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Covid-19 and pregnancy: vaccine hesitancy and how to overcome it

BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2862 (Published 22 November 2021) Cite this as: BMJ 2021;375:n2862
  1. Gareth Iacobucci
  1. The BMJ

What’s the vaccine uptake in pregnancy?

Some 80 000 pregnant women in England had received two doses of the covid-19 vaccine up to 31 October, up from 65 000 at the end of August, says the UK Health Security Agency.1 It’s not possible to say what proportion this is of all pregnant women, as England doesn’t collect data linking vaccinations, pregnancies, and births. But data from Public Health Scotland2 showed that only 15% (615/4069) of women who gave birth in August 2021 were fully vaccinated. Only 23% (165/704) of women aged 35-39 who delivered their baby in August 2021 had received two vaccine doses, compared with 71% of all adults aged 30-39 in the general population.

Why is it so low?

Pat O’Brien, consultant obstetrician and vice president of the Royal College of Obstetricians and Gynaecologists, believes that there are two main drivers. “The first is the natural and understandable reluctance of pregnant women to take anything unusual or new during pregnancy because of fear that it might harm their baby,” he told The BMJ.

The second is the initial advice from the Joint Committee on Vaccination and Immunisation (JCVI) that pregnant women were better to avoid the covid vaccine unless they were at high risk of serious disease, because of a lack of evidence on safety. This advice changed as new evidence emerged, and the JCVI advised in April 2021 that all pregnant women should be offered the vaccine.

O’Brien rejects accusations of mixed messages. “We have more information about the safety of the vaccine in …

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