Coronavirus and pregnancy

Health Watch

The Royal College of
Obstetricians and Gynaecologists (RCOG) in the United Kingdom (UK) is sharing information
on pregnancy and the
Coronavirus (Covid-19)

THE question and answers were updated in August and will be reviewed as new information and advice emerges.
The key messages are:

  •  THE Coronavirus (Covid-19) vaccines are recommended in pregnancy.
    Vaccination is the best way to protect against the known risks of the Covid-19 in pregnancy for both women and babies, including admission of the woman to intensive care and premature birth of the baby;
  •  WOMEN may wish to discuss the benefits and risks of having the vaccine with their healthcare professional and reach a joint decision based on individual circumstances.
    However, as for the non-pregnant population, pregnant women can receive a Covid-19 vaccine even if they have not had a discussion with a healthcare professional;
  •  YOU should not stop breastfeeding to be vaccinated against the Covid-19;
  •  WOMEN trying to become pregnant do not need to avoid pregnancy after vaccination.
    There is no evidence that Covid-19 vaccines will affect fertility; and,
  •  HAVING a Covid-19 vaccine will not remove the requirement for employers to carry out a risk assessment for pregnant employees, which should follow the rules set out in this government guidance.

    Resources to help with decision making
    Vaccination is recommended in pregnancy, but the decision whether to have the vaccine is your choice.
    You may find the following resources helpful:

  • NFORMATION leaflet and decision aid on the Covid-19 vaccination in pregnancy;
  •  UK teratology information service monograph on non-live vaccination in pregnancy;
  •  PUBLIC health England information for women of childbearing age, currently pregnant, planning a pregnancy or breastfeeding.

What is the latest advice on
the Covid-19 vaccination
and pregnancy?
The Covid-19 vaccines are recommended in pregnancy.
All pregnant women aged 18 and over have now been offered a Covid-19 vaccine, and all 16 and 17-year-olds were offered a Covid-19 vaccine at the end of August.
On April 16, the joint committee on vaccination and immunisation (JCVI) advised that all pregnant women should be offered the Covid-19 vaccine at the same time as the rest of the population, in line with the age group roll-out.
Previously, their advice was that pregnant women at high risk of exposure to the virus or with high risk medical conditions should consider having a Covid-19 vaccine in pregnancy.
Vaccination is the best way to protect against the known risks of the Covid-19 in pregnancy for both women and babies, including admission to intensive care and premature birth.
The decision whether to have the vaccination in pregnancy is your choice.
Make sure you understand as much as you can about the Covid-19 and about the vaccine and you may want to discuss your options with a trusted source like your doctor or midwife.

What is the advice on going
to work if I am pregnant and
have been vaccinated?
According to the government’s advice for pregnant employees, employers must carry out a risk assessment for pregnant employees taking into consideration the RCOG or RCM (Royal College of Midwives) guidance on the Covid-19 in pregnancy.
Employers are still required to carry out a risk assessment whether an employee has been vaccinated or not.

Is the Covid-19 vaccination safe
and effective for pregnant
women and their babies?
Robust real-world data from the United States – where over 148,000 pregnant women have been vaccinated mainly with mRNA vaccines, such as Pfizer-BioNTech and Moderna – have not raised any safety concerns.
Therefore, the JCVI advises that it is preferable for the Pfizer-BioNTech or Moderna mRNA vaccines to be offered to pregnant women in the UK, where available.
Public health England reported that more than 62,000 pregnant women in England had received one dose of the Covid-19 vaccination and p ublic health Scotland reported that 4,000 pregnant women had received a vaccine, with no serious adverse effects recorded.
The large clinical trials which showed that the Covid-19 vaccines are safe and effective did not include pregnant women.
As the vaccines were not tested in pregnant women, we cannot say for sure that they work as well in pregnant women as they do in other adults.
However, recent studies showed that pregnant women who had the vaccine made antibodies against the Covid-19, suggesting that the vaccine is effective in pregnancy.
Recent studies also showed that pregnant and non-pregnant women had similar mild side-effects from vaccination.
The Covid-19 vaccines do not contain ingredients that are known to be harmful to pregnant women or to a developing baby.
Studies of the vaccines in animals to look at the effects on pregnancy have shown no evidence that the vaccine causes harm to the pregnancy or to fertility.
The vaccines that we are using in the UK are not “live” vaccines and so cannot cause infection in you or your baby.
Vaccines based on live viruses are avoided in pregnancy in case they infect the developing baby and cause harm.
However, non-live vaccines have previously been shown to be safe in pregnancy (for example, flu and whooping cough). Pregnant women are offered other non-live vaccines, such as those against flu.
Studies shown that protective antibodies from vaccination did cross the placenta, helping with the baby’s immunity to the Covid-19.
Catching it during pregnancy can cause severe illness in a pregnant woman, especially in the third trimester – that’s why we recommend the vaccine in pregnancy.

  • Next Week: What is known about the impact of the Covid-19 vaccination on babies born to women who have been vaccinated in pregnancy?

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