Cholera Vaccine use while Breastfeeding
Drugs containing Cholera Vaccine: Vaxchora
Cholera 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 cholera vaccine. Breastfed infants should be vaccinated according to the routine recommended schedules.
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
Limited data indicate that breastfeeding can enhance the response of the infant to certain vaccine antigens.
Administration of injectable cholera vaccine increases milk secretory IgA antibodies against cholera in the breastmilk in some reports. Oral cholera vaccines result in a much lower increase in breastmilk anticholera antibodies.  However administration of oral cholera vaccine to the mother decreased the risk of cholera in their breastfed infants by 47% in one study. The authors hypothesized that vaccination of the mothers reduced their transmission of cholera to their infants.
An open-label study in Bangladesh compared the serum immune response to administration of an oral cholera vaccine (Dukoral; containing killed cholera organisms and cholera subunit B) found that withholding breastfeeding for 3 hours before giving the vaccine resulted in a greater antibody response in infants between 10 and 18 months of age. In infants between 6 and 9 months of age, no difference in antibody response was seen between infants who had breastfeeding withheld and those who did not.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
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. American Academy of Pediatrics Committee on Infectious Diseases, Kimberlin DW, Brady MT et al. Red Book: 2015 Report of the Committee on Infectious Diseases. 30th ed. Elk Grove Village, IL: American Academy of Pediatrics. 2015.
4. Pabst HF. Immunomodulation by breast-feeding. Pediatr Infect Dis J. 1997;16:991-5. PMID: 9380478
5. Merson MH, Black RE, Sack DA et al. Maternal cholera immunisation and secretory IgA in breast milk. Lancet. 1980;1:931-2. Letter. PMID: 6103281
6. Svennerholm A-M, Holmgren J, Hanson LA et al. Boosting of secretory IgA antibody responses in man by parenteral cholera vaccination. Scand J Immunol. 1977;6:1345-9. PMID: 605366
7. Jertborn M, Svennerholm AM, Holmgren J. Saliva, breast milk, and serum antibody responses as indirect measures of intestinal immunity after oral cholera vaccination or natural disease. J Clin Microbiol. 1986;24:203-9. PMID: 3528211
8. Clemens JD, Sack DA, Chakraborty J et al. Field trial of oral cholera vaccines in Bangladesh: evaluation of anti-bacterial and anti-toxic breast-milk immunity in response to ingestion of the vaccines. Vaccine. 1990;8:469-72. PMID: 2251873
9. Ahmed T, Svennerholm AM, Al Tarique A et al. Enhanced immunogenicity of an oral inactivated cholera vaccine in infants in Bangladesh obtained by zinc supplementation and by temporary withholding breast-feeding. Vaccine. 2009;27:1433-9. PMID: 19146904
Cholera Vaccine Identification
LactMed Record Number
Last Revision Date
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.