Covid: Is the vaccine safe for pregnant women?

Pregnant women are being urged to get their Covid-19 vaccinations “as soon as possible”.

In a release issued by the UK Health Security Agency on 16 December, the Joint Committee on Vaccination and Immunisation (JCVI) said that there is “growing evidence” which shows that women who are pregnant are at increased risk of “serious consequences” if they are diagnosed with Covid-19.

It adds that pregnant women should be considered a clinical risk group within the Covid vaccine programme.

“Given that the majority of pregnant women who have been admitted to hospital with severe Covid-19 are unvaccinated, the key priority is to increase the number of pregnant women completing their primary course (two vaccine doses eight weeks apart),” the government release says.

“Recent data published by the UK Health Security Agency (UKHSA) adds to the existing international evidence, which has not identified any safety concerns of vaccinating women during pregnancy.”

Professor Wei Shen Lim, Chair of JCVI Covid-19 Immunisation said there is “no evidence” that Covid vaccines could increase the risk of miscarriage, stillbirths, congenital abnormalities or birth complications for pregnant women.

He added: “Having a UK-approved Covid-19 vaccine is safer than having Covid-19 itself.

“Women who are pregnant are strongly encouraged to have a first, second or booster vaccine dose as appropriate in order to better protect yourself and your baby from any serious consequences from Covid-19.”

The advice comes as the UK has broken its highest daily figures for coronavirus, as the new variant Omicron sweeps the nation. This week, 78,610 new cases were reported on Wednesday while 88,376 new Covid cases were reported on Thursday.

The government has also urged the public to get their booster shot, with a “huge expansion” to the programme planned for this week and all adults over the age of 18 able to get their jab at a walk-in centre.

In October, experts warned that pregnant women were being turned away from Covid vaccine clinics due to confusion over whether or not the jab is safe for them.

Data from the Royal College of Obstetricians and Gynaecologists (RCOG) showed that only 15 per cent of pregnant women in the UK are fully vaccinated.

The number of pregnant women dying from Covid-19 has also risen, according to data from Oxford University’s MBRRACE-UK study. At least 13 pregnant women died with the virus between July and September 2021, compared to nine pregnant women in the first wave of the pandemic and 11 in the second wave.

Professor Marian Knight, who is leading the programme, told the Guardian that disjointed messaging across the health service is leading to women “being turned away from clinics”.

She added that while some NHS trusts are offering the Covid vaccine as part of its maternity service, “it is not universal so there are still barriers”.

Dr Edward Morris, president of the RCOG, warned that 98 per cent of pregnant women who have been admitted to hospital for urgent care related to Covid-19 this year were unvaccinated and urged those who haven’t accepted a jab yet to do so.

But previous medical advice, which is now outdated, cautioned against giving pregnant women a Covid vaccine and conflicting advice from medical professionals has led to confusion and hesitancy among this group.

So what is the current advice for pregnant women and is the Covid vaccine safe?

A spokesperson for the NHS said that pregnant women should not be turned away from vaccination clinics, adding: “Women should continue to come forward for the lifesaving Covid vaccine – they can make a booking through the national booking service online or by calling 110 any time between 7am and 11pm seven days a week.

“The NHS has advised midwifery staff to give pregnant women the information they need to make the right decision for them and their baby so if you are pregnant and have any concerns, please come forward and discuss them with a healthcare professional.”

Jenny Hughes, the south east regional chief midwife for NHS England and Improvement, said earlier this month: “I’d like to reassure pregnant women that the Covid-19 vaccines are considered safe at any time during pregnancy, but the risks that unvaccinated pregnant women face of becoming severely unwell if they catch Covid-19 show exactly why we advise you to get vaccinated as soon as possible.”

Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists (RCOG) said: “We welcome the announcement from the JCVI that recognises pregnant women are more vulnerable to severe illness should they get infected and will therefore be prioritised for vaccination. This is something we have been calling on the JCVI to introduce and we are pleased they have listened.

“It is vital that pregnant women can easily access the booster vaccine to ensure that a good level of protection against Covid-19 and the new variant is maintained. Women who do develop symptomatic Covid-19 have an increased risk of giving birth prematurely, and stillbirth. The latest data from UKHSA shows only a fifth of women who gave birth in August were vaccinated and we would strongly recommend that all pregnant women get vaccinated as soon as possible, as it’s the best way to protect themselves and their baby against COVID-19.”

Covid-19 vaccines are recommended at any stage of pregnancy, and the booster vaccination is recommended by the JCVI to all eligible pregnant women.

Although safety data on the Covid jab during pregnancy remain limited, there are studies that have shown that contracting the virus carries a higher risk to pregnant women than getting the vaccine.

One study published in the New England Journal of Medicine showed there was no evidence of an increased risk of first-trimester miscarriage after vaccination.

“Pregnant women with Covid-19 are at increased risk for adverse outcomes, and Covid-19 is recommended during pregnancy,” said the authors, from the Norwegian Institute of Public Health.

Another study that examined data from a small group of participants who conceived during the trial found that AstraZeneca’s Covid-19 vaccine had no adverse impact on pregnancy or fertility.

An analysis of the outcomes, published in The Lancet, found that the rate of miscarriage was about the same between those who received the vaccine and those who received a placebo.

No still births or neonatal deaths were recorded, and fertility also appeared to be unaffected by the jab.

“With increasing availability of misinformation, which continues to affect vaccine uptake, these data, along with published data on mRNA vaccines, can provide evidence to support women in making decisions regarding vaccination, said the authors, who were mainly from the University of Oxford.

However, the NHS recommends pregnant women receive the Pfizer or Moderna Covid vaccines because “they’ve been more widely used during pregnancy in other countries and no safety concerns have been identified”.

Experts warn that pregnant women who contract Covid-19 can suffer from “serious consequences” for both themselves and their baby.

Gill Walton, chief executive of the Royal College of Midwives, said women in the later stages of pregnancy were particularly at risk.

“[Having Covid-19] can double the chance of stillbirth and triples the chance of a preterm birth, which can have long-term health impact for the baby,” she said.

“We know that the vaccine is a safe and effective way of preventing this, with hundreds of thousands of pregnant women worldwide having been vaccinated with no adverse effects.”

One study suggested that the Delta variant of Covid-19 was particularly risky for pregnant women.

The study, conducted by researchers at the University of Texas Southwestern Medical Centre, observed a higher proportion of pregnant women dying with the Delta variant, “particularly in an underserved pregnant population where vaccine acceptance is low”.