Pregnancy testing prior to vaccination
Public Health England’s Immunisation Against Infectious Disease (The Green book) advises that routine questioning about last menstrual period and/or pregnancy testing is not required before offering the vaccine. Women who are planning pregnancy or in the immediate postpartum can be vaccinated with a suitable product for their age and clinical risk group.
Fertility and pre-conception Covid-19 vaccine advice
The British Fertility Society and Association of Reproductive and Clinical Scientists have produced a document addressing questions asked about COVID-19 vaccines and fertility. This states that there is absolutely no evidence, and no theoretical reason that any of the vaccines can affect the fertility of women or men.
Joint Committee on Vaccination and Immunisation advises that women do not need to avoid pregnancy after vaccination.
Vaccination during pregnancy
The Green book advises that there is no known risk associated with giving inactivated, recombinant viral or bacterial vaccines or toxoids during pregnancy. Since inactivated vaccines cannot replicate, they cannot cause infection in either the mother or the fetus. Although AstraZeneca COVID-19 vaccine contains a live adenovirus vector, this virus is not replicating so will not cause infection in the mother or the fetus. UKTIS have produced a monograph on the use of non-live vaccines in pregnancy which provides further information.
The Green book states that women who are pregnant should be offered vaccination at the same time as non-pregnant women based on their age and clinical risk group. Pfizer BioNTech and Moderna vaccines are the preferred vaccines to offer to pregnant women based on extensive post-marketing experience of their use in the USA with no safety signals so far. Clinicians should discuss the risks and benefits of vaccination with the woman, who should be told about the absence of safety data for the vaccine in pregnancy. The RCOG have developed a range of information for healthcare professionals and pregnant women about COVID-19 vaccination.
If a woman finds she is pregnant after she has started a course of vaccine, she may complete vaccination during pregnancy using the same vaccine product (unless contraindicated). Alternatively vaccination should be offered as soon as possible after pregnancy.
Termination of pregnancy following inadvertent immunisation should not be recommended.
Surveillance of inadvertent administration in early pregnancy
This is being conducted for the UK by the Public Health England Immunisation Department.
You should report cases of inadvertent administration of COVID-19 vaccines in early pregnancy to Public Health England. Information collected will be used to better inform pregnant women who are immunised, their families and health professionals who are responsible for their care.
The Green book advises that women who are inadvertently vaccinated in early pregnancy should be offered a second dose of the same product where not contraindicated.
- Updated to reference new RCOG information resources
- Amended to include revised recommendations from JCVI and Green book
- Linked to updated RCOG information
- Link to UKTIS website added
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- Updated to include detailed British Fertility Society statement about impact on fertility.
- RCOG press statement removed as superseded by British Fertility Society statement
- Updated page reference and wording from Green book
- Updated to include RCOG statement about impact on fertility