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Prakash Chandran (Host): This Healthy Takeout COVID-19 podcast was recorded on October 27th, 2021. Since the vaccines came out, questions and research about their possible side effects have increased. Regarding women's health, the United States NIH made 1.67 million dollars available for research. So, when it comes to the various COVID-19 vaccine effects on women's health, what is being researched and what are some things we need to know right now? We're going to talk about it today with Dr. Christine Carey, a Gynecologist at Harrington Hospital.

This is Healthy Takeout, the podcast from Harrington Hospital. My name is Prakash Chandran. So Dr. Carey, it's really great to have you here today. You know, I wanted to start by just covering something more broadly. You know, when we're talking about women's health, but what does it exactly mean for a woman to be in good health and conversely, what are some symptoms that might indicate that there is something wrong?

Christine Carey, M.D. (Guest): Sure. Okay. Well, thanks for having me. In general, well as a Gynecologist, I see women from adolescence up to ripe old age. I think my oldest woman is about 97 years old. So, a woman in good health in general, has a good, healthy well-balanced diet, exercises regularly. If she's in the reproductive age range, she has regular menstrual cycles. She is using birth control, protecting herself against infections. In older women who is menopausal, again, healthy diet, exercise not having any bleeding and they're following their recommended screening guidelines that we do such as pap smears, mammograms, bone density tests. So yeah, so in general, healthy diet, healthy lifestyle, seeing their doctor regularly for routine screening. On the other side, if you want to call it unhealthy or a problem visit, might include a women that has a problem with her menstrual cycles. She may have pain or discomfort in the pelvic area. Maybe a menopausal woman is bleeding. So, you know, a whole variety of issues that may be brought to my attention that could indicate there may be something going on that needs to be investigated.

Host: Yeah, thank you for that breakdown. And can you tell us some of the most common things that you see women for?

Dr. Carey: I would say the most common things I see women for are changes in their menstrual cycle. Whether it be they're heavier, they are not occurring or they're occurring too frequently. So, that's a big chunk of issues that I see women for and stress can do that. But then there's other, you know, a lot of other issues that can cause those changes also. The next biggest thing I probably see women for is say an abnormal pap smear, which women wouldn't know they had that unless they came for their screening study. So, there's definitely, that's why we do screening so we can find changes to their pap smear or precancerous changes that we can treat and eliminate the progression to cancer.

Those are probably the most common things I see women for. And then also I have a lot of elderly patients that have issues with, you know, if they are in menopause or they have issue with bladder control or pelvic support issues, you know, that's another group of women that I see quite frequently.

Host: Okay, thank you for that. So, you know, today we're talking about the COVID-19 vaccine and its effect on women's health. And I was wondering if you could speak to some of the things that you've heard, even potential myths around the vaccine and women. For example, one of the things that I've heard is that it can have potential changes to a woman's menstrual cycle. Is that something that you can speak to?

Dr. Carey: Sure. So, absolutely there has been lots of, lots of information out there. Some of it true, a lot of it not true about the COVID vaccine. And I think some of the controversy or some of the unknown at the beginning, especially when the vaccine first came out was it was new. It was first time that this type of vaccine was created. You know, it was an absolutely wonderful thing that the vaccine got created so quickly. But I think that was a big part of what, what prompted some questions about the vaccine. And so I have heard, some women will relate to me that their periods changed with their, after they got the vaccine, those are all anecdotal things.

So anecdotal means that it's a kind of, it's a story. So, this happened to me. So, what I can say to women is that's interesting. I'm not sure if that's caused by the vaccine. You know, it, it is being studied right now. Both ACOG and the NIH is studying does the COVID vaccine effect the menstrual cycle? If it does, at this point, it seems to be a very temporary change to the menstrual cycle. But not a permanent one, by any means. And another big myth out there that I hear quite a bit is that it can lead to infertility and that is, I think women are very scared of that. They're afraid that you know, this vaccine gets into my cells, changes my DNA, could possibly lead to infertility, and that is absolutely unequivocally wrong.

It's false. It is does not get into our DNA, does not change the cells. And there is absolutely no, no correlation that it leads to infertility. You know, that has really been unfortunately that's a big myth out there that women have that might be preventing them from getting the vaccine.

Host: You know, I want to speak to that one specifically because my sister fell squarely into this camp. Now she has since gotten the vaccine, but one of the things that had her holding out for so long was the fact that there really hasn't been any longitudinal studies about the vaccine and its effect on newborn babies.

You know, how could there be, you know, we're still in this thing. It's not necessarily infertility for her, but her fear around what it could do to the child over time. So, can you address women that might be concerned about how the vaccine could affect their potential unborn baby?

Dr. Carey: Sure. I mean, any woman, I'm a mother myself, any woman is going to be concerned about putting something into their body and I think that people are probably more concerned that it could affect the fetus than themselves. But I will back up to say that I think at the beginning, when the vaccine first came out, there were, again, there were some unknowns and I think there was a little bit of a disservice because when the vaccine first came out, the CDC said, okay, doctors, it's a doctor, patient relationship.

You guys discuss it and decide if you should get the vaccine or not. And I think that left a lot of unknowns or a lot of questions. So, therefore, you know, we don't know what we're doing or we don't know whether to recommend it or not. And what I can say unequivocally at this point, absolutely, anyone that is considering pregnancy or is currently pregnant, the vaccine is very safe.

