Classification: Official

Publication approval reference: C1189

To:

• Provider Chief Nurses
• Provider Medical Directors

CC:

• Regional Chief Nurses
• Regional Chief Midwives

19 March 2021

Dear Colleagues

All adults with underlying health conditions that put them at higher risk of serious disease and mortality (Group 6), as set out in Joint Committee on Vaccination and Immunisation (JCVI) guidance, are being offered the COVID-19 vaccine.

Conditions for eligibility have been specified in chapter 14a of Public Health England’s Green Book (Table 3). Pregnant women will be among these groups and should be offered a discussion around the risks and benefits of vaccination with a clinician, so they can make an informed choice about whether to receive it.

Maternity services are asked to take the following two actions, so that eligible pregnant women are identified and invited appropriately for vaccination, and are able to make an informed choice about receiving it.

• Please notify as soon as possible, and on an ongoing basis, the GPs of women in your care who are identified as having:
• • current gestational diabetes; or
  • a body mass index of ≥40 kg/m².

Eligible individuals in JCVI Group 6 are being identified via GP records. However, as women develop gestational diabetes when they are pregnant, and some women may be first identified as having a body mass index ≥40 kg/m² at the antenatal booking appointment, women in these particular circumstances may be identified by midwives or obstetricians within maternity services, rather than primary care. Notifying these women’s GPs will ensure they receive a timely invitation in line with JCVI prioritisation.

If your hospital hub has systems in place to enable vaccinations to take place for these women, you may wish to facilitate this.

Please continue to flag pregnant women in your care with significant heart disease (congenital and acquired) as ‘high risk’ with your trust COVID-19 data lead, so they can continue to be added to the Shielded Patients List.

• Please ensure you have staff available to provide advice on the risks and benefits of COVID-19 vaccination in pregnancy in a timely manner, when requested by women in your care.

We have worked in partnership with the vaccination programme so that all vaccination sites can ​offer on-site advice about the risks and benefits of COVID-19 vaccination in pregnancy, in line with PHE and RCOG advice. ​A checklist for vaccination sites can be found here.

However, we know that midwives and obstetricians are being approached for advice either during routine antenatal care, or through telephone triage. In future, maternity services may occasionally be contacted by health professionals at vaccination sites for immediate advice, or to organise contact for a woman who would like to discuss her decision with a maternity professional. Please ensure you have staff available to provide this advice in a timely manner and ideally within 3-5 days.

These midwives and obstetricians should provide advice in line with the vaccination site guidance, and should be familiar with the PHE and RCOG advice.

Thank you for carrying out this important request, and for your continued commitment to the care of pregnant women during the pandemic.

Yours sincerely

Matthew Jolly | National Clinical Director for Maternity and Women’s Health | NHS England and NHS Improvement

Professor Jacqueline Dunkley-Bent OBE | Chief Midwifery Officer | National Maternity Safety Champion | NHS England and NHS Improvement