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The Joint Committee on Vaccination and Immunisation (JCVI) has advised that 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.
The Joint Committee on Vaccination and Immunisation (JCVI) has advised that 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.
The update to the JCVI advice provides reassuring and welcome news for pregnant women and families. In pregnant women hospitalised with COVID, outcomes are worse than for non-pregnant women with the disease, including a higher risk of death. There is also evidence pregnant women with COVID have higher rates of ICU admission. Little is also known of the long-term effects of COVID-19 on the mother and the baby. Although, pre-approval vaccine clinical trials did not include pregnant women, large post-marketing US datasets coupled with reassuring developmental and reproductive toxicity studies for both Pfizer-BioNTech and Moderna make a compelling impact on the risk: benefit assessment for pregnant women.
Emerging data also shows COVID-19 mRNA vaccines generate robust humoral immunity in pregnant and lactating women. Sponsors should work with regulators to release rolling updates from pregnancy registries and phase 4 datasets to ensure clinical dilemmas in pregnancy are solved on the foundation of solid evidence, rather than guesswork.
Pregnant women deserve access to prophylactic immunisation and this momentum should now extend to including pregnant and breastfeeding women in the clinical development plans for COVID-19 treatments too.
This latest advice from the JCVI will ensure that pregnant women are not, paradoxically, the only adults in the UK who cannot choose to be vaccinated against covid-19. We know that over the last year more than 5000 pregnant women admitted to hospital have been diagnosed with covid-19. Around one in ten pregnant women admitted with symptomatic covid-19 has needed intensive care and around one in five have had a premature birth as a consequence. Most pregnant women recover but sadly around one in 200 admitted to hospital with covid-19 has died.
There is now substantial real world evidence, mostly from the US, that Pfizer and Moderna vaccines can be used safely in pregnancy, which has informed the JCVI decision to suggest that these vaccines should be offered to pregnant women where available.
It is important that pregnant women are enabled to have a discussion about their own potential risks of covid-19 alongside the benefits of vaccination – we know, for example, that older pregnant women, pregnant women who have other health conditions such as high blood pressure or diabetes, and pregnant women who are overweight or obese are more likely to be admitted to hospital with covid-19 – to allow them to make an individual choice about vaccination.