Diphtheria-Tetanus-Pertussis Vaccines use while Breastfeeding

Diphtheria-Tetanus-Pertussis Vaccines Levels and Effects while Breastfeeding

Summary of Use during Lactation

The Centers for Disease Control and Prevention and several health professional organizations state that vaccines given to a nursing mother do The Centers for Disease Control and Prevention and several health professional organizations state that vaccines given to a nursing mother do not affect the safety of breastfeeding for mothers or infants and that breastfeeding is not a contraindication to DTP vaccine.[1][2][3] Women who have not received acellular pertussis vaccine with tetanus and reduced diphtheria toxoids (Tdap) previously should be vaccinated with Tdap as soon as feasible in the postpartum period, even if they are breastfeeding, as long as they have not been vaccinated with tetanus and reduced diphtheria toxoids (Td) vaccine within the past 2 years.[4] After vaccination, anti-pertussis antibodies appear in milk within 1 to 2 weeks.

Breastfeeding also appears to reduce infant side effects associated with routine childhood immunization. Breastfed infants should be vaccinated according to the routine recommended schedules.

Drug Levels

Maternal Levels. Women who were within 24 hours postpartum received either 0.5 mL of Tdap vaccine (Adacel, Sanofi Pasteur; n = 39) or no vaccine (n = 11). Colostrum or breast milk and blood samples were collected at baseline and 7, 10, 14, and 28 days after vaccination. Breastmilk IgA levels against pertussis toxoid peaked at day 10 postpartum, then slowly decreased. Breast milk antibody levels against the other antipertussis vaccine components, filamentous hemagglutinin and fimbriae types 2 and 3, reached a plateau during days 10 to 14 and then slowly decreased. Breast milk antibody levels against another antipertussis vaccine component, pertactin, peaked on day 14 and then decreased by day 28.[5]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Limited data indicate that breastfeeding can enhance the response of the infant to certain vaccine antigens,[2][3][6] including tetanus toxoid.[7] Breastfed infants are also less likely to have fever[8] and may be less likely to experience anorexia and reduced energy intake[9] after routine childhood immunization than those who are not breastfed.

One study of previously vaccinated infants found that at 21 to 40 months of age breastfed infants had higher IgG levels against diphtheria, higher secretory IgA levels in saliva against diphtheria and tetanus and higher fecal IgM against tetanus than formula-fed infants.[10]

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

References

1. General recommendations on immunization --- recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011;60 (RR-2):1-64. PMID: 21293327

2. Gruslin A, Steben M, Halperin S et al. Immunization in pregnancy: No. 220, December 2008. Int J Gynaecol Obstet. 2009;105:187-91. PMID: 19367691

3. Anon. Human milk. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red Book: 2009 Report of the Committee on Infectious Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009.

4. Murphy TV, Slade BA, Broder KA et al. Prevention of pertussis, tetanus and diphtheria among pregnant and postpartum women and their infants. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2008;57 (RR-4):1-51. PMID: 18509304

5. Halperin BA, Morris A, Mackinnon-Cameron D et al. Kinetics of the antibody response to tetanus-diphtheria-acellular pertussis vaccine in women of childbearing age and postpartum women. Clin Infect Dis. 2011;53:885-92. PMID: 21946190

6. Pabst HF. Immunomodulation by breast-feeding. Pediatr Infect Dis J. 1997;16:991-5. PMID: 9380478

7. Perin MC, Schlindwein CF, de Moraes-Pinto MI et al. Immune response to tetanus booster in infants aged 15 months born prematurely with very low birth weight. Vaccine. 2012;30:6521-6. PMID: 22959983

8. Pisacane A, Continisio P, Palma O et al. Breastfeeding and risk for fever after immunization. Pediatrics. 2010;125:e1448-52. PMID: 20478932

9. Lopez-Alarcon M, Garza C, Habicht JP et al. Breastfeeding attenuates reductions in energy intake induced by a mild immunologic stimulus represented by DPTH immunization: possible roles of interleukin-1beta, tumor necrosis factor-alpha and leptin. J Nutr. 2002;132:1293-8. PMID: 12042449

10. Hahn-Zoric M, Fulconis F, Minoli I et al. Antibody responses to parenteral and oral vaccines are impaired by conventional and low protein formulas as compared to breast-feeding. Acta Paediatr Scand. 1990;1979:1137-42. PMID: 2085099

Diphtheria-Tetanus-Pertussis Vaccines Identification

Substance Name

Diphtheria-Tetanus-Pertussis Vaccines

Drug Class

Vaccines

Administrative Information

LactMed Record Number

101

Last Revision Date

20130907

Disclaimer

Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Disclaimer: This information is not intended as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. Use of this website signifies your agreement to the Terms of Use and Online Privacy Policy.

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