Rubella Vaccine

Drug Levels and Effects:




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 rubella vaccine. Breastfed infants should be vaccinated according to the routine recommended schedules. Although rubella vaccinevirusmight be excreted into milk, thevirususually does not infect the infant. If an infection does occur, it is well tolerated because thevirusesare attenuated.[1][2][3]


Drug Levels:


Maternal Levels.

Early studies found no transmission of rubellavirusto breastfed infants. None of 18 infants who were breastfed after maternal vaccination with rubella vaccine (various strains) had detectable antibodies in one study.[4]

Another study of two strains of rubella vaccine (HPV -77 DE5 and RA 27 /3) given by subcutaneous injection or intranasal inhalation found infectious rubellavirusorvirusantigen in the breastmilk of 8 of the 13 women.[5]

A study of mothers vaccinated with the Cendehill strain of live, attenuated rubellavirusfound no transmission of the livevirusto their breastfed infants.[6] However, rubella vaccineviruscan appear in breastmilk and result in infections in some infants.[7][8][9]

See

"Reported Side Effects In Breastfed Infants" below.

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.[1][3][10]

A paper reported on 511 women who received rubella vaccine in the immediate postpartum period. Three strains were studied: Cendehill (n = 210), HPV-77 DE-5 (Meruvax; n = 182) and RA 27/3 (n = 119). Sixty-three infants, 67% of whom were breastfed, were studied at 2 to 8 months of age. None of them had any evidence of side effects or seroconversion from maternal vaccination.[11]

One 12-day-old breastfed infant developed a rubella infection 11 days after maternal vaccination with live rubella vaccine.[12] However, it is questionable if maternal vaccination was the cause of the infant's infection.[13]

Another breastfed infant had live rubella vaccinevirusisolated from a throat swab after maternal immunization. The infant did not demonstrate seroconversion or adverse reactions.[7]

Some breastfed infants acquire passive immunity to rubella after maternal vaccination as do infants of mothers with natural rubella immunity. However, neither group of infants has a decreased response to rubella vaccine administered to the infant at 15 to 18 months of age.[8]

After immunization of their mothers with rubella vaccine, 25% of breastfed infants in one study showed transient seroconversion to rubellavirus(RA 27/3 strain), but without any clinical disease.[9]


Possible Effects on Lactation:


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


References:


1. Anon.Humanmilk. 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.
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. General recommendations on immunization --- recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011;60 (RR-2):1-64. PMID:21293327
4. Isacson P, Kehrer AF, Wilson H et al. Comparative study of live, attenuated rubellavirusvaccines during immediate puerperium. Obstet Gynecol. 1971;37(3):332-7. PMID:5101211
5. Losonsky GA , Fishaut JM, Strussenberg J, Ogra PL. Effect of immunization against rubella on lactation products. I. Development and characterization of specific immunologic reactivity in breast milk. J Infect Dis. 1982;145:654-60. PMID:7077089
6. Farquhar JD. Follow-up on rubella vaccinations and experience with subclinical reinfection. J Pediatr. 1972;81:460-5. PMID:5065683
7. Buimovici-Klein E, Hite RL, Byrne T et al. Isolation of rubellavirusin milk after pospartum immunization. J Pediatr. 1977;91:939-41. PMID:925824
8. Krogh V, Duffy LC, Wong D et al. Postpartum immunization with rubellavirusvaccine and antibody response in breast-feeding infants. J Lab Clin Med. 1989;113(6):695-9. PMID:2732617
9. Losonsky GA, Fishaut JM, Strussenberg J et al. Effect of immunization against rubella on lactation products. II. Maternal-neonatal interactions. J Infect Dis. 1982;145:661-6. PMID:7077090
10. Pabst HF. Immunomodulation by breast-feeding. Pediatr Infect Dis J. 1997;16:991-5. PMID:9380478
11. Grillner L, Hedstrom CE, Bergstrom H et al. Vaccination against rubella of newly delivered women. Scand J Infect Dis. 1973;5:237-41. PMID:4798559
12. Landes RD, Bass JW, Millunchick EW et al. Neonatal rubella following postpartum maternal immunization. J Pediatr. 1980;97:465-7. PMID:7191002
13. Lerman SJ. Neonatal rubella following maternal immunization. J Pediatr. 1981;98:668-9. Letter. PMID:7205504



Substance Identification:




Substance Name:

Rubella Vaccine

Drug Class:


  • Vaccines


  • Administrative Information:




    LactMed Record Number:


    242


    Last Revision Date:


    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.