After months of waiting, the U.K. Health Security Agency (UKHSA) has updated its ‘Vaccination in pregnancy’ tables in its ‘COVID-19 Vaccine Surveillance Report’.

Many of us have been complaining that the tables have not been updated for over six months, with the last set of data inputted in June 2022. Maybe it was working together with the ONS, which updated its ‘deaths by vaccination status’ data last week. The UKHSA data have now been updated to November 2022. I don’t understand why there is still such a big delay, but any update is better that nothing.

Previously, it has been noted that there were big drops in births when comparing 2022 with 2021. I can recall reading someone connected with the UKHSA or ONS saying that this was probably due to a data lag. Well, the updated data are here and they are still as worrying as before. The updated data have slightly decreased the number of births in 2021 and slightly increased the number in 2022, but not by much.

As the data only run until November 2022, I compared the number of women giving birth up to November 2021 with the number in 2022. In total between January and November there were 478,382 births in 2021 and 421,284 in 2022. That’s 57,098 fewer births in 2022, which is a drop of 11.9%.

This next chart shows the percentage decrease in births by month. As you can see, the biggest decrease occurred in month 9 (September) with a decrease of 15.7%

The vaccine surveillance report’s own graph shows this drop. I have drawn a red line to show where the drop off starts, which coincidentally matches the peak of the first dose in pregnancy figures.

The report emphasises that there is nothing to worry about and that studies have shown the vaccine is safe in pregnancy. It presents a number of graphs showing:

  • percentage of live-born babies at term without low birthweight;
  • percentage of live-born babies at term without low birthweight by age;
  • stillbirths;
  • low birthweights; and
  • premature births.

Its graphs attempt to show that there isn’t much difference between vaccinated and unvaccinated mothers. However, in my opinion, these data don’t show much and could be considered disingenuous because the authors never compare with unvaccinated women. Instead they use the term “no doses in pregnancy”. This means instead of being a purely unvaccinated control group, women who were vaccinated before they were pregnant are lumped in the same group.

Next, I analysed the drop in births by ethnicity. I used the September to November 2021 data from the week 11 2021 vaccine surveillance report and compared with the September to November 2022 data in this latest report.

(A note to the UKHSA – your table columns are still labelled “April to June 2022” whilst the table heading says “September to November 2022”. Clearly a cut and paste job which doesn’t instil confidence with such an important dataset.)

The report compares births in Asian, black, mixed, other, unknown and white women.

There is a big increase in ‘other’ births but in reality the difference is just a few thousand. The rest of the categories show drops ranging from -2.5% in black women to -38.7% in mixed race women. The vaccination rates at the time of delivery are as follows: Asian (75.9%). Black (53.9%), Mixed (62.1%), Other (64.9%), White (78%) and Unknown (58.9%).

So there is no clear pattern between percentage of women vaccinated and changes in number of births.

Next, looking at deprivation with 1 being most deprived and 5 the least deprived.

This time there is a clear pattern between deprivation status, vaccination status and decrease in births. Vaccination rates by deprivation status are as follows: 1 most deprived (63.7%), 2 (71.2%), 3 (77.8%), 4 (83.3%), 5 least deprived (87.2%).

Interestingly, the more deprived, the lower the birth rate drop. This is also coincides with a lower percentage of women vaccinated.

And finally by age.

Here the under 20s show an increase whilst the other age groups drop in number of births. The greatest drop is in the 30-34 year olds at minus-17.7%. Vaccination rates for this group are as follows: under 20s (46.8%), 20-24 (61.7%), 25-29 (69.8%), 30-34 (79.8%), 35-39 (82.7%), 40+ (81.8%).

Hopefully this massive drop in births can be explained by a data lag or maybe because there was a post-lockdown bounce in 2021, so numbers dropped back down in 2022. However, if this was due to a data lag you would expect the drop to be consistent in the different categories highlighted above.

Perhaps the drop is due to the ‘cost of living crisis’ – but then would you not expect the drop in numbers to be in poorer or younger women? Maybe it shows how the middle class are being hit the hardest?

But the effects of vaccination should not be dismissed and if I had the raw data I would want to look at this closer. The beginning of the drop coinciding with the peak in first vaccinations is worrying, as is the chart showing that the more wealthy and more vaccinated women are having fewer babies.

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