Vaccinations

Vaccine/Immunobiologic		Precautions for Breastfeeding	Citation
Immune globulins, pooled or hyper-immune	Immune globulin or specific globulin preparations	None	General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) MMWR Vol 51, RR-2;1-36   2/8/2002
Diphtheria-Tetanus	Toxoid	None	General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) MMWR Vol 51, RR-2;1-36 2/8/2002
Hepatitis A	Inactivated virus	Data on the safety of this vaccine in breastfeeding situations is not available. While it is unlikely that the vaccine would cause untoward effects in breastfed infants, consider administering immune globulin rather than vaccine.	Protection against viral hepatitis: Recommendations of the Immunization Practices Advisory Committee (ACIP) MMWR Vol 39, RR-2;1-26 2/0/1990
Hepatitis B	Recombinant or plasma-derived	None	Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Vol 53;1-40 04/30/2004
Influenza	Inactivated whole virus or subunit	None	Using Live, Attenuated Influenza Vaccine for Prevention and Control of Influenza MMWR Vol 52, RR-13;1-8 09/26/2003
	Live attenuated virus	Encourage the use of inactivated influenza vaccine when feasible for children aged 6 to 23 months, as well as for their close contacts and caregivers.
Japanese encephalitis	Inactivated virus	Data concerning the safety of this vaccine during breastfeeding is not available. Therefore, this vaccine should not be routinely administered.	Inactivated Japanese Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Vol 42, RR-1;12-13 1/8/1993
Measles	Live attenuated virus	None	General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) MMWR Vol 51, RR-2;1-36 2/8/2002
Meningococcal meningitis	Polysaccharide	None	Control and Prevention of Meningococcal Disease and Control and Prevention of Serogroup C Meningococcal Disease: Evaluation and Management of Suspected Outbreaks: Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Vol 46, RR-5;1-51 2/14/1997
Mumps	Live attenuated virus	None	General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) MMWR Vol 51, RR-2;1-36 2/8/2002
Pneumococcal	Polysaccharide	Data concerning the safety of this vaccine during breastfeeding is not available. However, it is unlikely that the vaccination would cause untoward effects in breastfed infants.	Prevention of Pneumococcal Disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Vol 46, RR-8;1-24 4/4/1997
Polio, inactivated	Inactivated virus	None	General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) MMWR Vol 51, RR-2;1-36 2/8/2002
Rabies	Inactivated virus	Data concerning the safety of this vaccine for breastfeeding infants is not available. However, this vaccine is commonly given to nursing mothers without observed untoward effects in breastfed infants.	General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) MMWR Vol 51, RR-2;1-36 2/8/2002
Rubella	Live attenuated virus	None	Recommendations for Using Smallpox Vaccine in a Pre-Event Vaccination Program Supplemental Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) MMWR Vol 52, No Dispatch2-26-03;1 02/26/2003 Smallpox Vaccination Information for Women Who Are Pregnant or Breastfeeding
Smallpox (Vaccinia)	Live attenuated virus	Do not administer this vaccine to nursing women.  If a smallpox outbreak occurs, contact your state health department for further recommendations.
Tuberculosis (BCG)	Attenuated mycobacterial	Data concerning the safety of this vaccine during breastfeeding is not available.
Typhoid (ViCPS)	Polysaccharide	Data concerning the safety of this vaccine during breastfeeding is not available. However, the vaccine may be used when the risk of exposure to typhoid fever is high.	Breastfeeding and Maternal Medication, Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs* (PDF - 609k)
Typhoid (Ty21a)	Live bacterial	Data concerning the safety of this vaccine during breastfeeding is not available. However, the vaccine may be used when the risk of exposure to typhoid fever is high.	Breastfeeding and Maternal Medication, Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs* (PDF - 609k)
Varicella	Live attenuated virus	None	Prevention of Varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Vol 45, No RR-11;1-25 07/12/1996
Yellow fever	Live attenuated virus	Avoid administering this vaccine to nursing mothers due to the theoretical risk of transmitting 17D virus to the breastfed infant.  However, when nursing mothers travel to high-risk yellow fever-endemic areas, vaccinations can not be avoided or postponed.	Yellow Fever Vaccine Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2002 MMWR Vol 51, No RR17;1 11/08/2002
Centers for Disease Control and Prevention. Health Information for International Travel 2003-2004. Atlanta: US Department of Health and Human Services, Public Health Service, 2003.

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