Intended for healthcare professionals


Covid-19: Breastfeeding women can have vaccine after guidance turnaround

BMJ 2021; 372 doi: (Published 08 January 2021) Cite this as: BMJ 2021;372:n64


Why were breastfeeding women denied the covid-19 vaccine?

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  1. Abi Rimmer
  1. The BMJ

The UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) has revised its guidance so that pregnant and breastfeeding women can receive the covid-19 vaccine.

Writing in BMJ Opinion, Helen Hare, an acute medicine trainee, and Kate Womersley, an academic foundation trainee, said that the change had come after strong pressure from campaigners, clinicians, and some of the women affected.1

The MHRA had previously recommended that breastfeeding women should not be given the vaccine, which Hare and Womersley said had been interpreted by NHS trusts as a blanket ban. But on 30 December the agency said that women who were breastfeeding could be given both the Pfizer-BioNTech vaccine and the Oxford-AstraZeneca vaccine.2

It also said that the vaccines could be considered for use in pregnancy but only when the potential benefits outweighed 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,” the MHRA advised.

In guidance also published on 30 December, the Joint Committee on Vaccination and Immunisation confirmed that, although the available data did not indicate any safety concern or harm to pregnancy, there was insufficient evidence to recommend routine use of covid-19 vaccines during pregnancy.3

Informed decision making

The Royal College of Obstetricians and Gynaecologists (RCOG) said that the new guidance meant that pregnant women who were frontline health or social care workers could discuss the option of vaccination. It also meant that frontline health and care workers who were breastfeeding should be offered vaccination, the college said.

Edward Morris, RCOG president, said, “For frontline health and social care workers, and other priority groups, informed decision making should be facilitated. It is important that women continue to be offered occupational protection during pregnancy, regardless of their vaccination choice.”

He said that, along with the Royal College of Midwives and other professional organisations, the RCOG was calling on the UK government to fund research studies to establish the suitability of any approved covid-19 vaccines for pregnant and breastfeeding women.

“The UK has a world leading research and development sector to support a national effort to research the vaccine’s suitability for use in pregnancy, and we are calling for research trials, supported by the Vaccine Taskforce, to begin urgently to get evidence on safety,” said Morris. “The outcomes of this research will be vital for the over 800 000 women each year who conceive, as well as the many women planning a pregnancy.”

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