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  • Dr. Bow Tie

COVID-19: BREAST MILK, MENSTRUATION, AND AVOIDING INFECTIONS

These days, there is a new level of vigilance regarding infectious disease. We still have a global pandemic going on with COVID-19, as well as an epidemic of Monkeypox, and now, as students return to school we will start to see more of the typical infections that return with students being crowded in a room together. Now, most of those - common colds, flu-like illnesses, stomach bugs, will be what we have been used to long before the pandemic hit. Still, things have changed, and despite what anti-vaccine advocates and COVID-denying physicians have said, we are not going back to pre-pandemic normal (and remember, pre-pandemic normal was not that great, either).


IS THERE mRNA IN BREAST MILK?!

Recently a paper was published in JAMA Pediatrics that anti-vaxxers have hyped up and, as usual, they're grasping for straws. The study looked at breast milk after COVID-19 vaccination. It found mRNA in breast milk.


But wait.


It detected literally a picogram of mRNA in the breast milk. That's 0.1 parts per billion. Viki Male, an immunologist, compares it to "a single tear in an Olympic pool." The study was also only in 11 people. That's a tiny study and not much on which to base any kind of decisions to change recommendations, which are currently that any pregnant or breastfeeding person without any real contraindication to the vaccine (of which there are extremely few) should get vaccinated. This paper is also in line with other small studies that showed the same thing - a tiny amount may end up in the breast milk, but it won't hurt. This is not a live vaccine, so there is no chance of spreading COVID-19 disease to the baby. Someone else also brought up that if the vaccine worked via ingestion...we would be doing that instead. There have also been other studies that did not find any of the other vaccine components (lipid molecule or polyethylene glycol component) in breast milk. There have been no adverse events seen from breastfeeding after vaccination - the only thing that happens is that the baby gets antibodies, which is exactly what is supposed to happen.


MENSTRUAL CYCLES...AGAIN

The Washington Post issued an article just yesterday (I literally had finished writing this and had to go back and edit) and I reported the corresponding Tweet as misleading. The terribly-framed headline? "Women said coronavirus shots affect periods. A new study shows they're right." First off, we knew that already. We already knew that menstruation can be TEMPORARILY affected by any number of factors, including the immune response to vaccines. Further, if you read the Tweet or further in the article, the study found that menstrual cycles were delayed, on average, by ONE DAY and it resolved, on average, after ONE CYCLE.


Multiple large studies have shown that there are no permanent adverse effects on menstruation or pregnancy from COVID-19 vaccines. What does cause potentially permanent adverse effects on menstruation and/or pregnancy? COVID-19 infection.


WHO IS GETTING COVID-19 INFECTIONS THESE DAYS?

A paper was published in the Lancet: Infectious Diseases which took a look at both vaccine-induced and infection-induced immunity against Omicron subvariant BA.2. It proved, of course, that both offered a significant degree of protection, but it also showed that the majority of infections these days are still *first* infections. The pandemic is still ongoing, and as we drop protections such as masks, more people who have protected themselves thus far find themselves exposed more and infected more. This will be especially true in classrooms if students and teachers do not wear masks in those close quarters. This is why vaccines/boosters, masks, frequent hand washing/sanitizing, and frequent testing is still important to reducing spread of this disease!


PLEASE TRY NOT TO SEND YOUR STUDENTS TO SCHOOL WHEN THEY'RE SICK

This is obviously easier said than done. I am not under any illusions that it is easy to keep a kid home from school. Still, if there is one thing that the pandemic has taught us it is that "perfect attendance" is extremely overrated, especially when it puts others at risk. School districts should allow for more sick days and now that we know we can do virtual learning options and accommodate for absences, why wouldn't we take continue to utilize those tools?

We know that masks and other mitigation measures provide remarkable protection against influenza, RSV, rhinoviruses, and less dangerous coronaviruses, as well as stomach bugs and enteroviruses such as EV-D68. We know that because of how far cases dropped over the past two years, and because all of these are resurging as we drop mitigations. They spread with close contact and other methods such as respiratory droplets or contaminated surfaces. So whenever possible (and this applies to work, too), stay home when sick!


BEWARE OF LONG COVID

Remember, even mild or asymptomatic COVID-19 infections can lead to Post-Acute Sequelae of COVID-19, better known as Long COVID. People have experienced persistent shortness of breath, increased oxygen requirements, fast heart beats and the resulting discomfort, extreme fatigue, brain fog and memory issues, and abnormalities in senses of smell and taste, among many other things. Some of these are temporary, but they can last for well over a year in some folks. Each infection or reinfection puts you at risk for Long COVID, and puts your loved ones at risk for it, too.


Get your primary vaccine series, and at least two months after that, get your bivalent booster.

Keep wearing masks in crowded (especially indoor) settings.

Keep testing yourself frequently when going out to avoid asymptomatic spread.

Keep in mind that despite what President Biden says, the pandemic is not over, but we can protect ourselves from its consequences.


JAMA Article: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2796427

I'm not posting the Washington Post article. It doesn't deserve clicks. But here is the NIH press release: https://www.nih.gov/news-events/news-releases/study-confirms-link-between-covid-19-vaccination-temporary-increase-menstrual-cycle-length

Lancet: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00578-3/fulltext



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