Getting the vaccine in late pregnancy - seeking advice!

[ProvisionallyAnxious]

Hello wise Mumsnetters. I am currently 29 weeks pregnant and have been given the appointment for my first vaccination. I feel extremely conflicted about whether to get the vaccine or not, and many of the generic advice pages about this aren't really helping satisfy my specific concerns. I was wondering if anyone here had any perspective!

• I will be getting the Pfizer vaccine, as far as I know, since the AZ isn't being recommended either for pregnant women or my age group. I feel much less sanguine about getting mRNA vaccine than I would the AZ since it is 'new' technology. It concerns me a bit that most of the language is that the mRNA particles are "unlikely" to cross the placenta: there have been some studies in rats but none in humans. This seems like a big unknown to me!

• I have been a bit concerned at the anecdotal, but fairly widespread, reports of the vaccine having an impact on women's menstrual cycles. I read one scientist theorising that it triggered an inflammatory response and possibly a change in estrogen levels - neither of which sound especially good things to risk when your endometrium is busy supporting a pregnancy.

• I worry that whilst there is evidence that it is broadly 'safe' - i.e. no women or babies seem to have come to noticeable harm so far - the research is still very generic, i.e. looking at big ticket issues such as rates of stillbirth or maternal death. Has there been any data on birth outcomes e.g. whether women who have had the vaccine are more likely to go into labour earlier, or to require more assistance giving birth?

• Scientifically speaking, is there any reason to be concerned about longer-term impacts on a child exposed to the vaccine in the womb -- since obviously we don't yet have any longitudinal studies available? At the back of my head is the "what if" of how I would feel if in 5, 10 years time I had taken the vaccine and evidence unfolds to this effect.

• I take the potential impact of catching covid in the third trimester very seriously, but there's also a part of me that feels I am kind of too 'late' for getting the vaccine to be worth the unknowns. Even if I ask them to bring the second dose forward I would probably be getting it at about 36 weeks - so only fully 'protected' at 38, by which point I may well have given birth.

I'm just going round in circles here, and I know the only person who can make the decision is me - but if anyone has come across any research that might help me make my decision, or can offer a scientific perspective, I'd really appreciate it!

I think you should talk with your own doctor and midwives. There are a lot of variables in being vaccinated including your own personal risk of catching covid (how exposed are your household? can you effectively shield?), cases in your local area, whether you've had covid so you already have antibodies, your own personal health risk factors etc.

RCOG advises to get it, but second trimester best - no magic changes things at 28 weeks but you'd want to be jabbed soon: www.rcog.org.uk/en/guidelines-research-services/coronavirus-covid-19-pregnancy-and-womens-health/covid-19-vaccines-and-pregnancy/covid-19-vaccines-pregnancy-and-breastfeeding/.

The US studies haven't highlighted issues so far, and there's no particular reason to suppose mRNA would cross the placenta directly just antibodies. This might be a useful article: www.nature.com/articles/s41577-021-00525-y.

As for what I'd do, I'm very pro vaccination and I've absolutely no idea what I'd do in that position, would perhaps go for one jab only to get some protection. I don't envy you, it's a tough decision either way.

I’m 21 weeks and plan on getting the first dose in the next 2-3 weeks, just waiting for the Pfizer clinic at my GP surgery. I want it ASAP as I work in a secondary school. They’ve been vaccinating pregnant women who work in healthcare since December in the UK, with no reported concerns so far.

I’m the US 100,000 women have bad Pfizer or moderna and the stats of miscarriage, stillbirth, complications and neonatal outcomes are comparable with rates pre-COVID, suggesting that the vaccine doesn’t increase the risk.

The mRNA vaccines have been deemed safer for pregnant women as mRNA degenerates quickly in the body, and is unlikely to cross the placenta or survive in the acidity of the babies stomach. This article reassured me www.uchicagomedicine.org/forefront/coronavirus-disease-covid-19/mrna-covid-19-vaccine-pregnancy-breastfeeding

Weighing up the stats on the outcomes in vaccinated pregnancies compared to the recently published stats of outcomes in pregnancy when contracting COVID in the later stages of pregnancy, I’d rather have the vaccine than take the risk.

What is your risk level like day to day? That might help you make the decision. Every case is very individual.

For example, a nurse friend of mine chose not to have it when put forward by her GP, because it was very early on in the pandemic/vaccine programme and pregnant women in the NHS were then sent home anyway.

I’m a teacher and technically I guess my job is lower risk, but I will be working right up to 39 weeks and the window in my classroom won’t stay open. I have a toddler and partner at home to think about. Therefore, I have had my first jab but second not due until after the baby is born.

My sister is furloughed and lives very rurally, but has asthma so is having her first jab this week at 39 weeks.

Three very different situations, three very individual decisions. What does your partner/family think? Could they help you decide?

I had Pfizer at 34 weeks, so my second dose will fall after baby is born, currently 38 weeks. I found the data from the big US study reassuring, as it showed no change in risk of birth complications etc. I agree with PP, it's worth discussing with your antenatal team and considering your own risks - I was able to work from home from 28 weeks, but have primary and nursery aged DC and was more worried about impact on baby of getting covid in the third trimester. It's a really difficult decision like so many in pregnancy, I've not got any answers but wishing you well with the decision and the rest of your pregnancy.

I really feel for you as I remember worrying about the swine flu jab in one of my pregnancies. In the end I had it. In hindsight I wouldn’t and didn’t on my next pregnancy.

It’s the longer term stuff that worries me too and I’m not even pregnant.

I would risk assess by you own chance of getting covid. Also is there a chance you already have had it and have an antibody test?

I was listening to a matron the other day who was saying that they are advising women to have the jab, if they haven’t already had it, at 36 weeks at her hospital. Due to the risk of catching Covid in hospital, and to give the baby antibodies before it’s born.
There was over 100 people in that hospital with Covid that day, but none of them were in HDU.

Thanks everyone for their thoughts. In the end, after conversations with my midwife, GP, and the head nurse at the vaccination centre, I decided not to have the vaccine.

As people suggest this was partly based on an assessment of the risk of catching covid. Cases in my area are relatively low, about 50 per 100,000 new cases per week. I live in a fairly rural (albeit quite touristy) area, socialise with the same half a dozen families or so, and whilst I'm "back in the office" for practical reasons I am usually the only person in the building and have my own enclosed office-space anyway.

I was really struck in all of my conversations with HCPs how ambivalent they sounded about the vaccine in pregnancy. GP emphasised that there's a lot we just don't know about the m-RNA vaccines yet. She actually suggested I go to the vaccine centre and discuss having the AZ instead (which I would have been comfortable with as the technology has been in use far longer) but the vaccine centre weren't comfortable with that as it went against the advice for my age group.

I guess I just couldn't get past the thought of how I would feel if in 5-10 years time data came out about long-term impacts on children who had been exposed to the vaccine in the womb. To me it seems the challenge is weighing up the known risk of getting covid (and thinking about one's own personal risk factors for that) versus the risk of all of the unknowns of the vaccine. If it were just my body involved I wouldn't hesitate (and will happily be getting the vaccine once baby is born and I am breastfeeding, since I feel much more confident about the mechanics of anything passing into milk rather than across the placenta), but I just don't feel comfortable making that decision for my current passenger.

As an aside, I'm also planning a homebirth, so all being well unlikely to be exposed in hospital.