Updated guidance and safety data from the RCOG and PHE Greenbook
Who should be offered Covid-19 vaccination in pregnancy?
• The JCVI has advised that pregnant women should be offered the Covid-19 vaccine at the same time as the rest of the population, based on their age and clinical risk group
What are the risks of Covid- 19 vaccination in pregnancy?
• There is no known risk associated with giving inactivated or recombinant viral vaccines during pregnancy. Inactivated vaccines cannot replicate so cannot cause infection in either the mother or the fetus. Although AstraZeneca vaccine contains a live adenovirus vector, this virus is not replicating
• Real-world data from the United States shows that around 128,000 pregnant women have been vaccinated, mainly with mRNA vaccines including Pfizer-BioNTech and Moderna, without any safety concerns being raised
• Based on this data the JCVI advises that it’s preferable for pregnant women in the UK to be offered the Pfizer-BioNTech or Moderna vaccines where available
• There is no evidence to suggest that other vaccines are unsafe for pregnant women, but more research is needed
• Studies to date show no significant difference between pregnant and non-pregnant women in their symptoms post vaccination, and a reduced incidence of systemic features such as fever in pregnant women
• PHE’s Green Book, still advises that pregnant women should discuss the risks and benefits of vaccination with their clinician, including the latest evidence on safety and which vaccines they should receive
Which are the preferred vaccines for pregnant women?
• Pfizer and Moderna vaccines are the preferred vaccines for eligible pregnant women of any age, because of more extensive experience of their use in pregnancy
• Pregnant women who commenced vaccination with AstraZeneca are advised to complete with the same vaccine
Recommended vaccine timing in relation to stage of pregnancy
• Covid-19 vaccines can be given at any time in pregnancy
• In low-risk situations some women may choose to delay vaccination until 12 weeks of gestation, aiming for vaccination as soon as possible thereafter
• If there is a higher chance of contracting infection, or a woman is at a higher risk of severe illness from Covid-19, the vaccine should be offered at the earliest opportunity including in the first trimester
Conception and breastfeeding
• Women who are planning pregnancy, are in the immediate postpartum, or are breastfeeding can be vaccinated with any vaccine, depending on their age and clinical risk group
• Women should be informed about the absence of full safety data for the vaccine in breastfeeding
This RCOG Information sheet and can be used to aid counselling
Written by Dr Claire Davies
Updated by Dr Poppy Freeman