‘Wait for more data’: COVID-19 vaccines not recommended for pregnant women

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists says most pregnant women should not get a COVID-19 vaccine at this stage due to insufficient data and a low number of cases in Australia.

The country recorded its ninth consecutive day with no community transmission on Tuesday, as globally the number of COVID-19 cases approaches 100 million.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists says there is insufficient evidence to recommend the routine use of COVID vaccines in pregnant women.Credit:AP

RANZCOG President Dr Vijay Roach said because of the limited spread of the virus in Australia, coupled with a general caution around advice to pregnant women about what medicines they can take, it seems “reasonable to wait for more data”.

“I think the underlying principal is caution when it comes to pregnant women and unborn babies,” he said.

“In the current context, given the risk of a pregnant woman [in Australia] acquiring COVID is so low, there isn’t a reason to suggest pregnant women get a vaccination.”

In its advice, published on Tuesday, the RANZCOG said the “large majority” of pregnant women who catch the coronavirus will experience mild to moderate flu-like symptoms. So far, there is no evidence of an increased risk of miscarriage or birth defects, the college said.

Pregnant women have not been part of earlier trials for the vaccines, so little is known about any potential adverse effects on those women or their developing fetuses. Dr Roach said that was the main reason the college decided it was not recommending the vaccine for most pregnant women yet.

“While it appears to be safe and while it’s probably safe, in a setting of low transmission we don’t recommend it be used universally,” he said.

In potential cases where women receive a vaccination while unknowingly pregnant, Dr Roach stressed the college did not believe there was any evidence it would cause harm.

It also said the vaccination could be an option for pregnant women with significant pre-existing medical conditions, chronic respiratory conditions, advanced chronic kidney disease, or solid organ transplant recipients.

For pregnant healthcare or essential workers at increased risk of exposure to the virus, RANZCOG recommended they be allocated to perform lower risk duties.

There was also no existing data on the safety of COVID-19 vaccinations for breastfeeding women and their effects on breastfed babies, but the vaccines were not considered a risk to those infants.

“It’s safe to have when you’re breastfeeding,” Dr Roach said.

Before releasing its own guidelines, RANZCOG reviewed advice issued by similar bodies overseas, including the UK’s Royal College of Obstetricians and Gynaecologists and the Centres for Disease Control and Prevention (CDC) in the US.

RANZCOG’s decision is mostly in line with the British advice. The UK college, however, said women who were frontline health or aged care workers could discuss the option of a vaccine to weigh up the benefits and risks on an individual basis.

In the US, which has recorded a seven-day average of 170,000 cases a day, the CDC said women who are pregnant and part of a group recommended for the COVID vaccine, such as healthcare workers, can choose to get vaccinated.

Dr Roach said if evidence emerges, potentially from the US, that the vaccine was safe for pregnant women, the college would be “absolutely ready” to change its advice.

The Federal Department of Health has been contacted for comment.

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