients are treated and researchers investigate the condition. Joseph Herrera, DO, Chair of Rehabilitation and Human Performance for the Mount Sinai Health System, and cardiology fellow Saman Setareh-Shenas, MD, explain what it means to be a COVID-19 long hauler and how the Mount Sinai Health System is working to get these patients back to physical activity.

What is long COVID patient?

Saman Setareh-Shenas, MD: This is a patient with Post-COVID Syndrome, which is a series of symptoms ranging from shortness of breath, chest pain, heart palpitations, heart racing, the inability to return to pre-COVID level of physical activity, and brain fog. These symptoms are present for weeks after their initial COVID-19 symptoms have resolved. We have seen patients experiencing these symptoms for six months, or even longer.

Joseph Herrera, DO: We are seeing some patients that have not even been hospitalized with COVID-19 who are having difficulty progressing their activity to pre-COVID-19 infection levels. They will have good days and bad days, and will try to push themselves physically. But, instead of taking two steps forward, they take 10 steps back. That is a common theme with our long haulers.

How do you guide a patient back to physical activity?

Dr. Herrera: Important for a patient’s physical and cognitive activity is understanding their submaximal exercise limits. This is a measure of a patient’s aerobic fitness and maximum oxygen uptake while doing rigorous—but not overly strenuous—activity like jogging on a treadmill or using an exercise bike. Some patients who have difficulty with physical exertion may also benefit from a formal breath work program that helps patients understand breathing techniques. At Mount Sinai, we progress patients using the rule of tens. This means that every 10 days we increase the intensity duration of the exercise by 10 percent. So, it does take some time to get ‘back to normal.’ But we advise our patients that their body needs that time to heal and rest. The symptoms resolve, but it does take a prolonged period for those symptoms to get better.

What advice do you have for long haulers who are trying to get back into exercise?

Dr. Herrera: If you have long COVID, you have to respect the symptoms you are experiencing and understand that your body is in the process of healing. I advise patients to create a diary of what they are experiencing and work with a physical therapist to address their concerns. Slowly working toward a gradual return to activity is the goal. You can’t rush this. Anytime our patients try to rush the process, they end up taking 10 steps back instead of three steps forward.

Dr. Setareh-Shenas: COVID-19 comes with a lot of inflammation and the body needs time to heal.  Give yourself that time; go slowly, and gradually you can get back to your baseline. Normal household stuff is important, like walking and grocery shopping. Then, once you are comfortable, move on to exercising and boosting your exercise capacity.

Dr. Herrera: I think the most important message is, if you’re experiencing any symptoms of long COVID, don’t push yourself too hard but do see a specialist. Get evaluated to see if you qualify for any of the programs that we offer at Mount Sinai.

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I Recovered From COVID-19. How Do I Get Back In Shape?

May 17, 2021 | COVID-19, Rehab Medicine, Your Health

Woman stops her run to check her Fitbit

If you are one of the millions who contracted COVID-19 in the past year, you may still be in the process of regaining the physical fitness lost from when the virus forced you to slow down and heal.

Joseph Herrera, DO, Chair of Rehabilitation and Human Performance for the Mount Sinai Health System, and cardiology fellow Saman Setareh-Shenas, MD, explain how those who have recovered from COVID-19 can get back into their pre-illness shape and how the Mount Sinai Post-COVID Care Center can assist them on their road to recovery. Two key takeaways: Take it slow and consider seeing a specialist if you encounter any hurdles along the way.

How does the effect of COVID-19 on the body influence my recovery?

Joseph Herrera, DO:  We are seeing a range of symptoms, from mild to severe, in patients after being infected with COVID-19. The virus affects them both physically and cognitively, everything from increased fatigue, shortness of breath, and tachycardia, a medical term of a rapid heartbeat, and difficulty concentrating, also known as brain fog. Because of this, some patients find it difficult to get back to their pre-COVID level of physical activity.

What about athletes? Does COVID-19 affect them differently?

Dr. Herrera: We’ve seen a range of people who have been impacted by COVID-19, from recreational athletes to marathon runners and professional athletes. I would say that they, similar to the general population, have a range of symptoms, some very mild all the way to severe. Overall, I don’t think your pre-infection conditioning really prevents anything.

Saman Setareh-Shenas, MD: COVID-19 doesn’t discriminate between athletes and non-athletes. We have seen major effects from the virus as well as post-COVID syndrome in very healthy athletes.

When is it safe to resume physical activity after recovering from COVID-19?

Dr. Herrera: We’ve been advising symptom-free patients to resume activity as tolerated. If they’ve been hospitalized due to COVID-19 or have spent a prolonged time in bed while recovering, whether in an intensive care unit bed or in their home, we want to make sure that they can return to normal activity before progressing to exercise.

Dr. Setareh-Shenas: Early on in the pandemic as the initial wave of patients were recovering, we started noticing a lot of our patients were not immediately able to go back to their baseline exercise level.

At the Mount Sinai Post-COVID Care Center, we help patients regain their pre-COVID strength and conditioning by using recommendations based on guidelines by the Leadership Council of the Sports and Exercise Cardiology Section of the American College of Cardiology and findings by British researchers. These guidelines advise those in recovery to return to exercise very gradually. Don’t go back to where your baseline was. Wait at least seven to 10 days, and then take it slowly from there.

