Pregnant women have been given the green light to have the Covid vaccine – but some are confused by the recent change in guidance.
The U-turn came after the Joint Committee on Vaccination and Immunisation (JCVI) said it’s now “preferable” for pregnant women in the UK to be offered the Pfizer/BioNTech or Moderna vaccines, where available.
Before this, the only people able to have the jab during pregnancy in the UK were those considered high risk, either because of an underlying health condition or their job (for example, being a frontline worker). This was because there was “insufficient evidence” at the time to recommend routine use of Covid-19 vaccines during pregnancy.
So, what changed? Well, while clinical trials testing the vaccine in pregnant women are only just starting, real-world data from the United States showed that around 90,000 pregnant women had been vaccinated, mainly with mRNA vaccines by Pfizer-BioNTech and Moderna, without any safety concerns raised.
The new guidance in the UK says pregnant women should be offered the Covid jab “at the same time as the rest of the population, based on their age and clinical risk group”.
Since this news, some pregnant women have called their GP and local hospitals to book in for their vaccine, while others have received messages calling them up. However, they haven’t been able to stipulate on booking forms that they’re pregnant and need a specific jab.
Labour MP Stella Creasy said she’d received a text offering her the vaccine but “maddeningly” couldn’t accept it, as the electronic booking system couldn’t guarantee that she’d be able to have the Pfizer or Moderna jabs.
Can you have the AstraZeneca jab in pregnancy?
You can – but ideally, only if you’ve already had the AstraZeneca jab before now and need your second dose. A letter from NHS England to healthcare professionals explains that “for pregnant women who have received a first dose of AstraZeneca and are due to receive their second dose, no further action is required and second dose appointments should continue as planned”.
Other pregnant women should be offered the Pfizer or Moderna jabs, where available. This is because there’s more evidence to suggest there are no safety concerns with the Pfizer and Moderna jabs – thanks to that data from the US – while there’s less evidence surrounding the AstraZeneca jab.
In the absence of data, experts can’t be 100% sure that vaccines will not cause adverse events in pregnancy.
Guidance has been issued from NHS England saying pregnant women should not be refused vaccination if the Pfizer/BioNTech or Moderna vaccines aren’t available. If a vaccination site doesn’t offer an alternative jab to AstraZeneca, they’re being urged to cancel first dose appointments if they know the patient is pregnant and direct them to another site that has the Pfizer/BioNTech or Moderna vaccines.
All vaccination sites should implement screening procedures to ensure pregnant women are identified and offered the Pfizer BioNtech or Moderna vaccine, the guidance states. So in short: your healthcare providers should be doing everything they can to offer you an alternative.
If the mRNA jabs aren’t available locally – and you’re desperate to have the vaccine before you give birth – is having the AstraZeneca vaccine safe?
It’s impossible to say it’s risk-free at this stage. There’s no evidence to suggest other Covid vaccines (including AstraZeneca) are unsafe for pregnant women, according to JCVI, but more research is needed. The committee said there have been no specific safety concerns identified with any brand of coronavirus vaccines in relation to pregnancy.
HuffPost UK contacted AstraZeneca to ask for any preliminary evidence they have suggesting the jab is safe to have in pregnancy, but is yet to hear back.
What should pregnant women do now?
Ideally, wait until you’re called up for your vaccine along with the rest of your age group – and know that you should be directed to a site that offers the Pfizer/BioNTech or Moderna vaccines, or call up your GP and request this.
The Royal College of Obstetricians and Gynaecologists (RCOG) says the vaccine should work at any stage in pregnancy, however it does note that some women might want to delay until after the first 12 weeks due to the risk from Covid complications mainly being in the later stages of pregnancy.
The first 12 weeks are also most important for the baby’s development – and we don’t know how the vaccines might impact that period at this stage. There’s no reason to suggest it would, but we don’t know.
Before you have the jab, it’s worth speaking to your healthcare provider about the risks and benefits – some of which we’ve detailed below.
The benefits
There’s limited UK data on Covid-19 vaccination and pregnancy, however data elsewhere suggests that – up until now – there have been no safety concerns raised when tens of thousands of pregnant women had the mRNA jabs.
Studies have also shown healthy babies have been born with antibodies that can fight Covid-19 after their mothers received vaccination.
There are a number of benefits to having the jab in pregnancy. Firstly, you’ll reduce your risk of getting severely ill from Covid-19 if you do catch it, and secondly, you’ll reduce the impact to your baby if you become severely ill.
In the later stages of pregnancy (particularly the third trimester), women are at increased risk of becoming seriously unwell from Covid. If this happens, it’s about three times more likely that your baby will be born prematurely, which can affect their long-term health.
By having the jab, you may also reduce transmission to vulnerable household members, as evidence suggests vaccination reduces the spread of the virus.
While more than half of women who test positive in pregnancy have no symptoms, some do end up with life-threatening illness, especially if they have underlying health problems. Professor Wei Shen Lim, Covid-19 chair for JCVI, said those at increased risk of severe outcomes from Covid-19 are “encouraged to promptly take up the offer of vaccination when offered”.
It’s worth noting Covid-19 vaccines don’t contain ingredients known to be harmful to pregnant women or developing babies. According to RCOG, studies of the vaccines in animals have shown no evidence the vaccine causes harm to the pregnancy or fertility. As the vaccines are not ‘live’, they can’t give you or your baby coronavirus. Other non-live vaccines like the flu and whooping cough jabs have been shown to be safe in pregnancy – and are recommended.
The risks
One risk could be the lack of long-term data available for pregnant women who have had the vaccine and given birth – several years on. There’s no reason to suggest the vaccine could be harmful, though, and of the 90,000 pregnant women vaccinated in the US, no safety concerns have been raised.
Another factor to consider is side effects, which are common. While these don’t affect pregnancy, it’s worth bearing in mind that you might experience pain at the injection site, headache, fever, chills and joint pain afterwards.
There has been concern surrounding blood clots with the AstraZeneca jab, which may be on the minds of pregnant women, as they’re five times more likely to experience a blood clot compared with those who are not pregnant.
HuffPost UK contacted the Medicines and Healthcare products Regulatory Agency (MHRA) to see whether any of the existing cases of blood clots linked to the AstraZeneca vaccine in the UK had occurred in pregnant women. They confirmed there have been no cases so far. However, very few pregnant women would have received the jab in comparison to the wider population.
Dr Mary Ross-Davie, director for professional midwifery and Covid-19 vaccine lead at the Royal College of Midwives (RCM), welcomed the change in guidance, saying it “empowers” pregnant women to make their own decisions about whether or not to receive the vaccine. “Ultimately it will be a woman’s choice and midwives and obstetricians will be there to support them to make an informed decision that is right for them.”
If you’re unsure, it’s best to speak to your midwife to discuss your options. RCOG has also created a useful decision aid tool to help women weigh up the pros and cons of vaccination.