Pregnant & Breastfeeding Women Who Get the COVID-19 Vaccine Are Protecting Their Infants, Research Suggests
Becky Cummings, who got vaccinated in December, snuggles her newborn, Clark, while he takes a nap.
Becky Cummings had multiple reasons to get vaccinated against COVID-19 while tending to her firstborn, Clark, who arrived in September 2020 at 27 weeks.
The 29-year-old intensive care unit nurse in Greensboro, North Carolina, had witnessed the devastation day in and day out as the virus took its toll on the young and old. But when she was offered the vaccine, she hesitated, skeptical of its rapid emergency use authorization.
Exclusion of pregnant and lactating mothers from clinical trials fueled her concerns. Ultimately, though, she concluded the benefits of vaccination outweighed the risks of contracting the potentially deadly virus.
"Long story short," Cummings says, in December "I got vaccinated to protect myself, my family, my patients, and the general public."
At the time, Cummings remained on the fence about breastfeeding, citing a lack of evidence to support its safety after vaccination, so she pumped and stashed breast milk in the freezer. Her son is adjusting to life as a preemie, requiring mother's milk to be thickened with formula, but she's becoming comfortable with the idea of breastfeeding as more research suggests it's safe.
"If I could pop him on the boob," she says, "I would do it in a heartbeat."
Now, a study recently published in the Journal of the American Medical Association found "robust secretion" of specific antibodies in the breast milk of mothers who received a COVID-19 vaccine, indicating a potentially protective effect against infection in their infants.
The presence of antibodies in the breast milk, detectable as early as two weeks after vaccination, lasted for six weeks after the second dose of the Pfizer-BioNTech vaccine.
"We believe antibody secretion into breast milk will persist for much longer than six weeks, but we first wanted to prove any secretion at all after vaccination," says Ilan Youngster, the study's corresponding author and head of pediatric infectious diseases at Shamir Medical Center in Zerifin, Israel.
That's why the research team performed a preliminary analysis at six weeks. "We are still collecting samples from participants and hope to soon be able to comment about the duration of secretion."
As with other respiratory illnesses, such as influenza and pertussis, secretion of antibodies in breast milk confers protection from infection in infants. The researchers expect a similar immune response from the COVID-19 vaccine and are expecting the findings to spur an increase in vaccine acceptance among pregnant and lactating women.
A COVID-19 outbreak struck three families the research team followed in the study, resulting in at least one non-breastfed sibling developing symptomatic infection; however, none of the breastfed babies became ill. "This is obviously not empirical proof," Youngster acknowledges, "but still a nice anecdote."
Leaps.org inquired whether infants who derive antibodies only through breast milk are likely to have a lower immunity than infants whose mothers were vaccinated while they were in utero. In other words, is maternal transmission of antibodies stronger during pregnancy than during breastfeeding, or about the same?
"This is a different kind of transmission," Youngster explains. "When a woman is infected or vaccinated during pregnancy, some antibodies will be transferred through the placenta to the baby's bloodstream and be present for several months." But in the nursing mother, that protection occurs through local action. "We always recommend breastfeeding whenever possible, and, in this case, it might have added benefits."
A study published online in March found COVID-19 vaccination provided pregnant and lactating women with robust immune responses comparable to those experienced by their nonpregnant counterparts. The study, appearing in the American Journal of Obstetrics and Gynecology, documented the presence of vaccine-generated antibodies in umbilical cord blood and breast milk after mothers had been vaccinated.
Natali Aziz, a maternal-fetal medicine specialist at Stanford University School of Medicine, notes that it's too early to draw firm conclusions about the reduction in COVID-19 infection rates among newborns of vaccinated mothers. Citing the two aforementioned research studies, she says it's biologically plausible that antibodies passed through the placenta and breast milk impart protective benefits. While thousands of pregnant and lactating women have been vaccinated against COVID-19, without incurring adverse outcomes, many are still wondering whether it's safe to breastfeed afterward.
It's important to bear in mind that pregnant women may develop more severe COVID-19 complications, which could lead to intubation or admittance to the intensive care unit. "We, in our practice, are supporting pregnant and breastfeeding patients to be vaccinated," says Aziz, who is also director of perinatal infectious diseases at Stanford Children's Health, which has been vaccinating new mothers and other hospitalized patients at discharge since late April.
Earlier in April, Huntington Hospital in Long Island, New York, began offering the COVID-19 vaccine to women after they gave birth. The hospital chose the one-shot Johnson & Johnson vaccine for postpartum patients, so they wouldn't need to return for a second shot while acclimating to life with a newborn, says Mitchell Kramer, chairman of obstetrics and gynecology.
The hospital suspended the program when the Food and Drug Administration and the Centers for Disease Control and Prevention paused use of the J&J vaccine starting April 13, while investigating several reports of dangerous blood clots and low platelet counts among more than 7 million people in the United States who had received that vaccine.
In lifting the pause April 23, the agencies announced the vaccine's fact sheets will bear a warning of the heightened risk for a rare but serious blood clot disorder among women under age 50. As a result, Kramer says, "we will likely not be using the J&J vaccine for our postpartum population."
So, would it make sense to vaccinate infants when one for them eventually becomes available, not just their mothers? "In general, most of the time, infants do not have as good of an immune response to vaccines," says Jonathan Temte, associate dean for public health and community engagement at the University of Wisconsin School of Medicine and Public Health in Madison.
"Many of our vaccines are held until children are six months of age. For example, the influenza vaccine starts at age six months, the measles vaccine typically starts one year of age, as do rubella and mumps. Immune response is typically not very good for viral illnesses in young infants under the age of six months."
