Drugs in Pregnancy and Lactation: Tenth Edition

VACCINE, MEASLES

Vaccine

PREGNANCY RECOMMENDATION: Contraindicated

BREASTFEEDING RECOMMENDATION: No Human Data—Probably Compatible

PREGNANCY SUMMARY

Measles (rubeola) vaccine is a live, attenuated virus vaccine (1,2). It should not be given in pregnancy. Animal reproduction studies have not been conducted with the vaccine.

FETAL RISK SUMMARY

Measles occurring during pregnancy may result in significant maternal morbidity, an increased abortion rate, stillbirth, prematurity, and congenital malformations (1). Although a fetal risk from the vaccine has not been confirmed, the vaccine should not be used during pregnancy because fetal infection with the attenuated viruses may occur (13). The manufacturer lists pregnancy as a contraindication to its use and states that pregnancy should be avoided for 3 months following vaccination (1). A shorter interval is recommended by the CDC (4). They recommend that women avoid becoming pregnant for 28 days after vaccination, but no cases of congenital malformations attributable to measles vaccine virus have been reported (4).

BREASTFEEDING SUMMARY

No reports describing the use of measles vaccine during lactation have been located. However, the vaccine is probably compatible with breastfeeding.

References

1.Product information. Attenuvax. Merck, 2004.

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

3.Linder N, Ohel G. In utero vaccination. Clin Perinatol 1994;21:663–74.

4.CDC. Guidelines for Vaccinating Pregnant Women. Available at http://www.cdc.gov/vaccines/pubs/preg-guide.htm. Accessed May 16, 2010.



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