With countries in the process of authorizing distribution of the first COVID-19 vaccines, lactation consultants may have questions about accessing the immunization as well as available safety information for breastfeeding and chestfeeding clients.
In this rapidly changing environment, ILCA is continuing to gather and disseminate international and regional updates about lactation-related COVID information here. Please consider sharing with us information or guidelines from your region that may be helpful to your colleagues and those you serve.
Watch here and on our social media for rapid updates as they become available.
Can IBCLCs and other lactation care providers be included in early priority groups to receive the vaccine?
While the World Health Organization (WHO) has provided guidance on vaccine access and allocation, decisions about how to prioritize who receives vaccines as they become available are being made at the local level. These plans are being made by countries, states or territories, depending on the region.
WHO guidelines prioritize health care workers for early access to the vaccine. However, their scenario-based recommendations vary based on factors including the local virus spread, the available vaccine in each community, and the healthcare worker’s risk of contracting the virus based on setting.
Understanding the role of IBCLCs in the health care system
If your local vaccine distribution plan follows the WHO framework, it is likely to prioritize your access based on local conditions and how the setting in which you practice impacts your risk of contracting COVID-19. You may also have the opportunity to play a leadership role in decisions at your facility or in your region. Here is some information you may find helpful as you navigate the question of how your role within the healthcare system relates to your priority status.
The independent international certification body conferring the IBCLC credential – the International Board of Lactation Consultant Examiners (IBLCE) – includes this in their definition of an IBCLC:
What is an IBCLC? International Board Certified Lactation Consultants function and contribute as members of the maternal-child health team. (Find it here)
The United States Centers for Disease Control and Prevention includes this definition of healthcare personnel in its resources on the coronavirus:
Healthcare Personnel (HCP): HCP refers to all paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances (e.g., blood, tissue, and specific body fluids); contaminated medical supplies, devices, and equipment; contaminated environmental surfaces; or contaminated air. HCP include, but are not limited to, emergency medical service personnel, nurses, nursing assistants, home healthcare personnel, physicians, technicians, therapists, phlebotomists, pharmacists, students and trainees, contractual staff not employed by the healthcare facility, and persons not directly involved in patient care, but who could be exposed to infectious agents that can be transmitted in the healthcare setting (e.g., clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, and volunteer personnel). (Find it here)
The World Health Organization, in a document on the National Health Workforce Accounts, offers this definition:
“The health workforce (HWF) includes all types of health, social, and support workers.” (p. 8) (find it here)
And in another document on health workers, offers this definition:
“This report defines health workers to be all people engaged in actions whose primary intent is to enhance health.” (find it here)
What can we tell clients about the safety of COVID-19 vaccines during pregnancy and lactation?
First, it is important to remind families that much of the information we need to make decisions is still forthcoming.
You may also provide them with guidance on what we know so far:
- Overall safety considerations for pregnancy and for lactation may be different and should be considered separately.
- Just as distribution of the vaccine happens locally, safety approval also is guided by local regulatory processes, typically at the national level.
- These safety approval processes include a review of the outcomes of clinical trials. However, phase three clinical trials, which test vaccines for efficacy and safety, have not yet been conducted on people who are pregnant or lactating.
- While additional data are on the way, in the short term, guidelines from different countries are likely to be conflicting as each region weighs the balance of limited evidence with a vaccine for a novel virus against their knowledge of the protective benefits of lactation.
We know that further information is critical for healthcare workers and essential workers who are also lactating. (See this op ed for context in the US setting.) ILCA will share more information as it becomes available.
Do you have information about how decisions about vaccine allocation is occurring or vaccine recommendations for those breastfeeding or chestfeeding in your community? Let us know in the comments or email us at media@ilca.org. We will continue to update ilca.org/COVID-19 with new information as it becomes available.
From NYTimes …” Pfizer representatives said on Friday that they had seen no evidence that the vaccine affects gestation or fertility. About two dozen women became pregnant during the clinical trials after being vaccinated, and the company is monitoring them.”