“It’s safe! It’s effective!”: Covid vaccine in pregnancy

While many who are pregnant are anxious about the potential impact on their health and the health of their baby of getting the vaccine, in reality it's Covid itself that poses the highest risk.

Greg Fell, Director of Public Health in Sheffield, is encouraging those who are pregnant to get the vaccine. He is unambiguous when he tells Now Then, “Get vaccinated! Clearly, unequivocally, no question, no hesitation. It's safe! It's effective!

"I think mums will - they’re humans, like everyone else – will be nervous and worried about side effects, and doubly so with regard to pregnancy, maybe triply so actually, with regard to pregnancy.

"But the way the evidence is playing out is that the side effects, particularly with regard to babies - which is clearly what mums are worried most about - they're just not there. There's no side effects that this affects babies in any way, shape or form at all."

If a pregnant person gets Covid, they are at higher risk of serious disease and hospitalisation, especially later in the pregnancy, and the risk of stillbirth increases by almost two times.

“We also know that [pregnant people who get Covid] are more likely to get pregnancy complications, such as needing a Caesarean, having their baby prematurely and sadly stillbirth," explains Helen Baston, Consultant Midwife at Sheffield's Jessop Wing. "And also because babies are born early, they’re more likely to need treatment in the neonatal intensive care unit.”

No link between getting the vaccine and miscarriage has been found.

Greg Fell continues: “If you talk to the intensive care doctors, they will say, ‘We have heavily pregnant mums in intensive care, with Covid’. This is not something we want to see, it's not good for anybody.

"In every context and in every guise, the benefits of being vaccinated outweigh any risks by many, many, many, many, many orders of magnitude.”

Helen Baston agrees: “All of the professional organisations that support pregnant people are recommending that pregnant people should take up the offer as soon as they can. And that includes the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives.

"They can get the vaccine at any stage in pregnancy... So they also don't need to delay getting pregnant if they're thinking of starting a family. And equally they can have it when they're breastfeeding, post-natally."

Vaccines are never side effect free, but for the vast majority of people side effects are limited to a few days and usually involve fatigue, soreness at the site of the injection, headaches and nausea. Serious side effects are exceedingly rare.

Fell says some people had worried about blood clots, but that "that’s not so much of a thing" with the Pfizer / Moderna vaccine being used currently.

“It was a thing with the AstraZeneca vaccine, but you're in the sort of the ‘struck by lightning’ type of territory in terms of quantifying the risk. Let's not pretend there aren't risks, because there are risks, but the very serious risks are very, very, very, very rare... The level at which the benefits outweigh the risks is just a different universe."

He also clarifies that despite fears of myocarditis, this has been mostly fairly mild and self limiting and "the risks of myocarditis from getting infected are 16 to 20 times higher than the risks of myocarditis from being vaccinated.

“Covid causes a whole bunch of bad stuff to happen and the point of vaccination is to prevent bad stuff happening.”

Of course the risk with Covid is not limited to serious illness and death, it also carries the risk of debilitating long-term conditions like Long Covid, which, as Helen Baston points out, “is certainly something you wouldn't want to be starting parenthood with.”

People, including those who are pregnant, are also being encouraged to get their flu jab this winter.

“We mustn't forget that flu is a killer," Baston notes. "And it certainly is important in pregnancy to be protected against flu. We offer flu vaccination and Covid vaccination here at the Jessop Wing and they can be given both at the same time. Each year the flu strain changes so, even if somebody’s had a baby the previous year, they need the flu vaccine this year as well.”

If you are pregnant and trying to make a decision about whether to get the Covid vaccine, your first port of call should be your own midwife or healthcare professional. Further resources include NHS and government websites.

Greg Fell recommends “a fairly selective number of places; Twitter isn't one of them, or Facebook. Go to the websites that end in nhs.uk, or websites that end in gov.uk.

"To their credit, the BBC has... done a huge amount of really good public service work in this space. I'd probably also suggest people look at the Royal College of Midwives and the Royal College of Obstetrics and Gynaecology.

“But being blunt, there's a whole bunch of rubbish out there. There are various forms of chat rooms and internet sites, so I tend not to point people towards them.”

For anything more nuanced that is not covered on these websites, midwives are very knowledgeable and can offer tailored advice to pregnant people.

Ultimately, Baston highlights the importance of considering the consequences of catching Covid when people are deciding whether to get the vaccine.

“If they're worried, they need to think about the implications of becoming unwell, either in pregnancy or as a new parent, and having to self-isolate, and all the things that just don't get parents off to a good start.

"We often think about the very clinical issues, but this is an important part of someone's life and they don't want to be isolating at this lovely time.”

Pregnant people in Sheffield can get their Covid vaccine as a walk-in patient at the Jessop Wing without an appointment.