Dr. Herrera: We guide patients using the ‘rule of tens.’ For example, if a patient were lifting a hundred pounds prior to getting infected with COVID-19, we have them cut everything in half—or even a quarter—of the weight they previously lifted. Then we apply the ‘rule of tens,’ by increasing either the intensity or the duration of exercise by 10 percent every 10 days. This way, they have a gradual increase in activity.

What precautions should post-COVID patients take when getting back to physical activity?

Dr. Setareh-Shenas: In the past year, we have seen a number of patients in our post-COVID population who are experiencing heart racing, palpitations, or a new arrhythmia.  So, as a precaution, I would say that patients recovering from COVID-19 who have chest pains or shortness of breath, should be evaluated by their physician or by an expert cardiologist at a Post-COVID Center.

For example, in our Cardiology Clinic within the Post-COVID Care Center at Mount Sinai, we evaluate patients who have complaints of chest pain or shortness of breath and conduct exercise testing to see their maximal exercise capacity and evaluate for any arrythmia during exercise. We want to know: Do they have any symptoms when exercising on the treadmill? Does their heart go under strain that’s not equivalent for their age group and their risk factors? So, patients should be mindful of this, especially if they have a history of cardiac issues.

Dr. Herrera: Most importantly, don’t push yourself too hard but do see a specialist. Get evaluated to see if you qualify for any of the programs that we offer at Mount Sinai.

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What You Need to Know About COVID-19 Vaccination in 12- to 15-Year-Olds

May 13, 2021 | Children's Health, COVID-19, Featured, Vaccines, Your Health

Schools, playgrounds, and, most of all, our children will soon be better protected against COVID-19, thanks to the latest news from the U.S. Food and Drug Administration (FDA). The agency has announced that the Pfizer-BioNTech COVID-19 vaccine is safe and effective for children between the ages of 12 to 15 and authorized emergency use of the vaccine; the CDC also recommends the vaccine in this age group. You may have questions about this new development. Kristin Oliver, MD, MHS, Assistant Professor of Pediatrics, and Environmental Medicine and Public Health, at the Icahn School of Medicine at Mount Sinai, has answers.

How effective is the Pfizer-BioNTech COVID-19 vaccine in children aged 12 to 15?

All indications are that COVID-19 vaccination is highly effective in children ages 12 to 15. In the trial, the vaccine prevented 100 percent of COVID-19 cases among participants who got the vaccine. It’s important to remember that the results we see in clinical trials—called efficacy—may be slightly better than what we see when the vaccine is out in the world—effectiveness. People in the clinical trials always get the vaccine exactly as indicated, but this isn’t always the case in the real world. Once we start immunizing more and more people over time, we’ll have a better sense of the vaccine’s effectiveness for ages 12 to 15, but I expect this will also be really high.

Is it safe?

The COVID-19 vaccine is safe for children ages 12 to 15, just as it is for people 16 and older. In addition, the FDA will continue to monitor safety for another two years. 

Researchers at the CDC are investigating a link between COVID-19 vaccines from Pfizer-BioNTech and Moderna and heart inflammation in young men and boys. Myocarditis and pericarditis can be serious but, fortunately, these side effects to vaccination are very rare and the cases connected to receiving the COVID-19 vaccine have been mild. So, the benefits of COVID-19 vaccination in this group still outweigh the risks of getting myocarditis from the vaccine.

Will our children experience any side effects from the vaccine?

We can expect children to have side effects similar to what we’ve seen in adults. The most common are pain and swelling at the injection site, tiredness, and headaches. In the study fewer than one in five 12- 15 year olds who get the shot, had a fever. The good news is that these side effects usually only last for a couple of days and can be treated with over-the-counter medication.

Remember: these types of side effects are a sign that the body’s immune system is responding to the vaccine, which is a good thing. We have seen more of these side effects to the COVID-19 vaccination than, say, the tetanus booster or HPV vaccine. For that reason, you might want to have your child take the vaccine on day when you know they can take is easy the next couple days.

Are there some 12- to 15-year-olds who should not take the vaccine?

Anyone who has had an allergic reaction to any component of the vaccine, or who had an allergic reaction to the first dose of the vaccine, shouldn’t take it.

But peanut, egg, and other food allergies are not a contraindication. If your child has any of these allergies, they can take the vaccine. If you have any questions about your child’s allergies and COVID-19 vaccine, check with your pediatrician.

If my child had COVID-19, do they still need to get a vaccine?

The U.S. Centers for Disease Control and Prevention has said that everyone who can get a COVID-19 vaccine should do so, even if they’ve already had COVID-19. In general, we don’t know how long protection against the virus lasts after an infection, or how well previous infection prevents infection with some of the new variants. In our efforts to keep everyone healthy, the recommendation is to get vaccinated.

What are the benefits of vaccinating children ages 12 to 15 against COVID-19?

Vaccines are an important tool in protecting us from developing COVID-19. It is exciting that children ages 12 to 15 can now get vaccinated—and it is important that they do so. While it is true that younger people are less likely than their elders to get seriously ill and die from COVID-19, they are not immune to the virus. Children can, and have, contracted the virus, gotten seriously ill, and even died. So the first benefit of vaccination is to protect them from the virus and its complications. Additionally, we know that children can transmit the virus to others who are more at risk for serious complications. By vaccinating young teens, we can help prevent that transmission as well as protect grandparents, babysitters, and other more vulnerable people who are in their orbit.

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