Smallpox Vaccine use while Breastfeeding

Summary of Use during Lactation

The Centers for Disease Control and Prevention recommends that nursing mothers not receive the smallpox vaccine, even if they are pumping their milk and feeding it to their infant by bottle feeding. If a woman received smallpox vaccine during pregnancy or breastfeeding, she should avoid breastfeeding and handling any baby for at least 3 to 4 weeks until the vaccination scab has separated from the vaccination site. The breasts can be pumped to maintain the milk supply, but the milk should be discarded.[1] The newer smallpox and monkeypox vaccine is a live, non-replicating vaccine and is not likely to have these problems during breastfeeding.

Drug Levels

Maternal Levels. Smallpox vaccine 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.[2]

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. The exact mechanism of transmission was not apparent.[3]

Effects on Lactation and Breastmilk

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

Alternate Drugs to Consider

Monkeypox Vaccine

References

1.

Acambis Inc. Medication Guide. ACAM2000 Smallpox (Vaccinia) Vaccine, Live. Version 1.0. 2007

2.

Acambis Inc. ACAM2000 (Smallpox [Vaccinia] Vaccine, Live) package insert. 2007

3.

Garde V, Harper D, Fairchok MP. Tertiary contact vaccinia in a breastfeeding infant. JAMA 2004;291:725-7 [PubMed: 14871916]

Substance Name

Smallpox Vaccine

Drug Class

Breast Feeding

Lactation

Milk, Human

Vaccines