GPs told to cancel planned AstraZeneca Covid vaccine for pregnant women

GPs should cancel all planned AstraZeneca vaccinations for pregnant women, NHS England has said.

Pregnant patients should instead be given the Pfizer or Moderna jab, doctors were told in a letter sent out to all practices.

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The advice was given after the Joint Committee on Vaccination and Immunisation (JCVI) said on Friday that pregnant women should be offered the Moderna or Pfizer jab.

The JCVI said there is "no evidence" to suggest other vaccines [like AstraZeneca] are unsafe for pregnant women, but said "more research is needed". 

NHS England told GPs yesterday that pregnant women should be redirected to a PCN site if there is no available alternative to the AstraZeneca vaccine for them.

It added in its letter that "all vaccination sites should implement screening procedures" to better identify pregnancies in patients.

And if a mum-to-be has already received her first dose of any vaccine – including the AstraZeneca vaccine – a second dose should "continue as planned".

This is in line with the Green Book, which states that if "a woman finds out she is pregnant after she has started a course of vaccine, she may complete vaccination during pregnancy using the same vaccine product (unless contra-indicated)".

Are pregnant women at risk of Covid?

Current evidence from the UK suggests that pregnant women are at no greater risk of catching the coronavirus compared with other healthy adults.

The majority of pregnant women experience only mild or moderate symptoms.

But overall, pregnant women may be at increased risk of becoming severely unwell compared to non-pregnant women, particularly in the third trimester.

Studies have shown that there are higher rates of admission to intensive care units for pregnant women with Covid compared to non-pregnant women.

Pregnant women are on the moderate risk (clinically vulnerable) list as a precaution.

The NHS says: "If you're at moderate risk from coronavirus, it's very important to follow social distancing advice to reduce your chances of catching or spreading the virus."

Information about all pregnant women with Covid is tracked in a registry called the UK Obstetric Surveillance System.

It has shown that women who did become severely ill were in their third trimester of pregnancy.

Risk factors included being over the age of 35, having a high BMI or underling health condition, and being from Black, Asian or ethnic minority background.

Studies suggest Covid is unlikely to cause problems with the baby, either causing miscarriage or problems after birth.

But global reports say babies have been born prematurely to women with severe Covid.

Source: The Royal College of Obstetricians and Gynaecologists

GPs should still discuss the risks and benefits of vaccination with each pregnant woman presenting for the jab, the letter said, and where necessary the person should be redirected to an obstetrician, midwife or GP team for further guidance, Pulse reports.

It also advised PCN sites to jab eligible mums-to-be with the Pfizer vaccine through excess supply from second dose clinics.

It comes after the JCVI guidance advised that it was "preferable" for pregnant women in the UK to be offered the Pfizer or Moderna vaccines where available.

It said in a statement on Friday: "There have been no specific safety concerns identified with any brand of coronavirus (Covid-19) vaccines in relation to pregnancy.

"Real-world data from the United States shows that around 90,000 pregnant women have been vaccinated, mainly with mRNA vaccines including Pfizer-BioNTech and Moderna, without any safety concerns being raised."

The JCVI added that there is "no evidence" to suggest that other vaccines are unsafe for pregnant women, but said "more research is needed". 

Many women have previously chosen to avoid the Covid vaccine due to a lack of evidence on its impact on pregnancies.

But experts have now confirmed that the jabs are safe to be offered to all expecting mums in line with recommendations already put in place by the Joint Committee on Vaccination and Immunisation (JCVI).

Professor Wei Shen Lim, Covid-19 chair for JCVI, said: "We encourage pregnant women to discuss the risks and benefits with their clinician – those at increased risk of severe outcomes from Covid-19 are encouraged to promptly take up the offer of vaccination when offered.

"There have been no specific safety concerns from any brand of Covid-19 vaccines in relation to pregnancy.

"There are more real-world safety data from the US in relation to the Pfizer-BioNTech and Moderna vaccines in women who are pregnant – therefore, we advise a preference for these to be offered to pregnant women."

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