Hundreds of thousands of pregnant women in the UK have been given the green light to receive a Covid vaccine in a move welcomed by bereaved families and campaigners.
All pregnant women would be offered the Pfizer or Moderna jab based on their age and clinical risk group after real-world data from the US showed about 90,000 pregnant women had been vaccinated without any safety concerns, the UK’s Joint Committee on Vaccination and Immunisation (JCVI) said on Friday.
Pregnant women, who had previously been advised not to take the vaccine because of a lack of data on the impact, will be able to have it at any stage. About 700,000 women give birth in England and Wales each year, with thousands more trying to conceive at any one time.
The new guidance states that women who are trying to get pregnant, recently had a baby or are breastfeeding can be vaccinated with any jab, depending on their age and clinical risk group.
Prof Wei Shen Lim of the JCVI said women should discuss the risks and benefits with their clinician, and those at increased risk should take up the offer of vaccination promptly.
“There have been no specific safety concerns from any brand of Covid-19 vaccines in relation to pregnancy,” he said. “There are more real-world safety data from the US in relation to the Pfizer/BioNTech and Moderna vaccines in women who are pregnant – therefore, we advise a preference for these to be offered to pregnant women.” The Oxford/AstraZeneca jab, which is the UK’s most used, has not yet been approved for rollout in the US.
Ernest Boateng, whose wife, Mary Agyeiwaa Agyapong, died after contracting the coronavirus, days after giving birth, said he hoped the vaccine would prevent other families having to go through the pain he and his children had suffered.
“I lost my wife, and she has left two kids behind. No family would want to see their pregnant wife go to hospital and not come home with her baby,” he said.
“If we are confident that these vaccines are going to be safe and it’s the best clinical decision then that is something we all want, we all want to see pregnant women protected. I welcome anything that is positive to make sure we are offering pregnant women the best support. But even with a vaccine we still need to keep other measures to help pregnant women – they need protecting.”
Dr Mary Ramsay, the head of immunisation at Public Health England (PHE), said the data provided “confidence that [mRNA vaccines] can be offered safely to pregnant women”. Dr Edward Morris, the president of the Royal College of Obstetricians and Gynaecologists (RCOG), said vaccination offered pregnant women the best protection from Covid.
“We believe it should be a woman’s choice whether to have the vaccine or not after considering the benefits and risks,” he said. “This move will empower all the pregnant women in the UK to make the decision that is right for them, at the same time that the non-pregnant population in their age group receive protection from Covid-19.”
The news would come as a “great relief” to pregnant women and their loved ones, said Joeli Brearley, the founder of campaign group Pregnant Then Screwed. She called for the government to take a further step and prioritise pregnant women for vaccines. Some research had shown they were at greater risk of becoming severely unwell if they contracted Covid, particularly in the later stages of pregnancy, she said.
According to the RCOG, UK studies suggest pregnant women are no more likely to catch Covid than other groups. But while the majority who do get the virus have no symptoms or mild symptoms, pregnant women may be at increased risk of having severe disease – a concern echoed by the US Centers for Disease Control and Prevention. Pregnant women who did get symptomatic Covid-19 infection were two to three times more likely to give birth to their baby prematurely, said the JCVI.
Brearley called for sensitivity towards pregnant women who might not feel confident taking the vaccine. “This must be dealt with carefully and compassionately as we begin to relax restrictions,” she said.
She added it was still crucially important that the government forced employers to complete a risk assessment and suspend pregnant women on full pay if they could not ensure they were 2 metres away from other people at all times. “We know from our own research that this is not happening and the lives of pregnant women and their babies are being put in danger every day,” she said.
PHE and the JCVI say the vaccine can be taken at any time during pregnancy, but women should feel they are in control of decision-making. If they choose not to have the vaccine before 12 weeks because they have any concerns about the early gestation period, that should be respected.
Before the change in guidance, the JCVI advice was that Covid vaccines should be offered to pregnant women at high risk of exposure to coronavirus, such as frontline health workers, or to those with certain underlying medical conditions.
However, the JCVI had said there was not enough evidence to recommend all pregnant women be given the jab – although there was no indication in the data to suggest the vaccines could pose any harm to a pregnancy.
The lack of evidence was largely because pregnant women are often excluded from clinical trials, although some women became pregnant after receiving the jab. There are several investigations under way to look specifically at use of the vaccine in pregnant women.
On 7 April, following concerns about a rare blood-clotting syndrome that had been identified in some recipients of Covid vaccines, the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) released new advice relating to the Oxford/AstraZeneca jab, including a note for pregnant women.
“Pregnancy predisposes to thrombosis, therefore women should discuss with their healthcare professional whether the benefits of having the vaccine outweigh the risks for them,” the MHRA said.
The JCVI has also recommended that all healthy under-30s in the UK are offered an alternative to the AstraZeneca vaccine.
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