Practices and other Covid vaccination sites without an alternative to the AstraZeneca vaccine should cancel first dose appointments for people who are pregnant, NHS England has said.
These patients should be redirected to a PCN or other site that is able to administer the Pfizer/BioNTech or Moderna vaccine, it added in a letter sent to practices on 17 April.
This follows updated guidance given on Friday (16 April) from the Joint Committee on Vaccination and Immunisation (JCVI), which recommended that pregnant women should now be offered the Covid-19 vaccine.
NHSE also said that ‘all vaccination sites should implement screening procedures’ to better identify pregnancies in patients, with a GP or midwife able to discuss the benefits and risks with each patient.
If a pregnant woman has already received their first dose of any vaccine – including the AstraZeneca vaccine – a second dose should ‘continue as planned’, it added.
This is in line with information in the Green Book, which states that if ‘a woman finds out she is pregnant after she has started a course of vaccine, she may complete vaccination during pregnancy using the same vaccine product (unless contra-indicated)’.
Healthcare professionals should still discuss the risks and benefits of vaccination with each pregnant woman presenting for vaccination, the letter said, and where necessary the person should be redirected to an obstetrician, midwife or GP team for further guidance.
Managing supply
NHS England also advised that PCN sites should vaccinate eligible pregnant women with the Pfizer vaccine through excess supply from second dose clinics in the first instance.
If PCNs do not have enough Pfizer vaccine to vaccinate eligible pregnant patients, they should contact their regional vaccination operations centre.
It added that local systems will have a ‘key role to play in managing demand and ensuring patients have access to the appropriate vaccines’.
JCVI guidance
The latest JCVI guidance advised that it was ‘preferable’ for pregnant women in the UK to be offered the Pfizer or Moderna vaccines where available.
‘There have been no specific safety concerns identified with any brand of coronavirus (Covid-19) vaccines in relation to pregnancy,’ the statement said.
‘Real-world data from the United States shows that around 90,000 pregnant women have been vaccinated, mainly with mRNA vaccines including Pfizer-BioNTech and Moderna, without any safety concerns being raised.’
The JCVI added that there is ‘no evidence’ to suggest that other vaccines are unsafe for pregnant women, but said ‘more research is needed’.
Updated booking system
Pregnant women who are currently eligible for the vaccine are those who are in cohorts one, two, four, six and the 45-49-year-old age group.
According to the NHS England letter, from today (19 April) all vaccination sites offering the Pfizer or Moderna vaccines are required to ensure that pregnant women are able to book appointments for vaccination at the same time as non-pregnant women based on age and clinical group.
The national booking system has also been updated to recommend that those who are pregnant speak to a healthcare professional such as a GP team, midwife or obstetrician before booking their appointment, it added.
Those using local booking systems will also need to update their systems to reflect the JCVI advice, NHS England said.
The JCVI said that patients should not be prioritised based on being pregnant, and that they should receive their invitation in line with their age and clinical risk group.
