What proportion of pregnant women have been fully vaccinated? | David Spiegelhalter and Anthony Masters

Recent articles have stated that only about 15% of pregnant women in the UK have been fully vaccinated. This seems low, but is it right? The figure is quoted in a Royal College of Obstetricians and Gynaecologists press release but the only source given is a Public Health England report that states that, up to 31 August, around 65,000 women receiving their second vaccination ticked a box asking: “Are you or could you be pregnant?”. However, this number does not tell us what we want to know.

Fortunately, Public Health Scotland links health records on vaccinations, pregnancies and births. Its report tells us that, of 4,069 women who gave birth in August 2021, only 615 (15%) had received two vaccine doses. These women will have been pregnant throughout the vaccine rollout and have clearly tended to avoid vaccination – of women aged 35-39 giving birth in August, 23% were fully vaccinated, far fewer than the 71% for all adults aged 30-39.

Things have changed: women who become pregnant now are likely to have been vaccinated already

So we’ve identified a public source for the 15% figure. But things have changed: women who become pregnant now are likely to have been vaccinated already.

This trend should reduce the consequences of the increased risks posed by having Covid-19 during pregnancy. A meta-analysis suggested pregnant women were about 20 times more likely to be admitted to intensive care if they had Covid-19, compared with other pregnant women without the disease. They were also around twice as likely to suffer a stillbirth or for their baby to die soon after birth. This is reflected in Intensive Care National Audit & Research Centre data showing that, of 1,435 women aged 16-49 admitted to intensive care with Covid-19 after 1 May, 420 (29%) were currently or recently pregnant. Since July, one in five Covid-19 patients put on a lung-bypass machine in England were unvaccinated pregnant women.

There is accumulated evidence for these vaccines’ effectiveness and safety in this vulnerable group. The RCOG and the Royal College of Midwives both recommend expectant mothers get fully vaccinated. While there still may be some hesitancy, the proportion of pregnant women who are vaccinated should now be much higher than 15%.