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January 22, 2021

Updated advice on COVID-19 vaccination during pregnancy and breastfeeding

The Joint Committee on Vaccination and Immunisation (JCVI) have recently updated their guidance on COVID-19 vaccinations, including women who are pregnant and breastfeeding.
 
 

Vaccination during pregnancy

The vaccines are non-live vaccines, hence they cannot create infection in the pregnant women or the unborn child. The current data indicates there is no safety concerns associated with giving the Covid-19 vaccines during pregnancy.

 

Due to unavailability of data, routine use of COVID-19 vaccine during pregnancy is not recommended.

 

JCVI recommends vaccination in pregnancy where the risk of exposure to COVID-19 infection is high and cannot be avoided, or where the women have underlying conditions that put them at very high risk of serious complications of COVID-19.

 

Pregnant women who are at risk of exposure to COVID-19 such as frontline health or social care workers, including carers in a residential home, can discuss the option of vaccination, because “the risk of exposure to COVID-19 may be higher, even if they have a lower risk of experiencing complications if they are otherwise well.”

 

The JCVI now advises that if a pregnant woman has an underlying condition that may put her at very high risk of experiencing serious complications of COVID-19, then she should discuss the options of COVID-19 vaccination with her obstetrician and/or doctor. These clinically vulnerable groups include:

  • Solid organ transplant recipients;
  • Those with severe respiratory conditions including cystic fibrosis and severe asthma;
  • Those who have homozygous sickle cell disease;
  • Those receiving immunosuppression therapies sufficient to significantly increase risk of infection;
  • Those receiving dialysis or with chronic kidney disease (stage 5);
  • Those with significant congenital or acquired heart disease.

 

 

 

Vaccination for breastfeeding women

 

There is not known risk in the vaccine given to breastfeeding women. However, women should be advised on lack of safety data.

 

 

HFEA advise fertility clinicians to  discuss “the risks and benefits of vaccination with the woman, who should be told about the absence of safety data for the vaccine in pregnant women. JCVI does not advise routine pregnancy testing before receipt of a COVID-19 vaccine. Those who are trying to become pregnant do not need to avoid pregnancy after vaccination. Public Health England have also released guidance on COVID-19 vaccination for women of childbearing age, pregnant or breastfeeding. The Association of Reproductive and Clinical Scientists (ARCS) and British Fertility Society (BFS) COVID Group have released an addendum to the joint guidelines regarding COVID 19 vaccination”.

 

 

 

Summary

We do not know if the vaccine is safe in pregnancy or if it can be safely given if a woman is trying to conceive. However, on balance, if you are a front-line worker or at significant risk of developing COVID-19 and you would like to be vaccinated, it would be reasonable for you to do so. It has to be your choice and we are unable to advise further.

 

We will continue with fertility treatment as planned if you wish, although a precautionary approach would still be to wait 2 months after the second dose.

 

 

 

To read more please click on the links below:

 

JCVI: Joint Committee on Vaccination and Immunisation: advice on priority groups for COVID-19 vaccination, 30 December 2020 - GOV.UK (www.gov.uk)

 

HFEA: covid-19-clinic-faqs-15-january-2021.pdf (hfea.gov.uk)