Pregnant women have been made a priority group for vaccination following research showing they are vulnerable to more serious illness and pregnancy complications if they are infected with Covid-19.
The vaccines watchdog, the Joint Committee on Vaccination and Immunisation (JCVI), announced on Thursday that pregnant women would be moved into priority group 6 alongside adults under the age of 65 who have long-term health conditions, and urged pregnant women to get first and second doses and booster jabs as soon as possible.
Prof Wei Shen Lim, the chair of JCVI Covid-19 immunisation, said there was no evidence linking vaccination in pregnancy to risk of miscarriage, stillbirths, congenital abnormalities or birth complications. “Having a UK approved Covid-19 vaccine is safer than having Covid-19 itself,” he said. “Women who are pregnant are strongly encouraged to have a first, second or booster vaccine dose as appropriate in order to better protect yourself and your baby from any serious consequences from Covid-19.”
Maternal health experts, who have repeatedly called for pregnant women to be prioritised, questioned whether the move would make a material difference to the ability of pregnant women to access vaccines.
In a joint statement the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists welcomed the recognition that pregnant women were an at-risk group, a move they had called for. But they called for access to vaccines for pregnant women to be improved, including by offering vaccination in all antenatal clinics.
The JCVI’s decision was underpinned by research from the University of Oxford showing that women in the later stages of pregnancy and their babies were at increased risk if they became infected.
The research found that 17 pregnant women died during the Delta wave of the pandemic – a 50% increase in maternal mortality compared with usual. It also found that of 1,436 pregnant women admitted to hospital during the Delta wave, 33% required respiratory support, about 2% had a stillbirth, 2% had pregnancy loss and about one in five had a preterm birth. Nearly 96% of these women were unvaccinated.
Marian Knight, a professor of maternal and child population health at the University of Oxford and chief investigator of the study, said the data revealed that outcomes for pregnant women had got worse with successive waves of the pandemic. “However, it also shows the very strong protection that receiving a vaccination provides,” she said. “With several hundred thousand pregnant women across the world having received a vaccine, it is clear that vaccination in pregnancy is safe. As infections increase, pregnant women can be reassured that getting a vaccine is the best way to protect them and their babies.”
Pregnant women are less likely than the general population to have been vaccinated. In August, when pregnant women had to wait until their age group became eligible, only 22% of women who gave birth in England had received a single dose, and 25% in Scotland and 18% in Wales. The proportion has increased since then, but pregnant women are still disproportionately less likely to be vaccinated, with the lowest rates seen in those from black and minority ethnic groups. The royal colleges are calling for the government to set new targets for increasing vaccination uptake in pregnancy.
The JCVI said there was also concerning evidence that clinical staff had been hesitant to treat pregnant women, even when severely ill, with effective drugs such as dexamethasone due to unfounded concerns about the foetal risk.
Gayatri Amirthalingam, from the UK Health Security Agency, said vaccines recommended for pregnant women had a good safety record. “I would urge all pregnant women to come forward and get their vaccine without delay,” she said. “This is the best way to protect you and your baby.”
Joeli Brearley, the founder of the campaign group Pregnant Then Screwed, said the latest announcement was “too little too late”. “We have known for over a year that pregnant women are more vulnerable and we have repeatedly called on the government to prioritise this group of women,” she said. “Had they done this from the outset then many more pregnant women would be vaccinated. Instead, months later, they shove them in priority group 6 without any practical plan as to how they will access the jab or the booster.”
