COVID-19 Vaccine
(Date: September 2022. Version: 8)
This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.
What are COVID-19 vaccines?
COVID-19 vaccines are recommended in pregnancy and pregnant women are a priority group for vaccination. Vaccination is the best way to protect against the known risks of COVID-19 in pregnancy for both women and their babies.
In July 2022, the Joint Committee on Vaccination and Immunisation (JCVI) announced that pregnant women, in line with recommendations for other high-risk groups, will be invited to receive an autumn booster dose.
Five COVID-19 vaccines are currently approved for use in the United Kingdom (Pfrizer/BioNTech, University of Oxford/AstraZeneca, NIH/Moderna and Janssen, and Novavax). It is currently advised that the Pfizer and Moderna vaccines are preferable for pregnant women in the UK.
COVID-19 vaccines work by training your immune system to recognise the ‘spike’ protein that is on the outside of the COVID-19 virus and to fight off the infection. None of the COVID-19 vaccines contain live coronavirus, and therefore vaccination cannot give you COVID-19.
What are the benefits of having the COVID-19 vaccine in pregnancy?
Pregnant women are at higher risk of developing severe complications if they become infected, particularly in late pregnancy.
Risks are higher for women from an ethnic minority group, those aged 35 or older, those that are overweight or obese, or with pre-existing medical conditions, such as high blood pressure, heart disease, asthma and diabetes.
Those who experience severe complications from COVID-19 in pregnancy have a higher chance of stillbirth, that their baby’s growth will be impaired, and of delivering their baby prematurely.
COVID-19 vaccines are highly effective at reducing the chance of becoming unwell from COVID-19 and preventing hospitalisation. Through reducing the risk of severe illness, some studies have also shown that vaccination decreases the risk of stillbirth and premature delivery, and that booster doses may decrease the risk even further.
Are there any risks with having the COVID-19 vaccine during pregnancy?
High quality information about the safety of COVID-19 vaccines in human pregnancy is now available from several countries, with at least 170,000 completed pregnancies vaccinated against COVID-19 reported. These women mainly received the Pfizer/BioNTech or Moderna vaccines in the third trimester.
Pregnant women do not appear to get more adverse reactions to the vaccine than non-pregnant women.
Reassuringly, numerous studies which collectively include more than 170,000 vaccinated women have found that vaccination in pregnancy does not increase the risk of:
• Stillbirth
• Preterm delivery
• Problems with the baby’s growth
• Risk of the baby dying, experiencing other medical complications, or needing to attend hospital in the first month of life
There is less information about the safety of vaccination in early pregnancy. However, a small number of studies have found that vaccination in pregnancy does not increase the risk of malformation or miscarriage.
There is no known risk with using non-live, weakened or non-replicating vaccines in pregnancy, and all of the COVID-19 vaccines being used in the UK are non-live, weakened or non-replicating.
There is less information about the long-term safety of COVID-19 vaccination in pregnancy. However, experience with the use of other vaccines in pregnancy and knowledge about how COVID-19 vaccines work means that there is no reason to be concerned about long-term effects following vaccination in pregnancy. One large study has followed-up around 16,700 infants born to women who were vaccinated with the Pfrizer/BioNTech vaccine in pregnancy for an average of around 130 days after delivery (some for much longer, around 200 days). The information that is currently available does not suggest that COVID-19 vaccination in pregnancy increases the risk of hospitalisation or infant death.
Are there any alternatives to having a COVID-19 vaccination in pregnancy?
COVID-19 vaccines are currently the most effective option for decreasing the risk of severe COVID-19. Although COVID-19 antiviral medications may also reduce the risk of severe COVID-19, the safety of these medications in pregnancy is unknown.
What if I prefer not to have a COVID-19 vaccination in pregnancy?
Studies of unvaccinated pregnant women have shown that they were more likely to have severe COVID-19. Those who developed symptoms and needed hospital treatment were more likely to need intensive care treatment. They were also more likely to have a stillborn baby or give birth prematurely.
Given that unvaccinated pregnant women are a group at increased risk of severe COVID-19, and the available safety data are highly reassuring, vaccination is recommended for all pregnant women.
What is the latest guidance about COVID-19 vaccination in pregnancy?
All the latest advice about COVID-19 in pregnancy is available from the Royal College of Obstetricians and Gynaecologists here.
The Royal College of Midwives have produced an information leaflet about COVID-19 vaccines in pregnancy which is available here.
The UK Health Security Agency have published advice which is available here.
NHS guidance is available here.
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General information
Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks. They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.
Medicines use in pregnancy
Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby. There are, however, some medicines that can harm a baby’s normal development. How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.
If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.
When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.
Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.
www.medicinesinpregnancy.org