Measles-Mumps-Rubella Vaccine use while Breastfeeding

Measles-Mumps-Rubella Vaccine 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 not affect the safety of breastfeeding for mothers or infants and that breastfeeding is not a contraindication to MMR vaccine. Breastfed infants should be vaccinated according to the routine recommended schedules. Although rubella vaccine virus might be excreted into milk, the virus usually does not infect the infant. If an infection does occur, it is well tolerated because the viruses are attenuated.[1][2][3] No clear evidence exists of live attenuated measles or mumps vaccine virus excretion into breastmilk.[4]

Drug Levels

Maternal Levels. No studies have evaluated the effects of the combined measles, mumps and rubella (MMR) vaccine during breastfeeding. A study of mothers vaccinated with the Cendehill strain of live, attenuated rubella virus found no transmission of the live virus to their breastfed infants.[5] However, rubella vaccine virus can appear in breastmilk and result in infections in some infants.[6][7][8][9] See "Reported Side Effects In Breastfed Infants" below.

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][10]

One 12-day-old breastfed infant developed a rubella infection 11 days after maternal vaccination with live rubella vaccine.[11] However, it is questionable if maternal vaccination was the cause of the infant's infection.[12]

Another breastfed infant had live rubella vaccine virus isolated from a throat swab after maternal immunization. The infant did not demonstrate seroconversion or adverse reactions.[6]

Some breastfed infants acquire passive immunity to rubella after maternal vaccination as do infants of mothers with natural rubella immunity. However, neither group of infants had a decreased response to rubella vaccine administered to the infant at 15 to 18 months of age.[7]

After immunization of their mothers with rubella vaccine, 25% of breastfed infants in one study showed transient seroconversion to rubella virus but without any clinical disease.[8]

Possible Effects on Lactation

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

References

1. 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

2. 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.

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

4. Alain S, Dommergues MA, Jacquard AC et al. State of the art: Could nursing mothers be vaccinated with attenuated live virus vaccine? Vaccine. 2012;30:4921-6. PMID: 22659446

5. Farquhar JD. Follow-up on rubella vaccinations and experience with subclinical reinfection. J Pediatr. 1972;81:460-5. PMID: 5065683

6. Buimovici-Klein E, Hite RL, Byrne T et al. Isolation of rubella virus in milk after pospartum immunization. J Pediatr. 1977;91:939-41. PMID: 925824

7. Krogh V, Duffy LC, Wong D et al. Postpartum immunization with rubella virus vaccine and antibody response in breast-feeding infants. J Lab Clin Med. 1989;113(6):695-9. PMID: 2732617

8. Losonsky GA, Fishaut JM, Strussenberg J. Effect of immunization against rubella on lactation products. II. Maternal-neonatal interactions. J Infect Dis. 1982;145:661-6. PMID: 7077090

9. Losonsky GA , Fishaut JM, Strussenberg J, Ogra PL. Effect of immunization against rubella on lactation products. I. Development and characterization of specific immunologic reactivity in breast milk. J Infect Dis. 1982;145:654-60. PMID: 7077089

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

11. Landes RD, Bass JW, Millunchick EW et al. Neonatal rubella following postpartum maternal immunization. J Pediatr. 1980;97:465-7. PMID: 7191002

12. Lerman SJ. Neonatal rubella following maternal immunization. J Pediatr. 1981;98:668-9. Letter. PMID: 7205504

Measles-Mumps-Rubella Vaccine Identification

Substance Name

Measles-Mumps-Rubella Vaccine

Drug Class

  • Vaccines

Administrative Information

LactMed Record Number

186

Information from the National Library of Medicine's LactMed Database.

Last Revision Date

2013-09-07

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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