Offer COVID-19 vaccination to pregnant women, advises JCVI

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, the Joint Committee on Vaccination and Immunisation (JCVI) has said.

The Pfizer/BioNTech and Moderna COVID-19 vaccines are the preferred vaccines for pregnant women of any age, because of more extensive experience of their use in pregnancy. | GETTY IMAGES
The Pfizer/BioNTech and Moderna COVID-19 vaccines are the preferred vaccines for pregnant women of any age, because of more extensive experience of their use in pregnancy. | GETTY IMAGES

Real-world data from the US show that around 90,000 pregnant women have been vaccinated, mainly with mRNA vaccines including the Pfizer/BioNTech and Moderna jabs, without any safety concerns being raised.

Based on these data, the JCVI advises that it is 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.

In a letter to GP practices and other NHS organisations, NHS England said that from 19 April, all vaccination sites must ensure that pregnant women in JCVI cohorts 1, 2, 4 and 6 - and those aged 45-49 - are able to book alongside other people of the same age or in the same clinical groups.

'All vaccination sites should implement screening procedures to ensure pregnant women are identified and offered the Pfizer/BioNTech or Moderna vaccine', the letter says.

Sites that do not currently offer alternatives to the Oxford/AstraZeneca jab 'should cancel first-dose appointments if they know the patient is pregnant and direct patients to a PCN site or a vaccination centre that is administering the Pfizer-BioNTech or Moderna vaccine', the letter adds.

For pregnant women who have already commenced vaccination with the Oxford/AstraZeneca vaccine, Public Health England's Green Book advises they complete their course with a second dose of the same vaccine, as planned. 

Women who are planning pregnancy, are in the immediate postpartum period, or are breastfeeding, can be vaccinated with any vaccine, depending on their age and clinical risk group.

Updated guidance

Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said: 'We are grateful to the JCVI for taking into consideration our evidence and updating the guidance around the COVID-19 vaccine in pregnancy.

'Vaccination offers pregnant women the best protection from COVID-19, which can be serious in some women.

'We believe it should be a woman’s choice whether to have the vaccine or not after considering the benefits and risks and would encourage pregnant women to discuss with a trusted source like their GP, obstetrician or midwife, or a healthcare professional in a vaccination centre.

'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 JCVI says that severe illness due to COVID-19, though uncommon, is more likely in later pregnancy. Pregnant women who do get symptomatic COVID-19 infection are 2 to 3 times more likely to give birth to their baby prematurely.

The greatest risk factor for severe outcomes from COVID-19 is age, which is why pregnant women should be invited for vaccination along with their age or clinical risk group.

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