COVID-19 vaccines in pregnancy and breastfeeding by RCOG
Current recommendations from the Joint
Committee on Vaccination and Immunisation (JCVI) UK and the Royal College of
Obstetricians and Gynaecologists (RCOG) state that, all
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.
Vaccination is the best way to protect against the known risks of COVID-19 in pregnancy for both women and babies, including admission to intensive care and premature birth.
The benefits and risks of COVID-19 vaccination in pregnancy should be considered on an individual basis.
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· Robust real-world data from the United States – where over 130,000 pregnant women have been vaccinated mainly with mRNA vaccines, such as Pfizer-BioNTech and Moderna – have not raised any safety concerns.
·
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 COVID-19 vaccines which are not ‘live’ vaccines and so cannot cause COVID-19 infection in person. Vaccines based on live viruses are avoided in pregnancy in case they infect the developing baby and cause harm.
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.
COVID-19 infection can affect the
pregnancy. In pregnant women with symptoms of COVID-19, it is twice as likely
that their baby will be born early, exposing the baby to the risk of prematurity.
A recent study has also
found that pregnant women who tested positive for COVID-19 at the time of birth
were more likely to develop pre-eclampsia, more likely to need an emergency
caesarean and their risk of stillbirth was twice as high.
The benefits of vaccination
include:
- reduction in severe disease for the pregnant woman
- reduction in the risk of stillbirth and prematurity
for the baby
- potentially reducing transmission to vulnerable
household members.
The vaccine is safe and effective
at any stage of pregnancy.
However, in low-risk situations some
women may choose to delay their vaccine until after the first 12 weeks (which
are most important for the baby’s development) and have the first dose
at any time from 13 weeks onwards.
If there is a higher chance of
contracting infection, or a woman is at a higher risk of severe illness from
COVID-19, the vaccine should be offered at the earliest opportunity, including
in the first trimester.
Second doses are given 8 to 12
weeks after the first dose and JCVI recommend that pregnant women
complete the course of vaccination before giving birth, or before enter the
third trimester, when the risk is greatest.
COVID-19 vaccines are recommended
to breastfeeding women. There is no plausible mechanism by which any vaccine
ingredient could pass to baby through breast milk. Women should therefore not
stop breastfeeding in order to be vaccinated against COVID-19.
https://www.medicinesinpregnancy.org/bumps/monographs/USE-OF-NON-LIVE-VACCINES-IN-PREGNANCY/
https://www.gov.uk/government/publications/covid-19-vaccination-women-of-childbearing-age-currently-pregnant-planning-a-pregnancy-or-breastfeeding/covid-19-vaccination-a-guide-for-women-of-childbearing-age-pregnant-planning-a-pregnancy-or-breastfeeding
Note: For informational purposes only. Consult your
textbook for advising your patients.
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