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Pregnant women can get Covid-19 vaccine if they fall into other priority groups

There may be other factors that put pregnant women at risk of Covid-19, and in these cases, they can get vaccinated.

Image: Shutterstock/wavebreakmedia

THE GUIDANCE ON whether pregnant women can get the Pfizer-BioNTech Covid-19 vaccine has been changed slightly to clarify that if pregnant women fall into other priority groups, they can get vaccinated after consulting with a healthcare provider. 

The reason for this is related to pregnant women who have other conditions that put people at a higher risk of becoming seriously ill from Covid-19, such as diabetes, according to updated guidance from the Royal College of Physicians of Ireland (RCPI).

Women who consent to get vaccinated will be asked to confirm that they have consulted their care giver, an obstetrician, or GP, and have decided to receive the vaccine.

In separate guidance published by the HSE last week, it said that although the available safety data do not indicate any safety concern or harm to pregnancy, there is insufficient evidence to recommend routine use of Covid‐19 vaccines during pregnancy.

It says: 

Administration of Comirnaty [the Pfizer-BioNTech vaccine] in pregnancy should only be considered when the potential benefits outweigh any potential risks for the mother and foetus. Pregnant women at high risk of severe disease and healthcare workers should be referred to their obstetrician or GP to discuss the risks and benefits of Covid‐19 vaccine.

If the vaccine is being administered to a pregnant woman, the clinical guidance from the HSE is that the two-dose schedule should not begin before 14 weeks gestation, and should be done by 33 weeks gestation.

“This is a precaution to minimise any possible association with miscarriage or pre-term birth,” the advice states.

Initial guidance on pregnancy and the vaccine

In the Government’s initial plan for the rollout of the Covid-19 vaccine, society was divided into 15 priority groups. People under the age of 18 and pregnant women were in the last group to be vaccinated – after the generally well members of the population aged between 18-54. 

This was because in the clinical trials of the vaccine on humans, pregnant women were not among volunteers in the trials. Trials on animals beforehand showed no adverse affects on pregnancy, however.

The government’s plan states that children and those who are pregnant will get the vaccine “if evidence demonstrates safety and efficacy” – you can read the rationale in full in TheJournal.ie Covid-19 vaccination Q&A here.

After the plan was announced on 8 December, there were calls from women and representative groups to make the vaccine available to pregnancy women. Since 23 December at least, the advice has been tweaked slightly.

The advice now is that if you are pregnant you can get a Covid-19 vaccine if you fall into one of the other priority categories. 

For example, if you are a pregnant healthcare worker, you can talk to your doctor about the possibility of getting vaccinated as part of the first group to be vaccinated against Covid-19.

When TheJournal.ie asked the HSE for confirmation of the advice changing, it referred us to the Royal College of Physicians of Ireland (RCPI). In a statement, the RCPI said:

We concluded that risk of severe complications from Covid-19 infection varies among pregnant women as do other medical conditions (such as hypertension and diabetes) and risk factors (such as obesity, and age) which are known to influence Covid-19 outcomes.

“Pregnant healthcare workers are numerous in our workforce and their specific needs should be considered equally alongside their non-pregnant colleagues.

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“Assessment of risk by the individual needs acknowledgment, and the pregnant woman should be able to choose vaccination if she falls into a priority group.

Counselling by healthcare provider should balance available data on vaccine safety, risks to pregnant women from Covid-19 infection, and a woman’s individual risk for infection and severe disease. 

It added that it was working on information to help women make decision on what to do.

A list of extremely clinically vulnerable pregnant women includes the following, as published by the UK’s Joint Committee on Vaccination and Immunisation:

  • Solid organ transplant recipients
  • Those with severe respiratory conditions including cystic fibrosis and severe asthma
  • Those who have homozygous sickle cell disease
  • Those receiving immuno-suppression 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.

It added that while there is no data on breastfeeding after taking the Covid-19 vaccine, there is “no known biological mechanism to cause harm”; the HSE said that the Covid‐19 vaccine can be given to healthcare workers who are breastfeeding.

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