New WHO Guidance: Interim recommendations for use of the Pfizer–BioNTech COVID-19 vaccine, BNT162b2, under Emergency Use Listing and a direct quote.

SAGE Recommendations:https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccines-SAGE_recommendation-BNT162b2-2021.1

“Lactating women Breastfeeding offers substantial health benefits to lactating women and their breastfed children. Vaccine efficacy is expected to be similar in lactating women as in other adults. However, there are no data on the safety of COVID-19 vaccines in lactating women or on the effects of mRNA vaccines on breastfed children. As the BNT162b2 vaccine is not a live virus vaccine and the mRNA does not enter the nucleus of the cell and is degraded quickly, it is biologically and clinically unlikely to pose a risk to the breastfeeding child. On the basis of these considerations, a lactating woman who is part of a group recommended for vaccination, e.g. health workers, should be offered vaccination on an equivalent basis. WHO does not recommend discontinuing breastfeeding after vaccination.”

 

Press release: Oxford University/AstraZeneca COVID-19 vaccine approved

Additional updates relating to use of the Pfizer/BioNTech vaccine

The CHM has also reviewed further data for the Pfizer/BioNTech vaccine as it has become available and has recommended the following changes:

  • Pregnancy and women who are breastfeeding – the vaccine should only be considered for use in pregnancy when the potential benefits outweigh any potential risks for the mother and baby. Women should discuss the benefits and risks of having the vaccine with their healthcare professional and reach a joint decision based on individual circumstances. Women who are breastfeeding can also be given the vaccine. This advice is in line with pregnancy and breastfeeding advice for the Oxford University/AstraZeneca vaccine
  • Allergies – anyone with a previous history of allergic reactions to the ingredients of the vaccine should not receive it, but those with any other allergies such as a food allergy can now have the vaccine.
  • Dosage interval – the advice has been updated to say that the second dose of the Pfizer/BioNTech vaccine should be given at least 21 days after the first dose.

Previous post. 8th December.

Vaccine to be withheld from breastfeeding mothers in England

Public health advocates are worried about the health impact, not just in the UK but globally, of new advice from Public Health England which could be a disincentive for women to breastfeed.  It is important to note that the advice is precautionary and not based on evidence of harm from the virus, but on lack of evidence of its safety in this population.

WHO, UNICEF and others are working on this problem and we hope that a risk/benefit analysis will be available soon that will inform a communication strategy that will take into account the importance of breastfeeding and risks of replacement feeding – factors that are so often overlooked.

In its emergency authorization of the Pfizer-BioNTech vaccine on Friday night, the Food and Drug Administration took an unexpected step, leaving open the possibility that pregnant and breastfeeding women may opt for immunization against the coronavirus. …..Although no coronavirus vaccine has been studied in these women, many scientists believe the benefits will outweigh any potential risks. ….In its emergency authorization of the Pfizer-BioNTech vaccine on Friday night, the Food and Drug Administration took an unexpected step, leaving open the possibility that pregnant and breastfeeding women may opt for immunization against the coronavirus…..

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Click here for WHO and UNICEF advice on COVID-19 and a repository  compiled by the Johns Hopkins Center for Humanitarian Health that  provides an overview of what peer-reviewed journal articles currently state on COVID-19, breastfeeding, infant feeding, and breast milkPublic Health England Guidance

Public Health England Poster

Excerpt from the PHE Guidance 6th December

If you are breastfeeding you should wait until you have finished breastfeeding and then have the vaccine. If you were breastfeeding when you had the first dose you are advised not to have the second dose until you have finished breastfeeding.

This advice is precautionary until additional evidence is available to support the use of this vaccine in pregnancy and breastfeeding. It may then be possible to have the Pfizer-BioNTech vaccine. Until that advice is changed you may be able to have one of the other COVID-19 vaccines that are expected.

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