Following updated advice from the Joint Committee on Vaccination and Immunisation (JCVI), NHS England said in a letter to GP practices and other NHS organisations that 'pregnant woman in eligible cohorts who have yet to receive a COVID-19 vaccination, should be offered the Pfizer/BioNtech vaccine or Moderna vaccine'.
From 19 April, all vaccination sites must ensure that pregnant women in JCVI cohorts 1, 2, 4 and 6 - and those aged 45-49 - should be able to book alongside other people of the same age or in the same clinical groups.
Vaccination sites have been told to 'implement screening procedures to ensure pregnant women are identified and offered the Pfizer/BioNtech or Moderna vaccine'.
Sites that do not currently offer alternatives to the Oxford/AstraZeneca jab 'should cancel first-dose appointments if they know the patient is pregnant and direct patients to a PCN site or a vaccination centre that is administering the Pfizer-BioNTech or Moderna vaccine', the letter says.
With the NHS currently focused predominantly on second-dose vaccinations after vaccine supply fell below expected levels this month, the letter said 'PCN-led and hospital hub sites should first look to vaccinate eligible pregnant women with Pfizer/BioNtech through excess supply for second-dose clinics' - and escalate to regional teams if they have insufficient supply.
However, the advice points to guidance in Public Health England's Green Book, which says: ‘Pfizer and Moderna vaccines are the preferred vaccines for pregnant women of any age, because of more extensive experience of their use in pregnancy.
'Pregnant women who commenced vaccination with AstraZeneca, however, are advised to complete with the same vaccine. If a woman finds out she is pregnant after she has started a course of vaccine, she may complete vaccination during pregnancy using the same vaccine product (unless contra-indicated). Alternatively, vaccination should be offered as soon as possible after pregnancy.
'Therefore, for pregnant women who have received a first dose of AstraZeneca and are due to receive their second dose, no further action is required and second dose appointments should continue as planned.'