It does not get into your cells. It does not change your DNA. It is not going to affect the pregnancy at all. There is now, the vaccine has been out long enough that there is research and there is data because women, sometimes women got the vaccine. They either didn't know they were pregnant or they got pregnant shortly after the vaccine.

And there is a large amount of data out there available now that the vaccine has been shown to be very safe. There are no safety issues observed with the vaccine during pregnancy.

Host: Yeah, that makes a lot of sense. And just to clarify for the audience, because it doesn't affect things on a cellular level, there's not really any way that it could stick around or affect the fetus or affect things in your body. So, it's a very scientific conclusion to come to because if it's not affecting your cells, well then it can't do all of the things that people are worried about. Is that at a high level correct?

Dr. Carey: Yes. Exactly. So what a vaccine does is it turns on our immune system to create antibodies or kind of like fighters against the virus if we get exposed to the virus. So, that's what a vaccine does. It turns on our immune system so that if we do in the future, get exposed to the COVID 19 virus, we're going to be equipped to fight it much better than if we were not vaccinated.

What we're seeing now, unfortunately, some obstetricians are seeing an absolute crisis of pregnant women that were not vaccinated. Significantly increased risk of needing to go into the ICU, mechanical ventilation, that's when a tube is down your throat, breathing for you and even death when compared to pregnant women who did receive the vaccine.

So if you look at groups of women, pregnant, one group received the vaccine. One group did not. The women that received the vaccine are much safer and the woman's safer, therefore her baby's safer. Just like the flu. That's why we recommend that women who are pregnant receive the flu vaccine. If you get COVID or you get the flu when you're pregnant, your lungs don't work quite the same as when you're not pregnant. You're a bit immunocompromised so that you're more susceptible for infections. So you can get much, much sicker. Definitely, both the flu vaccine and the COVID vaccine is highly recommended before, during and after pregnancy,

Host: And just to be clear, you can get those on the same day, at the same time. Right?

Dr. Carey: You can get them in same day, same time at any point in the pregnancy, you don't, you know, you can do it the first, second, third trimester. Absolutely at any time.

Host: Now, what about the vaccine for women who are breastfeeding? Is there an effect that's worth talking about there?

Dr. Carey: Same as when you're pregnant, so absolutely recommended. And there's no safety issue with getting the vaccine during breastfeeding. In fact, there are studies showing that the immune response that women make, so again, we generate antibodies against the COVID virus when we receive a vaccine; those antibodies are found in the breast milk. So that actually might be beneficial to the fetus, to the baby, I mean, now the baby is born.

Host: That's good to know. You know, one of the other things I had read is that a woman should wait to get a mammogram after receiving the COVID-19 vaccine. Is this true? And why is that?

Dr. Carey: So when we receive the COVID vaccine, there oftentimes is an immune response. So that means our body's immune system is turned on to create antibodies against the virus. That can cause lymph nodes to be a little bit larger or to be active. So what was found was that if women got received a mammogram shortly after receiving the vaccine, the mammogram could show some changes in the lymph nodes under the arm in the mammogram.

So therefore it is recommended at this point, if possible, to postpone the mammogram for anywhere from four to six weeks after completing your series of the vaccine. If it's not possible. So if you have the mammogram and you recently received the vaccine, simply let the technologists know so that the radiologist, when they're reading the mammogram can be aware that those changes will be because of the vaccine.

Host: It seems like the COVID-19 vaccine is good for any woman, but I guess the question is there any woman at any age that should not get the vaccine?

Dr. Carey: People that were contraindicated to get the vaccine is if you are allergic to the vaccine. So if you had an allergic reaction to the first dose of the vaccine, then you will not get the second dose. Or if you had any sort of allergic reaction to of the components of the vaccine, then it's contra-indicated. Other than that, I know of no contraindications to the vaccine in women at any age beyond age 12.

Host: Okay. And is there anything else just before we leave here today that you want women to know about the vaccine or women's health in general?

Dr. Carey: Well, I just like to say, know, I hope women can take the time and talk about this more with their own obstetrician, if there's still questions and there will be, again, women never want to do anything to harm themselves or their pregnancy; that hopefully they can get any questions answered with their healthcare providers. And hopefully they can feel a little bit more comfortable and actually maybe be pushed to say, maybe I should get this vaccine. It actually is a good thing for yourself and your pregnancy.

Host: Yeah, absolutely. And you know, one of the things that I think eventually made my sister make the decision is, you know, just talking to more people and it's okay to question things and it's okay to ask your provider questions that you've heard in the media or online. Because it's only in collecting more information that you can make the best decision for yourself and your baby. Wouldn't you say that's true, Dr. Carey?

Dr. Carey: Absolutely. Collect all the information. It's definitely a personal choice. But collect good information, you know? Absolutely. You know, there's lots of information out there. There's some stuff on social media that is just plain not true. So, collect all the information and make your own personal decision based on listening to your healthcare provider and all the information you can gather.

Host: And Dr. Carey, just for accurate information on the data, would you still recommend the CDC being the source of truth?

Dr. Carey: Yes, the CDC and then their healthcare provider.

Host: Okay. Thank you so much for your time, Dr. Carey. I truly appreciate it.

Dr. Carey: You're welcome. And thank you for taking the time to talk about this.

Host: That's Dr. Christine Carey, a Gynecologist at Harrington Hospital. Thanks for checking out this episode of Healthy Takeout. For more information, you can visit Harringtonhospital.org. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.

Thanks again for listening. My name is Prakash Chandran, and we'll talk next time.