Abstract
Breastfeeding mothers were excluded from the clinical trials conducted for vaccines against SARS-CoV-2. Since the start of the vaccination, some doubts have arisen regarding its compatibility with breastfeeding. The aim of this study was to analyse the presence of anti-SARS-CoV-2 antibodies in breast milk and serum (IgG and IgA) of vaccinated breastfeeding women. The main variables of the observational study were: adverse related events after vaccination and determination of the presence of IgG and IgA isotypes antibodies in serum and in breast milk of vaccinated women against the SARS-CoV-2 antigens. Results: 110 breastfeeding mothers were included; 70 women (63.6%) were vaccinated with two doses of BNT162b2, 20 women (18.2%) with two doses of mRNA-1273, and 20 women (18.2%) with a single dose of ChAdOx1-S. Regarding adverse reactions and vaccine safety, 38 women had no adverse reactions; 20 (18.2%) had general malaise or adenopathies; 10 (9.1%) had a headache; and 7 (6.4%) had fever. When analysing IgG antibodies, significantly higher levels of antibodies were found in serum and breast milk from mothers vaccinated with BNT162b2 or mRNA-1273 vs. ChAdOx1-S (p < 0.001 and p = 0.001, respectively). Analysing IgA antibodies, significant differences were found when comparing mean values in serum from mothers vaccinated with BNT162b2 or mRNA-1273 vs. ChAdOx1-S (0.12, 0.16, and 0.02, respectively; p < 0.001) and breast milk of mothers vaccinated when comparing BNT16b2 vs. ChAdOx1-S. All vaccinated breastfeeding mothers had serum anti-S1 IgG antibodies in response to vaccination against SARS-CoV-2, regardless of the commercial vaccine administered. Conclusions: the anti-SARS-CoV-2 vaccines were well tolerated by the mothers and the breastfed infant. In addition, breastfeeding mothers offer their infants IgA and IgG isotype antibodies directed against SARS-CoV-2 protein S in breast milk.
Highlights
The World Health Organization and scientific societies in America and Europe recommend exclusive breastfeeding for up to 6 months and continued breastfeeding combined with solid foods for 2 years or more for as long as the mother and the baby desire [1,2,3]
The main objectives of our study were to detect the presence of IgG and IgA antibodies directed against SARS-CoV-2 protein S in blood from breastfeeding women and to detect the presence of IgA and IgG isotype antibodies directed against SARS-CoV-2 protein S in breast milk
Our study shows that the anti-SARS-CoV-2 vaccines used were well tolerated by mothers and breastfed infants
Summary
The World Health Organization and scientific societies in America and Europe recommend exclusive breastfeeding for up to 6 months and continued breastfeeding combined with solid foods for 2 years or more for as long as the mother and the baby desire [1,2,3]. The World Health Organization recommends exclusive breastfeeding for the first 6 months of life, even if the mother is infected with the new SARS-CoV-2 coronavirus [10]. RNA particles of the virus were detected in about 10% of breast milk samples tested [12], neither viable nor transmissible SARS-CoV-2 was detected in breast milk, and there are no documented cases of transmission to the infant through breast milk [13,14]
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