Since the first Covid-19 vaccines were administered in the UK, their effects on various demographics have been scrutinised. At the time (December 2020), the UK was the first Western country to license a vaccine against the virus - the Pfizer/BioNTech vaccine - which was offered to those most at-risk and authorised for emergency use by the Medicines and Healthcare products Regulatory Authority (MHRA). Large-scale clinical trials had shown Pfizer’s Covid-19 vaccine was 95% effective at preventing the disease and the Oxford/AstraZeneca and Moderna vaccines followed shortly afterwards with similarly positive results. Concern surrounding the AstraZeneca vaccine emerged in March 2021 when a correlation surfaced in relation to blood clots in patients who had received the vaccine. Fortunately, the risk was found to be mild and affected predominantly younger - and therefore more resilient - groups.
Covid vaccinations have since been largely unhindered in the UK with more than 49 million people in the UK now fully vaccinated. However one group stands out as being consistently more hesitant towards receiving a vaccine than others: pregnant women. This report released by the Government's UK Health Security Agency documents the effects of Covid-19 vaccines on pregnant patients and addresses all concerns with regards to speculation over their safety.
An initially cautious approach was taken when advising women on the potential risks of contracting Covid or being vaccinated while pregnant because there was too little data to show its effects. This approach categorised pregnant women as immuno-compromised due to fluctuations in their immune responsiveness throughout pregnancy. It was appropriate to categorise them this way because data collected from the first wave of Covid-19 in England and Scotland showed an increased severity of symptoms among pregnant women resulting in higher intensive care admission rates within their demographic. Pregnant women were almost three times more likely to be admitted to ICU after contracting the virus and deaths were around 25% more likely.
Vaccines have since - and are still - recommended for pregnant women by all healthcare professionals including the NHS, the Joint Committee on Vaccinations and Immunisations and the Royal College of Obstetricians and Gynaecologists as the best way to protect themselves and their baby from Covid-19. These conclusions were drawn in April 2021 following evidence from clinical research in the US suggesting that mRNA vaccines provide some immunity to children in their first months after birth, with participants under six months of age experiencing lower rates of Covid-related hospitalisations.
Vaccine rates in pregnant women today
Vaccination rates for pregnant women in the UK have slowly increased over time with the latest data in December 2021 seeing 53.7% of women giving birth having been vaccinated and 43.3% of them having received both doses of an approved vaccine. These rates are shown to be higher among expectant mothers aged over 35 with more than half of them having received two doses.
But why is the rate of vaccination among pregnant women just over half?
2021 Vaccine Coverage Statistics showed that expectant mothers under the age of 20 had the highest rates of vaccine hesitancy with 81.4% being completely unvaccinated at the time of delivery. An article on the topic by the Guardian published in July 2021 shortly before these statistics were collated cited ‘mixed advice’ as the primary cause of vaccine hesitancy. It claimed that some pregnant women faced discouragement from healthcare providers in recommending new, unfamiliar vaccines. Vaccine coverage is also commonly lower among pregnant women of black ethnicity (24.9% having one dose) and pregnant women living in deprived areas (32.7% with one dose) revealing societal inequalities in relation to accessible healthcare and education. What is clear, however, is that pregnant women are not opposed to vaccinating themselves after birth: 38.5% of women who were unvaccinated when they gave birth between October to December 2021 went on to be vaccinated post-partum.
What the evidence says
Despite the rate of vaccinations among pregnant women in the UK creeping up slowly over the last year, the evidence has remained steady.
There are no safety concerns relating to the vaccination of pregnant women against Covid-19 to date.
The likelihood of vaccine side-effects is similar in pregnant and non-pregnant populations.
Stillbirths, low birthweight and premature delivery are similar or less likely in vaccinated women during pregnancy compared to unvaccinated pregnant women.
And in fact, a study in Scotland reported that unvaccinated pregnant women accounted for over 90% of Covid hospital admissions, 98% of Covid-related critical care admissions and all baby deaths.
Covid vaccinations for pregnant women in the UK have been approved for over a year. This means that where uncertainty sparked hesitancy before, the evidence on vaccine safety is now greater and broader. Research on their efficacy and assessments as to the benefits and risks they present will continue. But what we know now is that the benefits in vaccinating against Covid-19 for pregnant mothers and their unborn babies are numerous: they include providing invaluable antibodies to protect mother and baby from the dangers of contracting the virus. More than 200, 000 women in the USA have indicated they were pregnant when receiving their first vaccination dose up to 14 March 2022, you can - and should - too.