Letter to the Editor: Vaccine Must be Provided to Health Professionals Lactating Mothers

To the Editor,

The third wave of the pandemic is not only severe, but also unusual; it is affecting young, pregnant, and lactating mothers. Vaccine is the only hope, but we read, with great concern, the recently published letter by Mayo and Monfort (2021) on Breastfeeding and COVID-19 Vaccine. As health professionals working in a developing country like Pakistan, where infant mortality and malnutrition among children is major health problem, we are concerned that despite the fact that various vaccines against SARS-CoV-2 virus are now available, none of them included trials with lactating mothers (Bethesda, 2021).

Hence, in most countries, lactating mothers are denied the right to vaccination and they have to choose between getting a vaccine or continuing lactation. Breastmilk not only provides to children essential nutrients and antibodies against various diseases but also decreases risk of ovarian and breast cancers among lactating mothers (Mayo & Monfort, 2021).

We agree with Mayo and Monfort that, as there are no clear cut recommendations, either lactating mothers are advised to postpone the vaccine or stop breastfeeding. Many mothers have no option but to hide their lactating status to get the vaccine and hence it will be more difficult to draw data and have firm recommendations(Adhikari & Spong, 2021; Hotez et al., 2021; Bethesda, 2021).

In Pakistan, the government provided all health care professionals with the Chinese COVID-19 vaccine, Sinopharm, a live attenuated vaccine, having 79% efficacy in preventing symptomatic COVID-19. We conducted a survey to document side effects of the Sinopharm vaccine among health professionals in our institute, the Children’s Hospital and Institute of Child Health in Lahore. In that survey almost 1050 participants took part; we came across 11 lactating mothers who had the two doses of Sinopharm vaccine. The mean age of mothers was 30.9 (SD = 2.94) years and babies had a mean age of 13.9 (SD = 5.48) months with a minimum age of 4 months and a maximum of 21 months. Only one mother reported her baby having mild self-resolving flu lasting 1 day after she had had the first dose of Sinopharm vaccine, and the mother also had mild fever and flu at that time. After the second shot, however, neither mother nor child experienced any side effects. The 10 other mothers reported that their child experienced no apparent side effects after they received both shots of vaccine. All the mothers experienced either no or mild side effects like pain at injection site, fever, myalgia, sore throat, flu, or headache that usually resolved within 1–3 days without affecting their milk production or lactation.

Although we know our data are not enough to reach a proven conclusion about the safety of COVID-19 live attenuated vaccine in lactating mothers, we nevertheless feel that our findings might encourage health professionals and policy makers to help lactating mothers decide to choose to vaccinate and to continue breastfeeding.