Pregnant woman sitting on a yoga mat.

The Royal College of Gynaecologists & Obstetricians (RCOG) and The Royal College of Midwives (RCM) recommend Covid-19 vaccination in pregnancy. Vaccination is the best way to protect against the known risks of Covid-19 in pregnancy for both mother and baby. Find out more below.

Why is it important to consider the vaccine if you're pregnant?

While more than half of pregnant women who test positive for Covid-19 have no symptoms, some pregnant women can get life-threatening illness from Covid-19. This is especially the case if they already have underlying health conditions.

You’re at increased risk of becoming very unwell with Covid-19 in the later stages of pregnancy, and 1 in 10 pregnant women admitted to hospital with symptoms of Covid-19 need intensive care.

What’s more, if you’re pregnant and get Covid-19, it’s twice as likely your baby will be born early. You’re also more likely to develop pre-eclampsia, and more likely to need an emergency caesarean. Your risk of stillbirth is also twice as high, although this number still remains low (AJOG, 2021).

No pregnant women who have received both doses of the vaccine have been admitted to hospital since the vaccination programme began (RCOG, 2021; RCOG & RCM 2021). This Royal College of Midwives (RCM) leaflet has clear information on the Covid-19 vaccination during pregnancy.

Who can have the vaccine?

All pregnant women can have the vaccination (JCVI, 2021).

The decision on whether to have the vaccination is your choice. You can find further information on this This Royal College of Obstetricians and Gynaecologists (RCOG) info sheet which is there to help you make a personal decision. There's also this easy to read leaflet about the vaccination if you're pregnant or breastfeeding. You can discuss the benefits and risks of vaccination in pregnancy with a trusted person like your doctor or midwife. 

Further information can be found on the RCOG website here and here, or scan this QR code for the RCOG info sheet. 

RCOG decision aid QR code.

What is the evidence of safety?

Although clinical trials involving pregnant women in the UK are still underway, over 160,000 women in the US have been vaccinated mainly with mRNA vaccines (these include the Pfizer BioNTech and Moderna vaccines). More than 100,000 pregnant women have received a Covid-19 vaccination in England and Scotland. There haven't been any safety concerns reported following these vaccinations (RCOG, 2021; NHS 2021).

There is no evidence to suggest that the Covid-19 vaccines increase the risk of miscarriage or stillbirth. Six studies worldwide show the rates of miscarriage were the same in those who'd had the Covid-19 vaccination compared to the general population (RCOG, 2021).

Can I get vaccinated at any time during pregnancy?

The vaccination should work and is considered safe at whatever stage of pregnancy you are in. There is no evidence that delaying until after the first 12 weeks is necessary.

Some pregnant women have said they'd rather wait until after 12 weeks. However, as Covid-19 can be more serious in later pregnancy, it would then be important to have the vaccination soon after and before the third trimester. Second doses are given 8 weeks after the first dose. It is recommended that you receive both doses before giving birth and ideally before entering the third trimester. RCOG (2021)

How do I arrange to have the vaccination?

If you are pregnant and over 18, you can log onto the NHS website and book a vaccination

On the national booking page, there is an option to say that you are pregnant. This will mean you are offered an appointment at a centre with the type of vaccinations recommended for pregnancy. You can then discuss the risks and benefits of vaccination with your doctor or nurse. GOV.UK (2021)

Will having the vaccine give me Covid-19?

The Covid-19 vaccines we use in the UK are not 'live' and so do not cause a Covid-19 infection in you or your baby. 

Which vaccine will I have?

Because mRNA jabs, such as the Pfizer BioNTech and Moderna vaccines, have been used for over 148,000 pregnant women in the US without safety concerns, the JCVI is recommending that these vaccines should preferably be offered to pregnant women.

This is rather than the AstraZeneca vaccine, which hasn't been given in the US. Although there is no evidence to suggest it is unsafe to give to pregnant women, the JCVI says more research is needed. GOV.UK (2021)

At the same time, the government had also advised that people under 30 should be offered an alternative vaccine to the AstraZeneca vaccine because of the benefit to risk ration of that group. This is because of the reports that about four (non pregnant) people have experienced serious blood clots for every million doses of this vaccine.

What if I don't want the vaccine, will I lose my protection at work as an at-risk person?

You shouldn’t be put under any pressure to have the vaccine or not have the vaccine. Whether you are vaccinated or not, your employer is required to carry out a risk assessment with pregnant employees that considers the RCOG and RCM guidance on coronavirus in pregnancy HIFN (2021).

I’ve read on a forum that I shouldn’t have the vaccine – is this true?

You may find the decision on whether or not to get vaccinated an emotional and difficult one to make. But be aware that many messages on online and other forums are based on individual opinion and not on scientific evidence.

Speak to a health professional about the vaccine to get up-to-date and reliable guidance. This RCOG info sheet can also help you make an informed decision.

Page last reviewed: 11 October 2021

American Journal of Obstetrics & Gynecology: Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection at the time of birth in England: national cohort study https://www.ajog.org/article/S0002-9378(21)00565-2/fulltext (Accessed 11 October 2021)

Book or manage you Covid-19 vaccination (NHS) https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccinat…

COVID unlocking will create 'perfect storm' for pregnant women, say maternity Colleges https://www.rcog.org.uk/en/news/covid-unlocking-will-create-perfect-sto… (Accessed 11 October 2021)

GOV.UK COVID-19 vaccination: a guide for women of childbearing age, pregnant or breastfeeding (January 2021) https://www.gov.uk/government/publications/covid-19-vaccination-women-of-childbearing-age-currently-pregnant-planning-a-pregnancy-or-breastfeeding/covid-19-vaccination-a-guide-for-women-of-childbearing-age-pregnant-planning-a-pregnancy-or-breastfeeding

GOV.UK: JCVI issues new advice on Covid-19 vaccination for pregnant women https://www.gov.uk/government/news/jcvi-issues-new-advice-on-covid-19-v…

Hospital Infant Feeding Network (January 2021) https://www.hifn.org/covid-interim

MHRA https://www.gov.uk/government/news/mhra-issues-new-advice-concluding-a-…

NHS encourages women to get COVID-19 vaccine https://www.england.nhs.uk/2021/10/nhs-encourages-pregnant-women-to-get…

Royal College of Obstetricians and Gynaecologists (updated 9 April 2021) https://www.rcog.org.uk/en/guidelines-research-services/coronavirus-cov…

Royal College of Obstetricians and Gynaecologists COVID-19 vaccines and pregnancy https://www.rcog.org.uk/covid-vaccine?fbclid=IwAR2cAkENwY5yAcLt4AsffsQV…

Royal College of Obstetricians and Gynaecologists COVID-19 vaccines, pregnancy and breastfeeding https://www.rcog.org.uk/en/guidelines-research-services/coronavirus-cov… (Accessed 11 October 2021)

Royal College of Obstetricians and Gynaecologists (December 2020) https://www.rcog.org.uk/en/news/updated-advice-on-covid-19-vaccination-in-pregnancy-and-women-who-are-breastfeeding/

Royal College of Obstetricians and Gynaecologists merged information sheet and decision aid: (Updated 12 April 2021) https://www.rcog.org.uk/globalassets/documents/guidelines/2021-02-24-co…

Tommy's (January 2021) https://www.tommys.org/pregnancyhub/blogs-stories/covid-19-vaccine-pregnancy-and-breastfeeding

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