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SARS-CoV-2–Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

On December 20, 2020, Israel initiated a national vaccination program against COVID-19. One prioritized group was health care workers, many of whom are breastfeeding women.1 Despite the fact that the vaccine trial did not include this population2 and no other vaccine-related safety data had been published, breastfeeding women belonging to risk groups were encouraged to receive the vaccine.3 The Centers for Disease Control and Prevention has also recommended that breastfeeding women belonging to vaccine-target groups be immunized.4 We investigated whether maternal immunization results in secretion of SARS-CoV-2 antibodies into breast milk and evaluated any potential adverse events among women and their infants.

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Article Information

Corresponding Author: Ilan Youngster, MD, MMSc, Pediatric Infectious Diseases Unit and the Center for Microbiome Research, Shamir Medical Center, Zerifin 70300, Israel (youngsteri@shamir.gov.il).

Accepted for Publication: March 30, 2021.

Published Online: April 12, 2021. doi:10.1001/jama.2021.5782

Author Contributions: Dr Youngster had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr Perl and Ms Uzan-Yulzari contributed equally as co–first authors. Mr Rinott and Dr Youngster contributed equally as co–senior authors.

Concept and design: Perl, Uzan-Yulzari, I. Youngster.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Perl, Uzan-Yulzari, Asiskovich, M. Youngster, Rinott, I. Youngster.

Critical revision of the manuscript for important intellectual content: Klainer, M. Youngster, Rinott, I. Youngster.

Statistical analysis: Rinott, I. Youngster.

Administrative, technical, or material support: Perl, Uzan-Yulzari, Klainer, Asiskovich, M. Youngster.

Supervision: Perl, Rinott, I. Youngster.

Other: Uzan-Yulzari, Klainer.

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank Elkana Kohn, PhD, and Netanel Agajany, MD (both for data collection) and Dvora Stahi, MSc (for data analysis), all affiliated with Shamir Medical Center, Zerifin, Israel; none was compensated for his or her contributions.

References
1.
State of Israel Ministry of Health. The COVID-19 vaccine operation launched today. State of Israel Ministry of Health; 2021. Posted December 19, 2020. Accessed February 24, 2021. https://www.gov.il/en/Departments/news/19122020-02
2.
Polack  FP , Thomas  SJ , Kitchin  N ,  et al; C4591001 Clinical Trial Group.  Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine.   N Engl J Med. 2020;383(27):2603-2615. doi:10.1056/NEJMoa2034577PubMedGoogle ScholarCrossref
3.
Israel Society of Obstetrics and Gynecology. Guidelines for COVID-19 vaccination in pregnant and nursing women. Guidelines in Hebrew. Published December 20, 2020. Accessed February 24, 2021. https://govextra.gov.il/media/30093/pregnancy-covid19-vaccine.pdf
4.
Information about COVID-19 Vaccines for People who are pregnant or breastfeeding. Centers for Disease Control and Prevention. Accessed February 24, 2021. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html
5.
Pace  RM , Williams  JE , Järvinen  KM ,  et al.  Characterization of SARS-CoV-2 RNA, antibodies, and neutralizing capacity in milk produced by women with COVID-19.   mBio. 2021;12(1):1-11. doi:10.1128/mBio.03192-20PubMedGoogle ScholarCrossref
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