Pregnant and breastfeeding women should now be offered Covid vaccination

Women who are pregnant or breastfeeding should be offered Covid vaccination, following an update to guidance by the Joint Committee on Vaccination and Immunisation (JCVI).

JCVI now advises that ‘vaccination in pregnancy should be considered where the risk of exposure to [Covid] infection is high and cannot be avoided, or where the woman has underlying conditions that put them at very high risk of serious complications of Covid-19’.

It lists likely risk groups as:

• Solid organ transplant recipients
• Those with severe respiratory conditions including cystic fibrosis and severe asthma
• Those who have homozygous sickle cell disease
• Receiving immunosuppression therapies sufficient to significantly increase risk of infection
• Receiving dialysis or with chronic kidney disease (stage 5)
• Those with significant congenital or acquired heart disease 

‘In these circumstances, clinicians should discuss the risks and benefits of vaccination with the woman, who should be told about the absence of safety data for the vaccine in pregnant women,’ the guidance said.

Meanwhile, all breastfeeding women should be offered the vaccine and advised that there ‘is no known risk associated with giving non-live vaccines whilst breastfeeding’. 

The updated guidance applies to both the Pfizer/BioNTech or Oxford/AstraZeneca Covid-19 vaccines.

But the Royal College of Obstetricians and Gynaecologists and Royal College of Midwives (RCM) said in a statement that is is ‘recommending that pregnant women who might be eligible for vaccination should receive it through their maternity unit, or notify their local maternity unit when it is received’.

‘This is so that maternity staff can report it to the UKOSS/UKTIS vaccine registry, including report of follow-up post-vaccination of the women and their babies.’

RCM is also working with the Department of Health and Social Care to set up a Covid vaccine registry through the UK Obstetric Surveillance System and the UK Teratology Information Service for pregnancy, separate to the planned clinical trials, to ensure that adequate safety data are collected for women given one of the vaccines.

Note: This article was updated at 11.49am on Tuesday 5 January to clarify advice for all breastfeeding women to have the Covid vaccine. A previous version had erroneously suggested they needed to be clinically vulnerable.