Intended for healthcare professionals

Rapid response to:

Clinical Review State of the Art Review

Covid-19 vaccination in pregnancy

BMJ 2022; 378 doi: https://doi.org/10.1136/bmj-2021-069741 (Published 10 August 2022) Cite this as: BMJ 2022;378:e069741

Rapid Response:

Re: Covid-19 vaccination in pregnancy

Dear Editor,

Never again…

The study concludes “Covid-19 vaccination is the safest and most effective way for people who are pregnant to protect themselves and their babies against severe covid-19 disease”.

Has the medial profession forgotten the tragedy of falsely reassuring pregnant women about safe therapeutics in pregnancy?

In the 1950s thalidomide (1) was presented as a safe and effective drug to pregnant women for hyperemesis. Sadly, over 10 000 babies were born with congenital deformities and many died. In 1961 the drug was withdrawn and the medical profession vowed to never again test new treatments on pregnant women. The BNF (2) repeatedly reminds us, even when prescribing the most commonly used drugs such as paracetamol to consider the drug as not “safe” but “not known to be harmful”.

The article states: “Once mRNA from the vaccine has been read, it is destroyed” suggesting this is a quick process. However, studies demonstrate this can take weeks as opposed to minutes (3).

The article also states “COVID-19 vaccines are strongly recommended in pregnancy”. For a new injection using mRNA technology that has been licensed under emergency usage to be deemed “safe for pregnant women” with limited data is concerning. This is not the medicine and caution I was taught at medical school, but the chants of profiting medical pharmaceutical companies with a history of criminal fines (4), many of which are due to making false claims about their pharmaceutical products and suppressing trial results (5).

I remind doctors of our principles, “Do no harm”. It takes years and even decades to establish the safety of medication in pregnancy, even in a pandemic.

The number of pregnant women who have acquired immunity through prior infection, has not been acknowledged in the study, particularly in view of the evidence that natural immunity is on par with vaccine induced immunity (6)(7)(8). The waning and even negative efficacy data of the vaccine has also not been discussed. (9)

The term “vaccine hesitancy” refers to women who decline the intervention and “need educating”. Whatever happened to informed consent and autonomy? Declining a procedure does not make a woman hesitant and anxious. A pregnant woman’s decision to refuse an injection with no long term safety data, is a decision to be respected.

Dr Ayiesha Malik
Locum GP

1)https://pubmed.ncbi.nlm.nih.gov/21507989/
2) https://bnf.nice.org.uk/medicines-guidance/prescribing-in-pregnancy/
3) https://doi.org/10.1016/j.cell.2022.01.018
4) https://www.theguardian.com/business/2009/sep/02/pfizer-drugs-us-crimina...
5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2875889/
6) https://www.medrxiv.org/content/10.1101/2022.03.17.22272529v1.full.pdf
7)  https://www.medrxiv.org/content/10.1101/2021.06.01.21258176v3
8)  https://www.medrxiv.org/content/10.1101/2022.07.06.22277306v1 
9) https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00089-7/fulltext

Competing interests: No competing interests

12 August 2022
Ayiesha Malik
Locum GP
Member of the Hart Group - but writing in a personal capacity.
ayiesha.malik@nhs.net