If you’re pregnant, you may be wondering whether it’s safe to have the COVID-19 vaccine. In general, there is no known risk to pregnant women when they are routinely given vaccines, such as those for whooping cough or flu, according to the Royal College of Obstetricians and Gynaecologists (RCOG).
However, trials specifically testing the COVID-19 vaccine in pregnant and breastfeeding women have not yet been carried out.
The independent Joint Committee on Vaccination and Immunisation (JCVI), which advises the government on vaccinations, says available data doesn’t indicate any safety concerns or harm to pregnancy from the COVID-19 vaccine, but there’s insufficient evidence to recommend its routine use during pregnancy.
So until we have more information, pregnant women won’t be routinely vaccinated against coronavirus.
Nevertheless there are some important exceptions. Read on to find out what they are.
Who is being offered the COVID-19 vaccine?
- Those with high risk medical conditions (clinically extremely vulnerable) and at greater risk of severe illness from COVID-19.
- Health or social care workers who are at very high risk of catching COVID-19. This includes carers for older adults in residential care homes.
If you aren’t a health or social care worker and don’t have any of these medical conditions, you won’t currently be offered the vaccine during your pregnancy.
However, the RCOG and the Royal College of Midwives (RCM) urge all pregnant women to have a free winter flu vaccine to protect themselves and their baby from complications caused by flu.
This is because it’s possible to get infected with flu and COVID-19 at the same time, and research by Public Health England shows that if you get both concurrently you may be more seriously ill.
Options if you’re offered the vaccine in pregnancy
If you are included in these two groups of women, the RCOG says you have two options:
- Get a COVID-19 vaccine (read more about the pros and cons below)
- Wait for more information about the vaccine in pregnancy.
If you decide to have the vaccine, you are advised to tell the vaccination team that you are pregnant so that it can be recorded.
Pros and cons of the COVID-19 vaccine in pregnancy
Vaccination is effective in preventing COVID-19 infection, according to the RCOG, but you will need to weigh up the benefits and the possible risks.
PRO: Protects against COVID-19, which may be more dangerous in pregnancy
Studies show hospital admission and severe illness may be more common in pregnant women (compared with those who aren’t pregnant), especially in the third trimester.
Premature birth is more likely (compared to pregnant women without COVID-19) and pregnant women with underlying health conditions are at higher risk of severe illness (see list below).
PRO: You can’t get COVID-19 from vaccination
COVID-19 vaccines do not contain live coronavirus, and vaccines do not contain any additional ingredients that are harmful to pregnant women or their babies.
Other non-live vaccines (whooping cough and flu/influenza) are considered to be safe for pregnant women and their unborn babies.
CON: COVID-19 vaccines haven’t been specifically tested with pregnant women yet
Coronavirus vaccines have been given to large numbers of people to ensure they meet stringent safety and effectiveness standards. Available data doesn’t indicate any safety concerns or harm in pregnancy, but insufficient evidence is available for pregnant women and we are still waiting for results of further studies.
We don’t know whether the vaccine works as well in pregnancy and we don’t know whether there are unique risks in pregnancy, such as different side effects, increased miscarriage risk or developmental problems for the baby.
CON: Minor side effects from the vaccine are common
These don’t affect pregnancy, but may include:
- Injection site reactions (sore arm)
- Muscle pain
- Fever and chills
- Joint pain.
Will the vaccination situation change for pregnant women?
The RCOG and the RCM are calling on the UK government to fund research studies to establish the suitability of any approved COVID-19 vaccines for the 800,000 UK women who conceive each year, as well as those planning a pregnancy.
The RCOG told Which? that in the UK there are not yet any established clinical trials of the vaccine in pregnant women.
However, it says that ‘data on vaccination in pregnancy is being gathered via vaccination programmes worldwide – this will provide more evidence on safety in due course.’
This data includes inadvertent pregnancy (women having the vaccine who are not aware they are pregnant) and pregnant women opting to receive the vaccine in countries where they are offered it.
Underlying health conditions
If you have any of the high-risk medical conditions, then according to guidelines you should be offered a COVID-19 vaccination:
- Organ transplant
- Currently undergoing cancer treatment
- Bone marrow or stem cell transplant in the past six months
- Significant lung condition such as cystic fibrosis or severe asthma
- Conditions that significantly increase infection risk such as homozygous sickle cell disease or severe combined immunodeficiency (SCID)
- Conditions affecting your spleen, including having had your spleen removed
- Down’s syndrome
- Significant kidney conditions and/or on dialysis
- Significant heart conditions
- Your hospital doctor or GP feels there are other reasons why you may get more severe illness if you develop COVID-19.
There are some circumstances in which the potential benefits of vaccination are particularly important for pregnant women and, following discussions with your doctor, you may decide to have it.
What can you do in the meantime?
The RCOG advises pregnant women to:
- Follow government advice about social distancing
- Get your free flu vaccination this winter
- Have the whooping cough vaccine (ideally from 16-32 weeks of your pregnancy). This is to protect your baby in the first few weeks of their life.
Further information on coronavirus and pregnancy is available from the RCOG.
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