Should Pregnant and Lactating People Get the Vaccine?

Kelsey Linn, a 33-year-old pharmacist in Pittsburgh, decided to keep breastfeeding her 13-month-old, Michael, past her planned weaning date after she received her second dose of Moderna’s vaccine on February 14—her son’s birthday. Michael is attending day care three days a week, and since August, his classroom has been shut down twice due to suspected coronavirus exposures. Ajayi, the pediatrician in San Diego, plans to breastfeed newborn Ayokárí for about a year, and is stirring some of her milk into oatmeal and cereal for her older daughter, Tiwalọlà, who is three and a half, just in case it gives her body a boost.

In Virginia, Jeanel Little, a vaccinated nurse practitioner at UVA Health, sought out donor milk for her now-ten-month-old daughter, Ruby, after discovering that she had low supply last summer. Little and her husband figured that, odds are, some of their donors have been vaccinated or were infected, and might be providing some coronavirus-fighting antibodies in their milk. As the pandemic wears on, and Ruby remains unvaccinated, “the breast milk has helped to subside some of [our] fears,” Little told me.

It’s hard to quantify the increasing optimism about vaccinating pregnant and lactating people, or how influential such changes in perspective might be. More of these individuals are certainly signing up for shots—but shots are also more available now. Still, “I definitely think shifting attitudes could be a factor,” Kristen Nordlund, a CDC spokesperson, told me.

Recent data hints that this encouraging trend will continue. Asiodu, at UCSF, began surveying lactating and breastfeeding people about the new vaccines in February. Of the 110 or so people now enrolled in her study, she told me, most haven’t yet had the chance to get a shot. But a majority of them want to. Edlow, who works with patients in Massachusetts, echoes the sentiment: “To me, it seems people are feeling only more positive.”

The intense polarization regarding vaccines, and the public scrutiny over eligibility, has also intensified certain debates over pre- and postpartum health, fetal health, and breastfeeding—topics that were charged long before the pandemic began. Early on, “there was real shaming of pregnant and breastfeeding women on social media” who signed up for their shots, Swamy, of Duke University, told me.

Now there’s danger of stigmatizing vaccinated parents who are unable to, or choose not to, nurse their infants. “These parents aren’t ‘failing’ their children,” Stephanie Langel, an immunologist at Duke, told me. Distancing, hygiene, masking, and vaccinating the adults who interact with the baby will still confer indirect protection, like a cocoon, Edlow, of Massachusetts General Hospital, said. And soon enough, vaccines for infants as young as six months of age will likely be available as well, after going through their own clinical trials.

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