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

Sarah J E Stock, Jade Carruthers, Clara Calvert, Cheryl Denny, Jack Donaghy, Anna Goulding, Lisa E M Hopcroft, Leanne Hopkins, Terry McLaughlin, Jiafeng Pan, Ting Shi, Bob Taylor, Utkarsh Agrawal, Bonnie Auyeung, Srinivasa Vittal Katikireddi, Colin McCowan, Josie Murray, Colin R Simpson, Chris Robertson, Eleftheria VasileiouAziz Sheikh, Rachael Wood

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

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 a COVID-19 vaccine program 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 of 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 d 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 out of 80,456; 95% CI 5.1-6.2). Overall, 77.4% (3,833 out of 4,950; 95% CI 76.2-78.6) of SARS-CoV-2 infections, 90.9% (748 out of 823; 95% CI 88.7-92.7) of SARS-CoV-2 associated with hospital admission and 98% (102 out of 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.

Original languageEnglish
Pages (from-to)504-512
Number of pages512
JournalNature Medicine
Issue number3
Publication statusPublished - 13 Jan 2022

Keywords / Materials (for Non-textual outputs)

  • COVID-19 Testing
  • COVID-19 Vaccines/therapeutic use
  • COVID-19/epidemiology
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Complications, Infectious/epidemiology
  • Pregnant Women
  • Prospective Studies
  • SARS-CoV-2
  • Vaccination


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