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Maternity Royal Colleges express concern about access to COVID-19 vaccines for pregnant women, following change in guidance around the Oxford AstraZeneca vaccine

News 7 May 2021

The Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) have today expressed concern that pregnant women invited for vaccination are still struggling to access the right COVID vaccine for them. It comes as the Joint Committee on Vaccination and Immunisation (JCVI) and the Medicines and Healthcare Products Regulatory Authority (MHRA) have advised that all people under 40 should not be offered the Oxford AstraZeneca vaccine. 

The announcement today follows news on the 9 April 2021 that all under-30s should be offered either the Pfizer-BioNTech or Moderna vaccine, due to the evidence linking the Oxford AstraZeneca vaccine to rare blood clots more often in this age group.

On 16 April 2021, the JCVI announced it would be routinely offering all pregnant women the COVID-19 vaccine in line with the vaccine roll out plan for the UK, as real-world data from the US – where around 90,000 pregnant women have been vaccinated mainly with mRNA vaccines, such as Pfizer-BioNTech and Moderna – have not raised any safety concerns. The Committee advised that pregnant women in the UK should be offered the Pfizer-BioNTech or Moderna mRNA where available.

The statements from JCVI and MHRA have consistently made it clear that the risk of an extremely rare adverse event of concurrent thrombosis (blood clots) and thrombocytopenia (low platelet count) following vaccination is not directly linked to increased prothrombotic risks. Although younger women who are pregnant, recently pregnant, or on fertility treatment are all at increased thrombotic risk, the lack of a clear direct association between a thrombotic risk and the likelihood of this extremely rare adverse event should be considered.

Dr Pat O’Brien, Vice President at the Royal College of Obstetricians and Gynaecologists, said:

“We understand how confusing and difficult it has been for many pregnant women trying to access specific COVID-19 vaccines since the JCVI announced it would be routinely offering pregnant women the vaccine in line with the vaccine roll out plan for the UK..

“As the government’s vaccination programme continues to roll out through the younger age groups, more and more pregnant women will become eligible for the vaccine. Following the latest announcement today, we urge government and the NHS to ensure there is a system in place that enables pregnant women – including those over the age of 40 who have already been invited to book their vaccine – to easily access alternative vaccines.

“The latest government guidance for pregnant women is to contact their GP for advice on how to receive the appropriate vaccine. However GP practices are reporting that they don’t have the ability to do this, leaving pregnant women feeling frustrated and helpless as they are passed from pillar to post.  

“Healthcare professionals offering COVID-19 vaccination should continue to discuss the benefits and risks, including the side-effects, with pregnant and postnatal women and for those about to start - or who have started - fertility treatment. This should include discussion of the different vaccine types available, including the extremely rare adverse thrombotic events.”

Responding to the announcement, Mary Ross-Davie, Director of Professional Midwifery at the Royal College of Midwives (RCM), said:

“The NHS online booking system in England is letting down pregnant women, causing understandable anxiety and frustration. The speed of the rollout for the vaccine has been world-leading, but it needs the systems in place to keep pace. It’s distressing to hear of pregnant women being unable to access a vaccine centre that carries either the Pfizer BioNtech or Moderna vaccine. That is not acceptable.

“It is vital that pregnant women who have made the decision to be vaccinated and who are eligible to receive it, do not come up against these kind of organisational barriers. 

“As well as getting the right systems in place, healthcare professionals, from GPs to midwives, must ensure they are providing the most up-to-date information. We absolutely understand that this continues to be a fast moving situation, but we all owe it to the pregnant women in our care to ensure that we are giving them the best advice to enable them to make an informed choice. Pregnant women can receive the vaccine, and many of them will want to. We all have a role to play in helping them to do so.”

ENDS

For media enquiries please contact the RCOG press office on +44 (0)7986 183167 or email pressoffice@rcog.org.uk

To contact the RCM Media Office call 020 7312 3456, or email media@rcm.org.uk.

Notes to editors:

The RCOG have developed a range of information on our website for healthcare professionals and pregnant women eligible for COVID-19 vaccination.

The Faculty of Sexual and Reproductive Heathcare has released the following statement on the AstraZeneca COVID-19 vaccine, combined hormonal contraception and blood clots.

The Association of Reproductive and Clinical Scientists (ARCS) and British Fertility Society (BFS) U.K. statement on Covid-19 vaccine from 9th April 2021 can be viewed here.

The RCOG is a medical charity that champions the provision of high-quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision.

The RCM is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team. We provide workplace advice and support, professional and clinical guidance, and information, and learning opportunities with our broad range of events, conferences, and online resources. For more information visit the RCM website.