COVID-19 vaccinations during pregnancy: coverage and safety

1. In a cohort of pregnant women in the United Kingdom, COVID-19 vaccines did not alter perinatal outcomes.

Evidence Rating Level: 2 (Good)

The Coronavirus disease 2019 (COVID-19) has caused significant morbidity and mortality across the world. Mass vaccination has been a key strategy used by countries to help control the pandemic. Based off prior studies, COVID-19 vaccinations are concluded to be safe to administer during pregnancy. However, pregnant women are reluctant to receive the vaccines and guidance to healthcare providers has not been consistent. Therefore, this cohort study aimed to evaluate the uptake and safety of COVID-19 vaccines amongst pregnant women. The study retrospectively identified 1328 pregnant women that were eligible to receive a COVID-19 vaccine who delivered at St. George’s University Hospital between March and July 2021. The primary outcome measured was COVID-19 vaccine (Pfizer/BioNTech, Moderna, or Oxford Astra Zeneca) uptake among eligible women. Among this cohort, vaccination was accepted by 141 (28.7%) of 492 eligible women. Of those vaccinated, 128 received (90.8%) an mRNA vaccine (Pfizer/BioNTech or Moderna) and 13 (9.2%) received a viral vector vaccine (Oxford Astra Zeneca). Antenatal vaccine uptake was lower amongst women with maternal age below 30 years old (OR, 0.37; 95% CI, 0.15–0.90; P  =0.025), Afro-Caribbean ethnicity (OR, 0.25; 95% CI, 0.08–0.60; P = 0.005), and obesity (OR,  0.55;  95%  CI,  0.29–1.00;  P = 0.058). The secondary outcome measured was perinatal outcomes to assess safety, which included stillbirth, neonatal death, fetal abnormalities, intrapartum complications, birth weight, mode of birth, maternal intensive care unit admission, or neonatal intensive care unit admission. The study found that there were no significant differences in intrapartum complications or perinatal outcomes between women who did (versus those who did not) receive a COVID-19 vaccine during pregnancy. Although this study adds to the data supporting the safety of COVID-19 vaccination during pregnancy, larger randomized controlled trials involving pregnant women are needed to validate these results. Additionally, it demonstrates that public health measures need to be implemented to achieve better uptake rates in this population.

Click to read the study in JOG

Image: PD

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