COVID-19 Vaccination During Breastfeeding: Is It Worth It and Why

In the context of the extreme danger of coronavirus infection for all population categories, including pregnant and breastfeeding mothers, the question of whether to get the COVID-19 vaccine if a woman is nursing is very concerning for moms and those who are about to become them. Until recently, breastfeeding was a contraindication to vaccination. 

However, currently, the Ministry of Health has removed this point from the list of factors prohibiting coronavirus vaccination. Now, according to the vaccine instructions, the decision on whether to vaccinate against coronavirus while breastfeeding is made by the nursing woman herself. Before making a decision, she is advised to conduct an independent assessment of the benefits and risks of such vaccination.

COVID-19 Vaccination and Breastfeeding

Observations during the incomplete 2 years of the coronavirus pandemic cannot be called extensive. Therefore, until recently, coronavirus vaccination during breastfeeding was not recommended for nursing mothers. Moreover, breastfeeding a newborn was considered a medical contraindication for vaccination. Recommendations for vaccinations for breastfeeding mothers were updated by the WHO (World Health Organization) in July 2021. Experts concluded that there is no evidence of greater danger of coronavirus for breastfeeding mothers than for other population groups. Additionally, the WHO emphasized the safety of vaccination during breastfeeding for both mother and child. Based on these facts, the Russian Ministry of Health also revised recommendations for the use of “Sputnik V” for vaccinating pregnant and breastfeeding women, noting at the same time the uncertainty regarding the possibility of vaccine components entering breast milk.

Factors Affecting the Course of Coronavirus Infection in Breastfeeding Mothers

All population categories are susceptible to COVID-19, including women preparing to become mothers and those breastfeeding newborns. The presence of breastfeeding does not affect the increased or decreased risk of infection or the severity of the illness. The situation is complicated by the fact that an infected woman must care for her breastfed child. WHO experts have found no evidence that a mother can transmit COVID-19 to her baby through breast milk. 

However, she will need to take extra precautions while feeding to prevent infection either through airborne transmission or direct tactile contact with the newborn. In cases of severe illness or when separation from the baby is necessary, a woman may need to express her milk to continue important breastfeeding.

Vaccine Features: “Sputnik V”

The existing and approved drugs that can be vaccinated with in Russia today are “Sputnik V”, “EpiVacCorona”, and “CoviVac”. Despite the common goal, they all have different active ingredients and elicit an immune response in the human body differently. The most well-known is “Sputnik V”, considered permissible for coronavirus vaccination during breastfeeding. The drug is a vector combined vaccine, which includes two doses. 

Their composition contains adenovirus vectors that are incapable of reproduction and deliver the coronavirus S-protein gene into the body. The consequences of the vaccine’s action are the production of this protein by the body. The human immune system, in turn, develops its response to it in the form of antibodies to the coronavirus S-protein (specifically, to its receptor-binding domain), considered neutralizing or those that prevent infection. 

Nuances of “EpiVacCorona” and “KoviVak”

The two other drugs are newer and differ from the popular “Sputnik V” because:

• “EpiVacCorona” is a peptide vaccine, which differs from “Sputnik V” in that it does not contain a biological agent. The preparation includes short artificially synthesized peptide fragments of viral proteins. Through them, the immune system is trained, allowing it to recognize and neutralize the virus in the future.
• “KoviVac” is a so-called whole-virion vaccine. It contains the SARS-CoV-2 coronavirus, which has undergone special processing in such a way that all its infectious properties are destroyed while retaining the ability to elicit an immune response. As a result, a complex immune response is formed not only to the S-protein or its components but to all existing coronavirus proteins.

Contraindications for vaccination for breastfeeding women

If a woman decides to get vaccinated against the coronavirus while breastfeeding, she can do so on general terms. This means that the medical exemption for her to do so may be considered those contraindications that exist for other categories of citizens who have made a similar decision. 

This conclusion can be drawn from the fact that the Ministry of Health excluded breastfeeding from the list of things that may hinder vaccination. Nevertheless, before proceeding with vaccination, a woman who is breastfeeding should inform her family doctor to rule out any diseases or reactions that are considered contraindications for all other population groups.

When vaccination is not recommended

The list of contraindications for the COVID-19 vaccine is constantly being updated by the Ministry of Health. Until recently, vaccination during breastfeeding was considered inadmissible. By mid-December of this year, updates to the list of reasons that serve as obstacles to vaccination are expected. Currently, immunologists consider any chronic diseases in the acute stage as the main situational contraindications to COVID-19 vaccination, including for breastfeeding mothers. 

This could be the decompensation of diabetes mellitus or autoimmune processes at this stage. You should not get vaccinated in cases of:

• ARVI (Acute Respiratory Viral Infection);
• tonsillitis;
• acute bronchitis.

After recovery, the vaccine can be administered two weeks later. Permanent medical exemptions can only be due to a patient’s hypersensitivity to the components of previously administered vaccines or a severe allergic reaction to them.