Why pregnant women need clearer messaging on Covid vaccine safety

In the early stages of the coronavirus pandemic, there was uncertainty around almost everything, from who was more adversely affected by Covid-19 to who should get vaccinated first – or at all.

But as awareness about the illness and vaccine safety has grown, one group in particular remains confused and torn about the risk of immunisation: expectant mothers.

Latest figures from Public Health England show the numbers getting fully vaccinated within this group are still worryingly low: more than 84,000 have received their first dose, with about 67,000 receiving both doses. The Royal College of Obstetricians and Gynaecologists (RCOG) says just 15% of pregnant women have had two doses of the vaccine so far.

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Women have cited many reasons for their reluctance to get jabbed, including a lack of long-term information about the dangers of the vaccine to their child, healthcare providers giving unclear messaging around safety and misinformation being spread on social media.

Dr Pat O’Brien, consultant obstetrician and vice-president of the RCOG, said the number of pregnant women getting two doses remains “disappointing” given the fact there is much more evidence now on the safety of immunisation. “The reluctance is partly women being reluctant to take any medicine during pregnancy but also the initial advice was that they needed to be cautious about immunisation,” he said.

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Pregnant women are more at risk of respiratory illnesses such as flu, he said, because their immune system is suppressed. Another reason Covid is more dangerous while pregnant is that, as the baby gets bigger, a woman’s lungs are squashed by the womb so they cannot breathe as deeply, making it harder to clear infections.

Pregnant women with Covid have a one in five chance of delivering their baby prematurely and an increased risk of stillbirth, O’Brien said.

One soon-to-be mother, who asked not to be named, said she had already had coronavirus, suffering a mild reaction, so was less concerned about catching it again. Due to a lack of long-term data on the impact of immunisation, she will not be getting inoculated. “I suppose the testing that has been done for pregnant women is not that extensive,” she said.

She has had two miscarriages so is especially cautious. She said that while a lot of people blamed low uptake on conspiracy theories, she believed it was due to the lack of robust information from health professionals about the benefits.

But O’Brien said the message was now getting to frontline staff to promote vaccinations. “On the ground, we are seeing a change in atmosphere. Before, there was a real reluctance to get vaccines but now with the latest evidence of their benefits, the mood seems to be changing and I hope to see a change in figures and uptake as winter comes,” he added.

Nisha Prasad, 39, an NHS doctor who has recently given birth, said she was happy to be vaccinated but felt it was a difficult process to navigate and the onus was on her to get information.

“And I say this is as a medical professional. So I completely understand the perspective of many women who have chosen not to be vaccinated until after delivery because it wasn’t made clear from the outset,” she said. “But this decision also means that pregnant women must continue to live under strict Covid precautions, which just isn’t feasible now that there are minimal restrictions in place.”

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Joeli Brearley, founder of the charity Pregnant Then Screwed, would like to see a campaign from the government to increase uptake before winter. She said a new and emerging issue was pregnant women being told to travel long distances for second doses of the vaccination due to local centres prioritising booster jabs.

“We get at least 10 messages a day with problems about conflicting information being given to women or about people being unable to access vaccines,” she said.

Prasad agrees now is the time to take action: “As we are now entering autumn and winter, many women of a similar gestation to me are in a situation where they are unvaccinated but need to access hospital for frequent antenatal checks or are even admitted for delivery. This puts them in a very vulnerable position at what is already a very anxiety-provoking time.”