SARS-CoV-2 infection and COVID-19 vaccination rates in pregnant women in Scotland

Abstract

Population-level data on COVID-19 vaccine uptake in pregnancy and SARS-CoV-2 infection outcomes are lacking. We describe COVID-19 vaccine uptake and SARS-CoV-2 infection in pregnant women in Scotland, using whole population data from a national, prospective cohort. Between the start of COVID-19 vaccine programme in Scotland, on 8 December 2020, and 31 October 2021, 25,917 COVID-19 vaccinations were given to 18,457 pregnant women. Vaccine coverage was substantially lower in pregnant women than in the general female population 18-44 years: 32.3% of women giving birth in October 2021 had two doses of vaccine compared to 77.4% in all women. The extended perinatal mortality rate for women who gave birth within 28 days of a COVID-19 diagnosis was 22.6 per 1,000 births (95% CI 12.9-38.5; pandemic background rate 5.6 per 1,000 births (452/80,456; 95% CI 5.1-6.2). 77.4% (3,833/ 4,950; 95% CI 76.2-78.6) of SARS-CoV-2 infections, 90.9% (748/823; 95% CI 88.7-92.7) of SARS-CoV-2 associated with hospital admission, and 98% (102/104; 95% CI 92.5-99.7) of SARS-CoV-2 associated with critical care admission, as well as all baby deaths, occurred in pregnant women who were unvaccinated at the time of COVID-19 diagnosis. Addressing low vaccine uptake rates in pregnant women is imperative to protect the health of women and babies in the ongoing pandemic.