Postpartum varicella vaccination: Is the vaccine virus excreted in breast milk?
Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101-1448, USA. Obstetrics and Gynecology
(Impact Factor: 5.18).
12/2003; 102(5 Pt 1):970-7. DOI: 10.1016/S0029-7844(03)00860-3
To evaluate whether the varicella vaccine virus is detected in breast milk after vaccination of breast-feeding women and whether there is serologic evidence of exposure of the infant to varicella virus after maternal vaccination.
We enrolled women identified as varicella seronegative during routine prenatal screening at Group Health Cooperative. Participants received the first dose of varicella vaccine at least 6 weeks postpartum and the second dose at least 4 weeks later. They collected ten breast milk samples after each vaccine dose. Breast milk samples were tested for varicella zoster virus by polymerase chain reaction (PCR). Serum specimens were collected from the mothers 1 month after each vaccine dose, and peripheral blood from their infants was collected onto filter spots 1 month after the mother's second dose. These samples were tested for varicella immunoglobulin (Ig) G by whole-virus enzyme-linked immunosorbent assay (ELISA), or by the more sensitive glycoprotein ELISA. When possible, filter spots from the infants were also tested by PCR for the presence of varicella zoster virus deoxyribonucleic acid (DNA).
Twelve women were enrolled; all seroconverted after the first vaccine dose. Varicella DNA was not detected by PCR in any of the 217 postvaccination breast milk specimens. None of the infants was seropositive. Samples from six infants were tested for varicella zoster virus DNA by PCR, and all were negative.
We found no evidence of varicella vaccine virus excretion in breast milk. These findings suggest that postpartum vaccination of varicella-susceptible women need not be delayed because of breast-feeding.
Available from: smittskyddsinstitutet.se
Available from: journals.dev.aafp.org
[Show abstract] [Hide abstract]
ABSTRACT: All pregnant women should be offered screening for asymptomatic bacteriuria, syphilis, rubella, and hepatitis B and human immunodeficiency virus infection early in pregnancy. Women at increased risk should be tested for hepatitis C infection, gonorrhea, and chlamydia. All women should be questioned about their history of chickenpox and genital or orolabial herpes. Routine screening for bacterial vaginosis is not recommended. Influenza vaccination is recommended in women who will be in their second or third trimester of pregnancy during flu season. Women should be offered vaginorectal culture screening for group B streptococcal infection at 35 to 37 weeks' gestation. Colonized women and women with a history of group B streptococcal bacteriuria should be offered intrapartum intravenous antibiotics. Screening for gestational diabetes remains controversial. Women should be offered labor induction after 41 weeks' gestation.
[Show abstract] [Hide abstract]
ABSTRACT: This report is a revision of the General Recommendations on Immunization and updates the 2006 statement by the Advisory Committee on Immunization Practices (ACIP) (CDC. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2006;55[No. RR-15]). The report also includes revised content from previous ACIP recommendations on the following topics: adult vaccination (CDC. Update on adult immunization recommendations of the immunization practices Advisory Committee [ACIP]. MMWR 1991;40[No. RR-12]); the assessment and feedback strategy to increase vaccination rates (CDC. Recommendations of the Advisory Committee on Immunization Practices: programmatic strategies to increase vaccination rates-assessment and feedback of provider-based vaccination coverage information. MMWR 1996;45:219-20); linkage of vaccination services and those of the Supplemental Nutrition Program for Women, Infants, and Children (WIC program) (CDC. Recommendations of the Advisory Committee on Immunization Practices: programmatic strategies to increase vaccination coverage by age 2 years-linkage of vaccination and WIC services. MMWR 1996;45:217-8); adolescent immunization (CDC. Immunization of adolescents: recommendations of the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American Medical Association. MMWR 1996;45[No. RR-13]); and combination vaccines (CDC. Combination vaccines for childhood immunization: recommendations of the Advisory Committee on Immunization Practices [ACIP], the American Academy of Pediatrics [AAP], and the American Academy of Family Physicians [AAFP]. MMWR 1999;48[No. RR-5]). Notable revisions to the 2006 recommendations include 1) revisions to the tables of contraindications and precautions to vaccination, as well as a separate table of conditions that are commonly misperceived as contraindications and precautions; 2) reordering of the report content, with vaccine risk-benefit screening, managing adverse reactions, reporting of adverse events, and the vaccine injury compensation program presented immediately after the discussion of contraindications and precautions; 3) stricter criteria for selecting an appropriate storage unit for vaccines; 4) additional guidance for maintaining the cold chain in the event of unavoidable temperature deviations; and 5) updated revisions for vaccination of patients who have received a hematopoietic cell transplant. The most recent ACIP recommendations for each specific vaccine should be consulted for comprehensive details. This report, ACIP recommendations for each vaccine, and additional information about vaccinations are available from CDC at http://www.cdc.gov/vaccines.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.