Human Papillomavirus Vaccines and Breastfeeding

Summary of use during lactation

The Centers for Disease Control and Prevention and the several health professional organizations state that vaccines given to a nursing mother do not affect the safety of breastfeeding for mothers or infants.[1-5] A slightly higher percentage of infants who were breastfed during or after maternal vaccination with the active quadrivalent human papillomavirus vaccine (Gardasil) had pneumonia during the 30 days after maternal vaccination, but these effects were not thought to be vaccine related. No similar data exist for the bivalent vaccine (Cervarix). Maternal vaccination with human papillomavirus vaccine is not a contraindication to breastfeeding.

Drug levels in milk and infant serum

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

Effects in breastfed infants

A total of 995 nursing mothers were given Gardasil or placebo during the vaccination period of the clinical trials (vaccine n = 500, control n = 495). A total of 17 (3.4%) and nine (1.8%) infants of women who breastfed who received quadrivalent HPV vaccine or placebo, respectively, experienced a serious adverse event. Of the 23 experiences among the 17 infants of women who received vaccine, 12 were respiratory infections, five were gastroenteritis or diarrhea, and the remaining included various other single events. None of the reactions was considered vaccine related.[6,7]

Effects on lactation and breastmilk

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

References

1. Kimberlin DW, Brady MT, Jackson MA, et al. Red Book: 2018 Report of the Committee on Infectious Diseases. 31st ed. Elk Grove Village, IL: American Academy of Pediatrics. 2018.
2. Gruslin A, Steben M, Halperin S, et al. Immunization in pregnancy: No. 220, December 2008. Int J Gynaecol Obstet 2009;105:187-91.19367691 PubMed
3. Harpaz R, Ortega-Sanchez IR, Seward JF. Prevention of Herpes zoster: Recommendations of the advisory committee on immunization practices (ACIP). MMWR Recomm Rep 2008;57 (RR-5):1-30.18528318 PubMed
4. Committee opinion no. 467: Human papillomavirus vaccination. Obstet Gynecol 2010;116:800-3.20733476 PubMed
5. Kroger A, Bahta L, Long S, et al. CDC. General Best Practices for Immunization. https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html
6. Markowitz LE, Dunne EF, Saraiya M, et al. Quadrivalent human papillomavirus vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2007;56 (RR-2):1-24.17380109 PubMed
7. Garland SM, Ault KA, Gall SA, et al. Pregnancy and infant outcomes in the clinical trials of a human papillomavirus type 6/11/16/18 vaccine: a combined analysis of five randomized controlled trials. Obstet Gynecol 2009;114:1179-88.19935017 PubMed