Healthcare workers who breastfeed should be offered the covid-19 vaccine

The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) has advised that no breastfeeding woman should receive the Pfizer-BioNTech covid-19 vaccine. NHS Trusts have interpreted this as a blanket-ban. The decision disregards an individual’s particular level of exposure to the virus or her likelihood of developing a severe form of the disease. The MHRA’s stance, and associated restrictions around pregnancy, could undermine efforts to achieve high levels of vaccination, and worsen the UK’s already low breastfeeding rates. Breastfeeding women have been excluded from the Pfizer, AstraZeneca and Moderna vaccine trials. To date, no plausible biological mechanism for how an inactivated, recombinant vaccine would cause harm to a breastfed baby has been proposed. [1] However, any data gap leaves open a possibility of risk. Yet men who are trying to conceive can be vaccinated, even though no data exists about the vaccine’s effect on spermatogenesis. Regarding lactation, theoretical risk must be weighed against the established benefits of acquiring immunity to covid-19 and of continued breastfeeding.