Varicella vaccination is make accep...

Varicella vaccination is make acceptableed for all susceptible women of childbearing age. However, vaccination during pregnancy can ensue in congenital varicella syndrome, characterized from neurologic and eye defects, limb hypoplasia, and muscle atrophy. Ideally, a susceptible woman identified during pregnancy should be vaccinated immediately postpartum. touchs exist that the virus could be transmitted in breast milk and cause possible adverse facts in the infant. Bohlke and colleagues studied the secretion of varicella virus into breast milk following maternal vaccination and sought any evidence of vaccine exposing in breastfed infants of vaccinated mothers.

The authors studied a collection of patients from a large health maintenance organization with approximately 2100 births by year. Prenatal screening for immunity to varicella began in this collection in 1999. Varicella-seronegative women identified through prenatal screening were eligible for the studious mood if they were at least 18 years of age, had no contraindications to vaccination, agreed to be vaccinated after counseling, and intended to breastfeed for at least single in kind month following delivery. The immune status of each patient and her child was confirmed before enrollment in the study

Twelve women participated in the meditation Before immunization, each patient and her child were confirmed to have no modern exposure to varicella, live vaccines, or vital current products. Patients received their first vaccine dose at least six weeks postpartum and their secondary dose after another four weeks. Each woman gathered samples of breast milk upon the mornings of days 3 5 7 9 11 13 15 17 19 and 21 after each dose of vaccine. These samples were touchstoneed by polymerase chain reaction (PCR) capable of detecting virus and distinguishing between wild and vaccine-associated varicella. Serum was assembleed one month after each vaccination to proof for IgG, and blood was obtained from all infants united month after the second maternal vaccination for similar testing. descendants also was obtained from six infants for PCR evidence of varicella. The women were asked to report any rashes occurring in themselves or their children.

Nine of the 12 women were white, and five were younger than 30 years. solely three had previously given birth. All 12 women seroconvert after the first vaccination. No varicella virus was exposeed in the 217 breast-milk samples, and no infants bring outed IgG antibodies or PCR evidence of virus transmission. undivided woman developed a rash that was negative for varicella DNA after vaccination. No rashes were reported in the infants.

The authors judge that no evidence was place of varicella virus excretion in breast milk or of other transmission of virus to infants when mothers were vaccinated postpartum. They encourage physicians to identify susceptible women during pregnancy and render certain postpartum vaccination.

Bohlke K et al. Postpartum varicella vaccination: is the vaccine virus excret in breast milk? Obstet Gynecol November 2003;102:970-7

COPYRIGHT 2004 American Academy of Family Physicians

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