So far, the FDA has granted emergency use authorization of the Pfizer-BioNTech vaccine for children as young as 16 years old. The agency is considering data from Pfizer to lower that age limit to 12. Studies are also underway in children under age 12. Meanwhile, data from Moderna on 12-to 17-year-olds and from Pfizer on 12- to 15-year-olds have not been made public. (Pfizer announced at the end of March that its vaccine is 100 percent effective in preventing COVID-19 in the latter age group, and FDA authorization for this population is expected soon.)
"There will be step-wise progression to younger children, with infants and toddlers being the last ones tested," says James Campbell, a pediatric infectious diseases physician and head of maternal and child clinical studies at the University of Maryland School of Medicine Center for Vaccine Development.
"Once the data are analyzed for safety, tolerability, optimal dose and regimen, and immune responses," he adds, "they could be authorized and recommended and made available to American children." The data on younger children are not expected until the end of this year, with regulatory authorization possible in early 2022.
For now, Vonnie Cesar, a family nurse practitioner in Smyrna, Georgia, is aiming to persuade expectant and new mothers to get vaccinated. She has observed that patients in metro Atlanta seem more inclined than their rural counterparts.
To quell some of their skepticism and fears, Cesar, who also teaches nursing students, conceived a visual way to demonstrate the novel mechanism behind the COVID-19 vaccine technology. Holding a palm-size physical therapy ball outfitted with clear-colored push pins, she simulates the spiked protein of the coronavirus. Slime slathered at the gaps permeates areas around the spikes—a process similar to how our antibodies build immunity to the virus.
These conversations often lead hesitant patients to discuss vaccination with their husbands or partners. "The majority of people I'm speaking with," she says, "are coming to the conclusion that this is the right thing for me, this is the common good, and they want to make sure that they're here for their children."
CORRECTION: An earlier version of this article mistakenly stated that the COVID-19 vaccines were granted emergency "approval." They have been granted emergency use authorization, not full FDA approval. We regret the error.
Podcast: Wellness chatbots and meditation pods with Deepak Chopra
Leaps.org talked with Deepak Chopra about new technologies he's developing for mental health with Jonathan Marcoschamer, CEO of OpenSeed, and others.
Over the last few decades, perhaps no one has impacted healthy lifestyles more than Deepak Chopra. While several of his theories and recommendations have been criticized by prominent members of the scientific community, he has helped bring meditation, yoga and other practices for well-being into the mainstream in ways that benefit the health of vast numbers of people every day. His work has led many to accept new ways of thinking about alternative medicine, the power of mind over body, and the malleability of the aging process.
His impact is such that it's been observed our culture no longer recognizes him as a human being but as a pervasive symbol of new-agey personal health and spiritual growth. Last week, I had a chance to confirm that Chopra is, in fact, a human being – and deserving of his icon status – when I talked with him for the Leaps.org podcast. He relayed ideas that were wise and ancient, yet highly relevant to our world today, with the fluidity and ease of someone discussing the weather. Showing no signs of slowing down at age 76, he described his prolific work, including the publication of two books in the past year and a range of technologies he’s developing, including a meditation app, meditation pods for the workplace, and a chatbot for mental health called Piwi.
Take a listen and get inspired to do some meditation and deep thinking on the future of health. As Chopra told me, “If you don’t have time to meditate once per day, you probably need to meditate twice per day.”
Highlights:
2:10: Chopra talks about meditation broadly and meditation pods, including the ones made by OpenSeed for meditation in the workplace.
6:10: The drawbacks of quick fixes like drugs for mental health.
10:30: The benefits of group meditation versus individual meditation.
14:35: What is a "metahuman" and how to become one.
19:40: The difference between the conditioned mind and the mind that's infinitely creative.
22:48: How Chopra's views of free will differ from the views of many neuroscientists.
28:04: Thinking Fast and Slow, and the role of intuition.
31:20: Athletic and creative geniuses.
32:43: The nature of fundamental truth.
34:00: Meditation for kids.
37:12: Never alone.Love and how AI chatbots can support mental health.
42:30: Extending lifespan, gene editing and lifestyle.
46:05: Chopra's mentor in living a long good life (and my mentor).
47:45: The power of yoga.
Links:
- OpenSeed meditation pods for people to meditate at work (Chopra is an advisor to OpenSeed).
- Chopra's book from 2021, Metahuman: Unleash Your Infinite Potential
- Chopra's book from 2022, Abundance: The Inner Path to Wealth
- NeverAlone.Love, Chopra's collaboration of businesses, policy makers, mental health professionals and others to raise awareness about mental health, advance scientific research and "create a global technology platform to democratize access to resources."
- The Piwi chatbot for mental health
- The Chopra Meditation & Well-Being App for people of all ages
- Only 1.6 percent of U.S. children meditate, according to the National Center for Complementary and Integrative Health
Podcast: The Friday Five weekly roundup in health research
Scientists have designed a phone app that could alert consumers to high levels of cancer-causing chemicals, Yale researchers revive organs in dead pigs, and more in this week's Friday Five.
The Friday Five covers five stories in health research that you may have missed this week. There are plenty of controversies and troubling ethical issues in science – and we get into many of them in our online magazine – but this news roundup focuses on scientific creativity and progress to give you a therapeutic dose of inspiration headed into the weekend.
Listen to the Episode
Listen on Apple | Listen on Spotify | Listen on Stitcher | Listen on Amazon | Listen on Google
Covered in this week's Friday Five:
- A new blood test for cancer
- Patches of bacteria can use your sweat to power electronic devices
- Researchers revive organs of dead pigs
- Phone apps detects cancer-causing chemicals in foods
- Stem cells generate "synthetic placentas" in mice
Plus, an honorable mention for early research involving vitamin K and Alzheimer's