Publication - FOI/EIR release

Fertility treatment deferrals and COVID vaccines: FOI release

Published: 14 November 2023
Directorate: Children and Families Directorate
Topic: Public sector
FOI reference: 202200284968
Date received: 3 March 2022
Date responded: 30 March 2022

Information request and response under the Freedom of Information (Scotland) Act 2002.

Information requested

The following information/documentation, regarding the current and previous rules applied to NHS patients seeking fertility/assisted conception services:

What number of women in Scotland have miscarried or birthed stillborn children as a direct result of contracting coronavirus, since the pandemic began?
What number of pregnant, unvaccinated women were admitted to ICU for treatment due to Covid, without an underlying health conditions?
Did the JCVI advise that women undergoing fertility treatment should not receive it if they were unvaccinated, or did the JCVI suggest only that pregnant women should be vaccinated?
What meeting of Scottish Government officials and medical professionals was the catalyst for the decision to halt all treatment for unvaccinated women? And could you provide minutes?
When was the review conducted to update guidance on ACS treatment for unvaccinated women, scheduled for 28 February. This review was expected to be conducted by 28 Feb at the latest, why was there no review before 1 March? (The Scottish Government press office has stated there was no update as of 1 March). Can the appropriate notes of this meeting be provided?
Why did the Scottish Government instruct nurses at Glasgow’s Royal Infirmary to tell patients they could receive their second vaccine four weeks after their first? Was their support from the medical community to support this?
If there was support for such a move, why was this not filtered out to the head of the vaccinations in NHSGGC, which has been confirmed by patients and the health board? To this point, it says in the Scottish Gov ACS guidance that: 'Centres can, in some cases, seek to reduce the time between the first and second dose for you if you choose and as soon as you are vaccinated you can start your treatment.' What is the evidence behind this and why has this not been communicated to all vaccine leads? If this was possible, why is it not routinely happening?
How many women are now being refused treatment as a result of this decision?
Any brief notes which might be necessary to understand the context of the information provided. If the information requested contains sections of confidential information, please blank out or remove these sections, and mark clearly that they have been removed.

Response

While our aim is to provide information whenever possible, in this instance the Scottish Government does not collect some of the information you have requested. This is the information regarding the number of women in Scotland that have miscarried or birthed stillborn children as a direct result of and contracting coronavirus, since the pandemic began, and the number of pregnant, unvaccinated women who were admitted to ICU for treatment due to Covid, without an underlying health condition.

However, Public Health Scotland may be able to provide this information that you request. They can be contacted at Freedom of Information (FOI) and Environmental Information Regulation (EIR) requests - Contact us - Public Health Scotland or by email PHS.FOI@phs.scot or you can write to them at:

Corporate FOI team
Public Health Scotland
Gyle Square
South Gyle Crescent
Edinburgh
EH12 9EB

Additionally, the Scottish Government does not hold the information that you requested on the numbers of women whose fertility treatment was temporarily deferred. Individual health boards may be able to provide this information that you request. However we can provide information on the following:

Advice from the Joint Committee on Vaccination and Immunisation
The Joint Committee on Vaccination and Immunisation (JCVI) advice is that pregnant women should now be considered as a clinical risk group and part of priority group 6 within the vaccination programme, and therefore should come forward and receive vaccination. Pregnant women urged to come forward for COVID-19 vaccination - GOV.UK (www.gov.uk)

Meetings prior to the temporary deferral of fertility treatment for unvaccinated patients
Lead Clinicians from the four NHS Assisted Conception Units (ACU’s) raised concerns about providing fertility treatment for unvaccinated patients at the Assisted Conception Unit Leads meetings of the 14 and 21 December 2021. A copy of the draft note from those meetings is attached. Names of attendees have been redacted under Freedom of Information (Scotland) Act 2002, Section 38 (1) (b) exemption.

Confirmation of the temporary deferral of fertility treatment for unvaccinated patients and the review timeline
In his letter of 7 January 2022, the Chief Medical officer advised that the recommendation for the temporary deferral of NHS fertility treatment for patients who are not fully vaccinated against COVID-19 would be reviewed, alongside emerging evidence of risk, as well as the prevailing levels of COVID-19, during January and February 2022. The purpose of the review was to determine whether it was appropriate for the recommendation for temporary deferral to remain in place. The recommendation was kept under continual review and the Chief Medical Officer, in his letter of 4 March 2022, recommended that fertility treatment for unvaccinated patients no longer be deferred. Three of the links within the letters of the 7 January and 16 December 2021 are now out of date. Updated links to the Public Health Scotland data can be found here, the letter of 16 December 2021 link to the Royal College of Obstetrician and Gynaecologists guidance on COVID-19 infection in pregnancy for health professionals can be found here and the decision aid can now be found here.

Meetings at which the review of the temporary deferral of fertility treatment for unvaccinated patients were discussed
A copy of the draft minutes of the ACU Leads meeting of 15 February 2022 and National Infertility Group meeting of 24 February 2022, where the review was discussed, are attached. Information outside the scope of your request has been redacted from the minutes of both of these meetings. Names of attendees have been redacted under Freedom of Information (Scotland) Act 2002, Section 38 (1) (b) exemption.

Vaccine dosage intervals and communication of this information to leads in Health Boards
All Covid-19 vaccines used in Scotland are authorised to be given by the Medicines and Healthcare products Regulatory Agency (MHRA) with a 4 weeks dose interval between doses. The JCVI recommended an interval between doses of 8 to 12 weeks as a routine but under exceptional circumstances where someone requires early protection, this can be reduced to the minimum authorised interval. This is detailed in the Green Book and the CMO letter of the 9 March 2021, which is attached, that are sent out to NHS Boards, including Immunisation Co-ordinators and all the vaccination team members should be aware of this.

About FOI

The Scottish Government is committed to publishing all information released in response to Freedom of Information requests. View all FOI responses at http://www.gov.scot/foi-responses.