AstraZeneca COVID vaccine safe for breastfeeding women, health experts say, after official advice causes confusion

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Mother wearing knitted jumper cradles baby in blanket.
In Australia, COVID-19 vaccination is recommended for breastfeeding women.(Pexels: Kristina Paukshtite)

Sophie Hill scheduled an appointment to see her GP after government health advice changed recently, advising persons under 40 living in COVID-19 epidemic areas like Sydney to seriously consider taking the AstraZeneca vaccination. The Pfizer COVID-19 vaccination is recommended for breastfeeding mothers in Australia, although many are ineligible in places where Pfizer only offers it to those over the age of 40. Breastfeeding women, unlike pregnant women, are not at elevated risk of serious disease from COVID-19, and thus are not a priority group. Ms Hill’s doctor told her not to acquire the AstraZeneca vaccine and to wait until additional Pfizer doses became available at her next GP appointment.

Pfizer recommendation based on age, AstraZeneca still safe

The Royal Australian College of Obstetricians and Gynaecologists (RANZCOG) has now clarified that the AstraZeneca vaccination can be given to breastfeeding women, removing some of the confusion. According to RANZCOG’s COVID-19 vaccine standards, “any Pfizer, Moderna, or AstraZeneca vaccine is considered safe.” “Pfizer or Moderna’s mRNA is rapidly broken down in the body and does not appear to pass into breastfeeding.” AstraZeneca’s viral vector is incapable of infecting the body.”

Person holds baby's hand.
If you get a COVID-19 vaccine, you do not need to stop breastfeeding before or after vaccination.(Unsplash: Aditya Romansa)

The latest Pfizer recommendation, according to Karen Price, president of the Royal Australian College of General Practitioners (RACGP), is based on age-related risk factors related to the AstraZeneca vaccination, not because the vaccine is harmful to breastfeeding mothers or their babies. Breastfeeding isn’t a “contraindication” for the AstraZeneca vaccination, which means there’s not a cause to skip it. Breastfeeding women, like other persons under 40 living in epidemic areas, should speak with their doctor about their unique circumstances, she said.

COVID vaccination recommended for breastfeeding women

Because breastfeeding women were omitted from the COVID-19 vaccine studies, clinical safety data for this group is currently lacking. According to infant feeding specialist Karleen Gribble, based on what is known about similar vaccines, there are no theoretical safety concerns, and COVID-19 vaccines, including the AstraZeneca jab, are not thought to cause any risk to lactating women or their children. The COVID-19 vaccine’s chemicals aren’t likely to transfer into breast milk, and even if they did, they’d be quickly destroyed in the baby’s gut, according to her. She cited WHO advice that the AstraZeneca vaccine “is biologically and clinically unlikely to pose a risk to the breastfeeding kid” because it is not a live virus vaccination. According to preliminary studies, nursing women generate the same antibody response to COVID-19 immunizations as non-breastfeeding women, implying that the vaccines are as efficacious. In terms of side effects, multiple studies have found that breastfeeding women react to mRNA COVID-19 vaccinations — such as the Pfizer jab — in the same way as the general population does.

Close-up of baby wearing grey pants lying in cot.
There is no known risk associated with giving non-live vaccines whilst breastfeeding.(Pexels: Leah Kelley)

Vaccine may offer protection to babies

Apart from the fact that there is no proof that COVID-19 vaccinations can be passed on through breastfeeding, research suggests that vaccination may have some indirect benefits for infants. Breastfeeding women who have received a COVID-19 mRNA vaccination have antibodies in their breastmilk, according to several modest studies, which may give their baby with some short protection against the disease. More research is needed, however, to discover what level of protection these antibodies may provide. “Women who are presently nursing should seek advice from their doctor regarding COVID-19 immunizations,” according to a representative for the Department of Health. The health department’s decision-making advice on assessing potential advantages against the risk of damage from AstraZeneca was also mentioned by the spokesman.

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