COVID-19 vaccination in pregnancy: vaccinator checklist



Classification: Official

Publications approval reference: C1293

Version 2, updated 19 May 2021

Latest Joint Committee on Vaccination and Immunisation (JCVI) advice

The JCVI has advised that women in eligible cohorts who are pregnant should be offered vaccination at the same time as non-pregnant women, based on their age and clinical risk group.

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.

Based on this data, the JCVI advises that it’s preferable for pregnant women to be offered the Pfizer-BioNTech or Moderna vaccines where available. There is no evidence to suggest that other vaccines are unsafe for pregnant women, but more research is needed.

Public Health England’s Green Book has been updated to reflect this latest advice.

Accessing the recommended vaccines on the National Booking Service

The National Booking Service now includes screening questions to identify women who are or might be pregnant, and offers them an appointment for the Pfizer/BioNTech or Moderna vaccines.

GPs, midwives and obstetricians can now advise these women to book an appointment using the National Booking Service, when they are eligible and invited to do so.

Providing pre-vaccination advice

To ensure that women who are or may be pregnant can provide informed consent for vaccination, the vaccine site must have the following provisions in place:

  • A healthcare professional who can discuss the potential benefits and risks of COVID-19 vaccination in pregnancy and gain informed consent using the checklist below.
  • A pathway for obtaining advice from the onsite clinical lead so women who have further queries can make their decision during their appointment.
  • For women who, after vaccination counselling onsite, would prefer a further conversation with a GP or healthcare professional from the maternity service, a pathway for obtaining this ideally within 3-5 working days. This could include either the woman or the health professional organising this through the vaccination site’s identified point of contact or with local GP/maternity services. Alternatively, it may be arranged using contact details a woman has been given for her own GP/maternity service where this is not local to the vaccination site.

The following checklist should be used by health professionals obtaining consent at vaccination sites for all women of childbearing age:

  • Ask whether the woman is, or might be, pregnant. Record the response in the point of care IT system. If the woman is pregnant and is aware of her estimated date of delivery, please record this.
  • If the woman is pregnant, or thinks she might be, and is attending for her first dose, she should be offered the Pfizer BioNtech or Moderna vaccines. If your site doesn’t offer these vaccines, advise the woman that she should rebook through the National Booking System.
  • If the woman received a first dose of AstraZeneca and is attending for her second dose, she should continue to receive AstraZeneca as planned, unless contraindicated.
  • If the woman is pregnant, or thinks she might be, give her the PHE and RCOG information leaflets. Offer pre-vaccination counselling on the potential benefits and risks of vaccination in line with these documents, so the woman has the opportunity to make an informed decision about vaccination onsite. Document this in the point of care IT system.
  • If the offer of vaccination is accepted, record that informed consent has been obtained before administering the vaccine. Signpost to the MHRA’s Yellow Card Vaccine Monitor information.
  • If the woman has any further questions or concerns that she would like to resolve before consenting to vaccination, follow the local pathway to obtain immediate advice from the site clinical lead, or refer the woman to a GP, or a healthcare professional in her maternity service, for timely advice.