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25 May 2021

Can you have the Covid-19 vaccine if you're pregnant?

We look at current vaccination guidance being given to expectant women from the Royal College of Obstetricians and Gynaecologists

If you're pregnant, you may be wondering whether it's safe to have the Covid-19 vaccine.

We've answered some of the most common questions to help put your mind at ease.

Is it safe to have the vaccine while pregnant?

Although UK data is limited because our large clinical trials didn't include pregnant women, the best real-world data we have so far is from the United States where around 90,000 pregnant women have been vaccinated mainly with mRNA vaccines, such as Pfizer-BioNTech and Moderna, and no safety concerns have been raised.

You should discuss the risks and benefits of having the vaccine with your healthcare professional so you can make an informed decision together.

The same applies to women who aren't currently expecting but are trying to get pregnant, whether that's imminently or in a few years time.

Will I be vaccinated just because I'm pregnant?

Currently you won't be given the vaccine just because you're pregnant but rather - and in line with what's happening with the rest of the population - pregnant women are being advised to have the vaccine based on their age and clinical risk group.

As vaccinations become available to younger people in the general population, they will also be made available to pregnant women in those age groups, too. However, whether you have the vaccine is still your choice.

Covid-19 vaccination is currently also being offered to the following pregnant women:

  • Those with high risk medical conditions who have a greater risk of severe illness from Covid-19
  • Health or social care workers, who are at very high risk of catching Covid-19
  • Individuals considered at high risk of Covid-19 because of health and personal factors that include age, ethnicity, BMI and underlying health conditions (this includes pregnant women in priority group 6)
  • Women diagnosed with gestational diabetes in pregnancy or pregnant women with a BMI greater than 40

What are the benefits of having the vaccine while pregnant?

The benefits of vaccination include:

  • Reduction in severe disease for pregnant women
  • Reduction in the risk of prematurity for the baby
  • Potentially reducing transmission to vulnerable household members

The RCOG says: 'The benefits and risks of Covid-19 vaccination in pregnancy should be discussed on an individual basis. The discussion should include acknowledgment that, while there is no known risk associated with giving other non-live vaccines to pregnant women, there are no specific data as yet about the safety of Covid-19 vaccination in pregnancy.'

Is it possible the vaccine might harm my baby?

Vaccines for Covid-19 don't contain ingredients that are known to be harmful to pregnant women or to a developing baby. Not only that, but there's no evidence from studies in animals that the vaccine causes harm to the pregnancy or to fertility.

The RCOG says: 'In the absence of data, we cannot be 100% sure that vaccines will not cause adverse events in pregnancy. However, this uncertainty needs to be weighed against the risk of Covid-19 in pregnancy.'

The vaccines used in the UK are not 'live' vaccines so can't cause Covid-19 infection in either mum or baby. Non-live vaccines have previously been shown to be safe in pregnancy (e.g. flu and whooping cough) and are regularly given.

Is there a specific vaccine I should have?

The latest information from the JCVI (Joint Committee on Vaccination and Immunisation), which advises the government on vaccinations, is that it's preferable for pregnant women in the UK to be offered the Prizer-BioNTech or Moderna mRNA vaccines, where available.

The reason for this is that these vaccines have been given to around 90,000 women in the United States and the data hasn't raised any safety concerns.

The Royal College of Obstetricians and Gynaecologists (RCOG) says: 'If a woman chooses to have a particular vaccine, for example to avoid vaccination with the Oxford AstraZeneca vaccine, then they should be able to choose to do so.'

How do I book my vaccine to ensure I get the right one?

Pregnant women are now able to book their vaccine through the national booking service once they have received an invitation to be vaccinated.

During the booking process you'll be asked if you're pregnant to make sure you're directed to a vaccine centre that has Pfizer or Moderna vaccines available.

If a suitable vaccine isn't immediately available in your area, keep trying the national booking service.

Is it safe to have my second dose of AstraZeneca if I've found out I'm pregnant?

If you've had your first dose of AstraZeneca then discover you're pregnant, you should speak to your midwife, GP or obstetrician about whether to have your second dose.

There is no clear data on whether mixing different vaccines alters how well they work or how safe they are.

However, the JCVI currently says: 'To date, there are no reports of the extremely rare thrombosis/thrombocytopenia events following receipt of the second dose of the AstraZeneca Covid-19 vaccine.

'All those who have received a first dose of the AstraZeneca Covid-19 vaccine should continue to be offered a second dose of AstraZeneca Covid-19 vaccine, irrespective of age. The second dose will be important for longer lasting protection against Covid-19.'

The RCOG says you can choose whether to have the second dose of AstraZeneca in pregnancy or defer until after pregnancy, although a second dose is recommended to ensure maximum protection against Covid-19.

Use the RCOG's decision aid on vaccination in pregnancy to help you decide what to do. You can also visit the RCOG Covid vaccination hub, which has information and guidance on Covid-19 vaccines, pregnancy, fertility and breastfeeding.

What side effects might I experience?

Non-pregnant women may experience mild and short-lasting side effects such as muscle ache or a fever lasting a day or two.

More recently there have been reports of serious but rare blood clots following vaccination with the AstraZeneca vaccine. However, the numbers are very small and therefore the risk of the serious side effect of blood clots with the AstraZeneca vaccine is extremely low.

When during my pregnancy should I be vaccinated?

As Covid-19 has more serious complications later on in pregnancy, you may choose to have your vaccine before your third trimester - in other words, in your second trimester, if you haven't already had it in your first trimester.

You should discuss with your healthcare professional the risks and benefits of when to have the vaccine.

Can I have the vaccine if I'm undergoing fertility treatment?

Yes. The British Fertility Society says you can have the vaccine during your fertility treatment. This includes IVF, frozen embryo transfer, egg freezing, ovulation induction, intra-uterine insemination and using donated gametes.

However, it says that you may wish to consider the timing of having a Covid-19 vaccine during your fertility treatment, taking into account that some people may get bothersome side effects in the few days after vaccination that they do not want to have during treatment. For example, injection site tenderness, fever, headache, muscle ache or feeling tired.

It adds: 'It may be sensible to separate the date of vaccination by a few days from some treatment procedures (for example, egg collection in IVF), so that any symptoms, such as fever, might be attributed correctly to the vaccine or the treatment procedure. Your medical team will be able to advise you about the best time for your situation.'

Can I try to get pregnant after having the vaccine?

Yes, you can. The RCOG says that women trying to get pregnant don't need to avoid pregnancy after vaccination and there is no evidence to suggest the Covid-19 vaccines will affect pregnancy.

Further information on coronavirus and pregnancy is available from the RCOG.

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