The Institute of Obstetricians and Gynaecologists welcomes new NIAC recommendations that pregnant women should be offered mRNA COVID-19 vaccination between 14-36 weeks gestation following an individual benefit/risk discussion with their obstetric care giver.
Pregnant women are at similar risk of COVID-19 infection to non-pregnant women of the same age. The overall risk of severe illness in pregnancy is low. However, pregnant women with COVID-19 infection are more likely to develop serious disease or to die than either pregnant women without COVID-19 or similar aged non-pregnant women with COVID-19. Additionally, COVID-19 in pregnancy may increase the risk of adverse pregnancy outcomes, such as preterm birth, compared with pregnant women without COVID-19.
Dr Cliona Murphy, Chair of the Institute of Obstetricians and Gynaecologists said: “The NIAC recommendations mean that every pregnant woman is enabled to make an individual decision based on benefits and risks. Vaccination offers pregnant women the best protection from COVID-19, which can be very serious in some women. We believe that pregnant women should be supported in making an informed decision regarding whether to accept or not.
We are beginning to see the impact of COVID vaccines in society, which are reducing the incidence of COVID-19 infections in the community which will be protective for pregnant women. Current clinical advice is for pregnant women to notify their treating hospital if they test positive for COVID-19, so as to ensure appropriate follow up, and to present early if there are concerns regarding reduced foetal movements. Pregnant women should continue all measures to avoid contracting COVID-19 infection”.
In Ireland, the epidemiology of intensive care admissions in pregnant and postpartum women with COVID-19 changed between the first and subsequent waves. COVID-19 in pregnancy is a risk factor for admission to ICU and although absolute numbers are not high, they are disproportionate to the number of pregnant women in the population. There is evidence of an increase in premature delivery and in the stillbirth rate in Ireland and the UK in 2021.
There is no evidence that any COVID-19 vaccine affects fertility or the foetus. No unexpected pregnancy or infant outcomes have been observed related to COVID-19 vaccination during pregnancy.
There is limited data regarding efficacy of vaccines in pregnancy but no evidence to show they are less efficacious than in the population. Emerging data indicates that the maternal COVID-19 antibodies can cross the placenta, which may offer neonatal protection. Pregnancy is a time sensitive condition. There is a specific window during which vaccination can be offered (14-36 weeks). The HSE will administer the implementation of the NIAC recommendations.
Chapter 5A of the HSE Immunisation Guidelines includes a section on COVID-19 Vaccines and pregnant women. You can view the guidelines here.