Current Government Advice (from the Green Book):
Pregnancy and Breastfeeding
There is no known risk associated with giving inactivated, recombinant viral or bacterial vaccines or toxoids during pregnancy or whilst breast-feeding (Kroger A et al., 2013). 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. As with most pharmaceutical products, specific clinical trials of COVID-19 vaccine in pregnancy have not been carried out.
Although the available data do not indicate any safety concern or harm to pregnancy, there is insufficient evidence to recommend routine use of COVID-19 vaccines during pregnancy. The Pfizer BioNTech vaccine is formulated in lipid nanoparticles, and although studies with other mRNA liposome vaccines in non-pregnant animals do not suggest any problem is likely (Bahl K et al (2017), Liang F et al (2017), animal reproductive toxicity studies have not been completed. Whilst testing of the COVID-19 mRNA vaccine in pregnant animals is undertaken, the MHRA has put forward a very precautionary approach. In addition to not vaccinating in pregnancy, MHRA advise that pregnancy should be avoided until 2 months after the second dose of vaccine. They also have advised vaccination should not be given whilst breastfeeding. MHRA have not advised performing a pregnancy test prior to offering vaccination.
JCVI recognises that the MHRA’s advice is based on the absence of evidence in pregnancy, and not on the presence of evidence to implicate toxicity in pregnancy. To appropriately reflect this stance, JCVI have advised that routine questioning about last menstrual period and/or pregnancy testing is not required before offering the vaccine. JCVI have agreed that those