Land of Confusion

The sheer determination of people to be confused by the straightforward is quite something to behold. Contrarian Twitter has been beside itself with self-righteous fury because it believes pregnant women have 'quietly' been advised against vaccination by the UK government. But here's the actual timeline.

  • December 2020 - pregnant women were advised against vaccination, other than in cases of significant risk. 
  • April 2021 - pregnant women were now to be invited along with their age group.
  • December 2021 - in view of high numbers of unvaccinated pregnant women in ICU, they were made a priority.
Simple, huh? Not if you're a contrarian. 

As part of Emergency Authorisation for approval of the Pfizer mRNA vaccine under 'Regulation 174', in December 2020, a report was issued, which included a section on reproductive and developmental toxicity with the following conclusion:

The absence of reproductive toxicity data is a reflection of the speed of development to first identify and select COVID-19 mRNA Vaccine BNT162b2 for clinical testing and its rapid development to meet the ongoing urgent health need. In principle, a decision on licensing a vaccine could be taken in these circumstances without data from reproductive toxicity studies [in] animals, but there are studies ongoing and these will be provided when available. In the context of supply under Regulation 174, it is considered that sufficient reassurance of safe use of the vaccine in pregnant women cannot be provided at the present time: however, use in women of childbearing potential could be supported provided healthcare professionals are advised to rule out known or suspected pregnancy prior to vaccination. Women who are breastfeeding should also not be vaccinated. These judgements reflect the absence of data at the present time and do not reflect a specific finding of concern.

This underlines the position at December 2020, uncontroversially. Now, someone noticed that the page holding this report on official websites had been changed on 16th August 2022. Through malice, ignorance or stupidity, this was taken to date-stamp the entire report, and represent new 'advice'. This was taken up en masse by high-profile accounts with great 'scandal of the century' froth. How a group of people who presumably have some intellectual pride can be so collectively dumb is beyond me. It is clear that

  • This is a report, not advice.
  • An update does not change everything within.
  • Government advice is to vaccinate this group as a priority.

All of this can be found with a minimum of due diligence. But then, this is Twitter, so...

Meanwhile over on YouTube, Dr John Campbell had evidently picked up the buzz around this, and on the same day the fuss blew up, issued a video entitled "new advice on Covid vaccination in pregnancy". This, one might think, was related to the ongoing fuss around the 174 report of December 2020. But no, Dr Campbell had found something new to be confused by. Wafting around a press release clearly dated April 2021, he says this is the 'new advice' of his title. Digging for the advice he believes it replaces, he then discovers a non-government site indicating that pregnant women were (in December 2021) to be treated as 'priority'. So he thinks April 2021 replaces the advice of December 2021, which of course had not happened yet... in reality, of course, the advice superseded by April 2021 was that of December 2020 - "vaccinate with age group instead of advise against", not "vaccinate with age group instead of being priority". He himself had issued a video in November 2020 highlighting the risks of Covid in pregnancy; his 2020 self might have been pleased to see the advice of April 2021 and its strengthening in December 2021. But time moves on.

He managed to squeeze another video out of it: "UK confusing vaccine guidelines". This time, he had picked up on the 174 report, and joined the Twitter influencers in both believing it to be advice, and to be current. A lengthy comparison with the 'Green Book' follows. But again there is absolutely nothing to be confused about, unless you're trying.

I was a vaccine centre volunteer in February 2021. I clearly recall pregnant women being advised against. I also recall that advice changing, and then changing again to make them priority due to high numbers in ICU. But it seems many of the people commenting on this have not been following developments in the area about which they regularly pontificate. The defence that it is 'confusing' doesn't fly; it isn't to anyone who understands the flow of time and the significance of release and update dates. The defence that this is all 'government guidance' is weak also; it is possible to misinform by presenting guidance out of sequence, or by presenting reports as guidance. 

This manufactured confusion undermines confidence and puts mothers and babies at risk. Stop it. 

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