Smallpox Vaccine use while Breastfeeding
Medically reviewed by Drugs.com. Last updated on Jul 20, 2024.
Drugs containing Smallpox Vaccine: Dryvax
Smallpox Vaccine Levels and Effects while Breastfeeding
Summary of Use during Lactation
Worldwide, three vaccines are available for smallpox, known as MVA-BN, ACAM-2000 and LC16. Only MVA-BN (Jynneos) and ACAM-2000 are available in the United States. The MVA-BN vaccine does not replicate and behaves like a non-live vaccine. The ACAM-2000 vaccine is live and is contraindicated in breastfeeding. No information is available on the LC16 (minimally replicating) vaccine during breastfeeding. The US Centers for Disease Control and Prevention and the World Health Organization state that the MVA-BN vaccine can be offered to breastfeeding women who are otherwise eligible and breastfeeding need not be discontinued after vaccination. The risks and benefits of the vaccine should be discussed with the patient using shared decision-making.[1-3]
Drug Levels
Maternal Levels. Smallpox vaccine ACAM-2000 has not been studied in lactating women. Live vaccinia virus can be inadvertently transmitted from a lactating mother to her breastfed infant. Infants are at high risk of developing serious complications from live vaccinia smallpox vaccination.[4]
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
One 5-month-old breastfed infant acquired a vaccinia lesion on her upper lip, tongue and cheek after her mother developed vaccinia lesions on both areolas. The mother's infection apparently originated from the father who had been vaccinated about 10 days prior with a live vaccine (exact type not stated). The exact mechanism of transmission was not apparent.[5]
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
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References
- 1.
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Centers for Disease Control and Prevention. Mpox clinical care and treatment during pregnancy. January 30, 2025. https://www
.cdc.gov/mpox /hcp/clinical-care/pregnancy.html - 2.
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World Health Organization. Smallpox and mpox (orthopoxviruses): WHO position paper, August 2024. WHO Weekly Epidemiological Record 2024;99:429–56. https://www
.who.int/publications /i/item/who-wer-9934-429-456 - 3.
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Hombach J., Lewis R., Holten J. V., et al. Breastfeeding mothers in DR Congo should have access to the mpox vaccine. Lancet Glob Health 2024;12:e1932. [PubMed: 39577965]
- 4.
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Acambis Inc. ACAM2000 (Smallpox [Vaccinia] Vaccine, Live) package insert. 2007.
- 5.
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Garde V, Harper D, Fairchok MP. Tertiary contact vaccinia in a breastfeeding infant. JAMA 2004;291:725–7. [PubMed: 14871916]
Substance Identification
Substance Name
Smallpox Vaccine
Drug Class
Breast Feeding
Lactation
Milk, Human
Vaccines
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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.
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