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Covid-19: Vaccines and Pregnancy

Volume 812: debated on Monday 14 June 2021


Asked by

To ask Her Majesty’s Government when they will (1) analyse, and (2) regularly share, data relating to the safety of the use of COVID-19 vaccines in pregnant women with the Royal Colleges and other relevant parties.

My Lords, it is vital that we know what treatment is appropriate and safe for pregnant women, so it is imperative that clinical trials are inclusive of this group where possible. The current advice to vaccinate pregnant women is based on a US real-world study of more than 125,000 people. Recruitment to the first Covid vaccine study in the UK involving pregnant women was launched on 17 May. In addition, adverse reaction reports on Covid-19 vaccines in pregnant women are collected by the MHRA, carefully assessed and reviewed.

My Lords, I thank my noble friend for that Answer. I must say, though, that there is a lot of concern among the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives that the take-up of the vaccination among pregnant women is not routinely published. I would like to know from my noble friend what the real commitment to doing this is, what proportion of pregnant women have been offered a vaccine, what proportion of those women have accepted it and what proportion of them have had two doses. What is the mechanism for linking this data with follow-up in relation to the outcomes for women and their babies?

My Lords, my noble friend made a clear case for the importance of improving the way in which patient data is collected and analysed in this country. It is something that we are working on at the moment. She highlights a very difficult situation. A third of women do not know that they are pregnant, of course, and, when they are pregnant, their data is first caught at the hospital where they decide to have their birth. Those databases are not easily linked. We do not have a countersignal for pregnancy at the moment; it is therefore not an acute priority. However, I take my noble friend’s point and will look into it further.

My Lords, I declare an interest as chair of the trustees of the Royal College of Obstetricians and Gynaecologists. The RCOG survey found that more than half of those who declined the vaccine did so because they were waiting for more information about the safety of the Covid-19 vaccination during pregnancy. Will the Government, as a matter of urgency, issue guidance to all pregnant mothers explaining that the vaccination will not harm their unborn babies? Will they also provide facilities for pregnant women to be vaccinated at antenatal clinics as a mechanism to increase the take-up of vaccinations by pregnant women?

I am extremely grateful for those constructive suggestions from the noble Baroness. We have a very large amount of materials specifically for pregnant women, including guidance for pregnant women and a guide for women who are of childbearing age, pregnant or breastfeeding; those are widely distributed by GPs. However, as I said, a lot of pregnant women do not know that they are pregnant, so it is not possible to reach all of them all the time. At the moment, our priority is to ensure that those aged over 50 take their second jab. We will sweep up other demographics, and we will make that a priority when we reach it.

A close family member rang her surgery to ask for advice about being called for vaccination while breastfeeding. They said that it was nothing to do with them and told her to ring the main vaccine booking line. That person said, “Just ask the person who vaccinates you”, who said, “Oh, I don’t know. I’ll have to check”. Last week, Channel 4 reported that this is a widespread problem for pregnant and breastfeeding mums. It is evident that there is no clear guidance for front-line staff on what to tell mums. Can this be remedied as a matter of urgency?

The noble Baroness alluded to a problem that is, I am afraid, commonplace in the healthcare system: an acute sensitivity about giving advice to those who are pregnant because people are very concerned about giving the wrong advice, which sometimes leads to no advice being given. We are aware of this problem but I assure the noble Baroness that material is given to those on the front line—I have mentioned some of the materials that we have published—and GPs have all that material at their disposal. We have recognised this problem, we have moved on it and we are making as much material as possible available to the right people.

My Lords, I hope that noble Lords can see me because I do not seem to be being picked up very well. Can the Minister comment on what additional steps are being taken to publicise the up-to-date position to women who are either trying for a baby or are pregnant? Is this information being shared with the organisations in this field, such as the National Childbirth Trust and Mumsnet, to share with their communities?

My Lords, the up-to-date advice is this: get the vaccine. That is absolutely being promoted very widely.

My Lords, if the up-to-date advice is “Get the vaccine”, which is exactly what it should be, what work is being done to assess the effect on women of having Covid during their pregnancy? What is the effect on the child? Is there any research on that?

My Lords, the noble Baroness points to one of the challenges of longitudinal research: the babies have not been born for very long, of course. We need to do long-term studies to understand the effect. There is no evidence at all of a negative outcome but we will need to monitor that; research resources will be dedicated to looking at it.

To tackle the risk of stillbirths and emergency Caesareans among mothers who are giving birth and have contracted Covid-19, as we see the vaccination programme extend further—particularly into the younger age groups—will the Minister look at prioritising pregnant women for vaccinations? I refer particularly to women in the later stages of pregnancy.

My Lords, the JCVI has a clear set of prioritisation protocols, which we are sticking to. The fact of being pregnant does not seem to have a direct impact in terms of severe disease or death, so there is no clear evidence at the moment for putting in or changing the prioritisation of pregnant women. However, we constantly review that and we are naturally concerned to protect both the mother and the child.

The Minister referred to women who do not know that they are pregnant. The place where women go to find out whether they might be is a pharmacy. What are the Government doing to make sure that pharmacies are places where women can access accurate information and guidance?

The noble Baroness is entirely right. Pharmacies have played an absolutely critical role in the vaccine rollout, and we owe them huge thanks for their contribution. Pharmacists have undertaken a huge amount of training in both the delivery and explanation of the vaccine. I attribute some of the success of the vaccine programme to the extremely effective communication from pharmacists on all aspects of the vaccine, including relating to pregnancy.

My Lords, would it not be a good idea if the Chief Nursing Officer and the Chief Midwifery Officer gave a conference from Downing Street to reinforce the message that the Minister has given today about the safety of the vaccine? Can he tell me what the Government are doing specifically about the conspiracy theories going round in relation to safety risks to mothers and babies?

My Lords, when it comes to conspiracy theories, we have found that the best people to communicate on that are those who women and mothers trust and are dealing with during their pregnancy, typically their nurses and doctors. We have ensured that all the right materials are there, so that difficult questions can be answered in a collaborative dialogue. That is the most effective way of dealing with this.

My Lords, can the Minister comment on or indicate the extent of the level of co-operation between the UK Government and the devolved Administrations regarding vaccination take-up and pregnant women?

My Lords, the vaccine programme has worked extremely well across all the nations of the UK, and there is a huge amount of collaboration, particularly between the CMOs. Material is routinely shared between all the countries, and I am not aware of any differential outcomes in any particular part of the UK.