Poliovirus Vaccines use while Breastfeeding

Poliovirus Vaccines Levels and Effects while Breastfeeding

Summary of Use during Lactation

The Centers for Disease Control and Prevention and American Academy of Pediatrics 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 poliovirus vaccine. The injectable polio vaccine now recommended in the United States is inactivated and poses no risk when given to mothers who are breastfeeding.[1][2] Breastfeeding also appears to reduce infant side effects associated with routine childhood immunization. Breastfed infants should be vaccinated according to the routine recommended schedules. Exclusive breastfeeding improves the response to oral polio vaccine in countries with poor infant nutrition and high rates of infant diarrhea.

Drug Levels

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

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

Effects in Breastfed Infants

Breastfed infants are less likely to have fever[3] and may be less likely to experience anorexia and reduced energy intake[4] after routine childhood immunization than those who are not breastfed.

Administration of oral poliovirus vaccine to nursing infants is less effective if it is given the neonatal period, due to maternal antibodies in colostrum and breastmilk.[5][6][7] However, when given according to accepted vaccination schedules, breastfeeding does not interfere with the infant's response to oral polio vaccine.[8][9][10]

One study found that in previously vaccinated infants at 21 to 40 months of age breastfed infants had higher neutralizing antibody titers, higher secretory IgA levels in saliva and higher fecal IgM against polio than formula-fed infants.[11]

A study in Zambia found that infants whose mothers were infected with HIV had reduced antibody responses to oral polio vaccination than infants whose mothers were HIV negative. However, when results were corrected for duration of breastfeeding, difference was small. The authors concluded that HIV-positive mothers breastfed for shorter durations (mean 6 months) than HIV-negative mothers (mean 15 months), resulting in a lowered immune response to oral polio vaccine.[12]

A study in Bangladesh found that antibody titers for oral poliovirus vaccine (OPV) type 3 were inadequate in 13.6% of infants who received OPV at 6 months and 7.3% of infants who received OPV at 12 months. Failure rates for types 1 and 2 were lower, as was the failure rate for intramuscular polio vaccine. Malnutrition and more than 2 diarrheal episodes appeared to be the causative factors for the poor response. Exclusive breastfeeding was associated with a better response to OPV 3.[13]

Possible Effects on Lactation

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

4. 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

5. World Health Organization Collaborative Study Group on Oral Poliovirus Vaccine. Factors affecting the immunogenicity of oral poliovirus vaccine: a prospective evaluation in Brazil and the Gambia. J Infect Dis. 1995;171:1097-106. PMID: 7751683

6. Plotkin SA, Katz M, Brown RE et al. Oral poliovirus vaccination in newborn African infants. Am J Dis Child. 1966;111:27-30. PMID: 5900282

7. Zaman S, Carlsson B, Jalil F et al. Specific antibodies to poliovirus type I in breastmilk of unvaccinated mothers before and seven years after start of community-wide vaccination of theirinfants with live, oral poliovirus vaccine. Acta Paediatr Scand. 1991;80:1174-82. PMID: 1785290

8. Triki H, Abdallah MV, Ben Aissa R et al. Influence of host related factors on the antibody response to trivalent oral polio vaccine in Tunisian infants. Vaccine. 1997;15:1123-9. PMID: 9269056

9. Kim-Farley R, Brink E, Orenstein W et al. Vaccination and breast-feeding. JAMA. 1982;248:2451-2. Letter. PMID: 7131700

10. John TJ, Devarajan LV, Luther L et al. Effect of breast-feeding on seroresponse of infants to oral poliovirus vaccination. Pediatrics. 1976;57:47-53. PMID: 174056

11. 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;79:1137-42. PMID: 2085099

12. Sanz-Ramos M, Manno D, Kapambwe M et al. Reduced poliovirus vaccine neutralising-antibody titres in infants with maternal HIV-exposure. Vaccine. 2013;31:2042-9. PMID: 23474309

13. Haque R, Snider C, Liu Y et al. Oral polio vaccine response in breast fed infants with malnutrition and diarrhea. Vaccine. 2014;32:478-82. PMID: 24300591

Poliovirus Vaccines Identification

Substance Name

Poliovirus Vaccines

Drug Class

  • Vaccines

Administrative Information

LactMed Record Number

221

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

Last Revision Date

2014-02-04

Disclaimer

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