Drugs in Pregnancy and Lactation: Tenth Edition

VACCINE, CHOLERA

Vaccine

PREGNANCY RECOMMENDATION: Compatible

BREASTFEEDING RECOMMENDATION: Compatible

PREGNANCY SUMMARY

Cholera vaccine is a killed bacteria vaccine (1). Cholera during pregnancy may result in significant morbidity and mortality to the mother and the fetus, particularly during the 3rd trimester. The risk to the fetus from maternal vaccination is unknown because there is no specific information on the safety of the vaccine during pregnancy (2).

BREASTFEEDING SUMMARY

Maternal vaccination with cholera vaccine has increased specific IgA antibody titers in breast milk (3). In a second study, cholera vaccine (whole cell plus toxoid) was administered to six lactating mothers, resulting in a significant rise in milk anticholera toxin IgA titers in five of the patients (4). Milk from three of these five mothers also had a significant increase in anti-cholera toxin IgG titers.

References

1.Amstey MS. Vaccination in pregnancy. Clin Obstet Gynaecol 1983;10:13–22.

2.CDC. Recommendations of the Immunization Practices Advisory Committee. Cholera Vaccine. MMWR 1988;37 (No. 40):617–24.

3.Svennerholm AM, Holmgren J, Hanson LA, Lindblad BS, Quereshi F, Rahimtoola RJ. Boosting of secretory IgA antibody responses in man by parenteral cholera vaccination. Scand J Immunol 1977;6:1345–49.

4.Merson MH, Black RE, Sack DA, Svennerholm AM, Holmgren J. Maternal cholera immunisation and secretory IgA in breast milk. Lancet 1980;1:931–2.



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