Explained: The row in UK around breastfeeding mothers getting Covid-19 vaccine

The NHS says on its website:

“You should wait to have the COVID-19 vaccine if you’re pregnant – you should wait until you’ve had your baby — (and) if you’re breastfeeding — you should wait until you’ve stopped breastfeeding.”

Also, “If you have the vaccine, you should not get pregnant for at least 2 months after having the 2nd dose.”

So is the vaccine unsafe for lactating or pregnant women?

Somewhat confusingly, the NHS also says at the same time that “If you later find out you were pregnant when you had the COVID-19 vaccine, do not worry. The vaccine cannot give you or your baby COVID-19”; and,

“There’s no evidence it’s unsafe if you’re pregnant or breastfeeding. But more evidence is needed before you can be offered the vaccine.”

On its website, the UK government underlines that the advice is precautionary in nature, and does not mean that the vaccine is unsafe.

It says: “The Pfizer-BioNTech COVID-19 vaccine is a new type of vaccine that has been shown to be effective and to have a good safety profile”, but “it has not yet been assessed in pregnancy, so it has been advised that until more information is available, those who are pregnant should not have this vaccine.”

According to the government, it is “standard practice when waiting for such data on any medicine, to avoid its use in those who may become pregnant or who are breastfeeding”.

It adds: “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.”

How many women can be impacted by this advice?

“Hundreds of thousands”, according to The Guardian. This would include an estimated 20,000 frontline workers. Quoting data from Nuffield Trust, an independent health think tank, The Guardian said that in 2018-19, about 46 per cent of mothers in England were breastfeeding babies aged 6-8 weeks.

What have other countries advised?

In the United States, the majority of members in a Centres for Disease Control and Prevention (CDC) Work Group “agreed that breastfeeding would not be a contraindication to receive a COVID-19 vaccine”. In its report, the Work Group noted that there were “limited data on pregnancy expected from Phase III trials” and that the “Work Group did not reach a consensus”. However, the report said that the “majority felt that if a woman is recommended to receive the vaccine in an early allocation phase, pregnancy should be a precaution, but not a contraindication to receive a COVID-19 vaccine”.

There is no specific advice on this aspect in India as yet.

So what are the protesters in the UK arguing?

The Guardian quoted Dr Vicky Thomas of the Hospital Infant Feeding Network (HIFN) as underlining the fact that there was no evidence that the vaccine would be harmful to breastfeeding mothers or their children. “Denying women the opportunity to be protected, or alternatively forcing them to lose the health impacts of breastfeeding for themselves and their children is yet another example of the way women have been disproportionately affected by Covid-19,” The Guardian quoted Dr Thomas as saying.

The same report quoted Dr Hannah Barham Brown, the deputy leader of the Women’s Equality Party and a trainee GP, as saying: “To insist without any evidence that certain women shouldn’t access it is completely irresponsible, especially as women make up the majority of essential workers in high-risk jobs. Unless the regulatory bodies reassess their position, women will face an unacceptable choice between giving up breastfeeding or putting themselves and those around them at risk.”