Drugs in Pregnancy and Lactation: Tenth Edition

VACCINE, TULAREMIA

Vaccine

PREGNANCY RECOMMENDATION: Compatible—Maternal Benefit >> Embryo–Fetal Risk

BREASTFEEDING RECOMMENDATION: No Human Data—Probably Compatible

PREGNANCY SUMMARY

Tularemia vaccine is a live, attenuated bacteria vaccine (1,2). Because tularemia is a severe disease, preexposure prophylaxis of indicated persons should occur regardless of pregnancy (1).

FETAL RISK SUMMARY

Tularemia is a serious infectious disease occurring primarily in laboratory personnel, rabbit handlers, and forest workers (1). The risk to the fetus from the vaccine is unknown. One report described vaccination in a woman early in the 1st trimester with transplacental passage of antibodies (2,3). No adverse effects were observed in the term infant or at 1-year follow-up.

BREASTFEEDING SUMMARY

No reports describing the administration of tularemia vaccine during human lactation have been located.

References

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

2.Albrecht RC, Cefalo RC, O’Brien WF. Tularemia immunization in early pregnancy. Am J Obstet Gynecol 1980;138:1226–7.

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



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