Is Yellow Fever Vaccine safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Yellow Fever Vaccine. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
A review article reports three Nigerian breastfed neonates 10 days, 23 days and 5 weeks whose mothers received the 17D vaccine during first month of infant s life. Each infant developed encephalitis. Other details are not provided.[ 8 ] One probable case of yellow fever vaccine-associated neurologic disease (YEL-AND) was reported in a 38-day-old infant whose mother was vaccinated 24 days earlier with the Brazilian-manufactured yellow fever vaccine 17D (probably the 17-DD strain). The infant was exclusively breastfed. Although it was not possible to determine if the breast milk was the mode of transmission, no other plausible cause was identified.[ 9 ] A woman who was exclusively nursing her newborn received 17DD yellow fever vaccine on day 15 postpartum. Eight days later her infant developed fever, irritability and refused to nurse. One day later, the infant developed seizure-like activity. The infant was hospitalized and had periods of somnolence and irritability and required intravenous anticonvulsants to control seizures. An MRI was consistent with encephalitis. Yellow fever-specific IgM antibodies were detected in serum and CSF. Laboratory examination of the infant's cerebrospinal fluid confirmed the presence of a viral strain identical to the vaccine. This was the first case of laboratory-confirmed, breastfeeding-associated transmission of 17DD yellow fever vaccine virus from a recently vaccinated mother.[ 5 ] A Canadian mother had received a yellow fever vaccination (probably the 17D-204 strain) when her breastfed (extent not stated) infant was 10 days of age. At 5 weeks of age, the infant developed focal seizures on alternating sides, poor appetite, and vomiting following a 2-day history of fever and irritability. The infant's serum was positive for yellow fever, and the cerebrospinal fluid was positive for yellow fever antigen, but negative for yellow fever virus. Although the authors could not entirely rule out other causes, they judged the adverse reaction
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Eleven nursing mothers were inadvertently vaccinated with the 17DD strain of yellow fever vaccine (Fiocruz, Brazil). Milk samples were obtained on days 8, 10 and 15 after administration. None of the samples contained detectable yellow fever vaccine RNA. One mother s serum was positive for yellow fever IgM on day 8 after the vaccine administration.[ 4 ] Eight Sudanese nursing mothers received the yellow fever vaccine (17DD, Bio-Manguinhos/Fiocruz) within 9 months of delivery. Milk specimens were collected by hand expression while the infant was nursing on the opposite breast. The specimens from the right and left breasts were expressed into separate containers. Collection of milk specimens performed on four occasions: the first collection time was 3-14 days from the date of the vaccination. The three following collections were 3-4 days apart. All 8 women participated in the first collection, 6 in the second, 4 in the third, and 3 in the fourth collection. In the first collection, 5 mothers milk contained IgM antibodies against the vaccine and milk from 3 women contained yellow fever vaccine (YFV) RNA. In the second collection 4 of 6 samples contained YFV RNA. In the third collection, 1 of 4 milk samples contained YFV RNA. In the fourth collection, none of the three milk samples contained YFV RNA. The minimal clearance time of the viral RNA in milk was 11 days after vaccination and the maximum was 24 days after vaccination.[ 7 ] Infant Levels. Relevant published information was not found as of the revision date.
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.