Last update Nov. 9, 2023

Influenza (flu) Vaccines

Compatible

Safe substance and/or breastfeeding is the best option.

Inactivated strains of type A and B Influenza virus vaccines.

Both inactivated (flu shot) or live-attenuated (nasal spray) vaccines are compatible with breastfeeding. (Canadá 2023, AAP 2022, CDC 2021, Red Book 2021-24 p.455, CAV-AEP 2019, Lawrence 2016 p402,​​​​​ Briggs 2015)

Vaccines are usually compatible with breastfeeding either if they are formed by live, attenuated, inactivated, death strains or microorganism toxoid. Except for rubella vaccine, they are not excreted into breast milk and do not cause harm to the infant. Yellow fever vaccine has a higher risk for harm effect on infants younger than 6 months old. 

Breastfeeding may enhance antibody response to vaccines and cause fewer side effects as fever or anorexia.

Early postpartum period is appropriate to get mothers vaccinated against measles, rubella and mumps in case they were not immunized.

Breastfeeding mothers should be protected by providing recommended vaccination for adults.

Eleventh WHO's Model List of Essential Drugs 2002: Compatible with breastfeeding. (WHO 2022)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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José María Paricio, founder of e-lactancia.
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References

  1. CDC- ACIP. Vaccine Recommendations and Guidelines of the ACIP. Special Situations. Breastfeeding and Vaccination. - 2023 Consulted on Oct. 25, 2023 Full text (link to original source)
  2. CDC - Centers for Disease Control and Prevention. Vaccination Safety for Breastfeeding Mothers. Breastfeeding and Special Circumstances. 2023 Full text (link to original source) Full text (in our servers)
  3. Canada.ca National Advisory Committee on Immunization (NACI). Statement on seasonal influenza vaccine for 2023-2024. Health Vaccines and immunization 2023 Full text (link to original source)
  4. AAP. COMMITTEE ON INFECTIOUS DISEASES.. Recommendations for Prevention and Control of Influenza in Children, 2022-2023. Pediatrics. 2022 Oct 1;150(4). pii: e2022059275. Abstract Full text (link to original source)
  5. CDC. Centres for Disease Control and Prevention. Influenza (Flu) and Breastfeeding. Breastfeeding and Special Circumstances. 2021 Full text (link to original source)
  6. (Red Book). AAP. Kimberlin DW, Barnett ED, , Lynfield R, Sawyer MH eds. Red Book: 2021-2024. Report of the Committee on Infectious Diseases. 32th ed. Elk Grove Village, - 2021
  7. CAV-AEP. Comité asesor de vacunas de la Asociación Española de Pediatría. Lactancia materna y vacunas. None 2019 Full text (link to original source) Full text (in our servers)
  8. Taylor CM, Shelton CM. Vaccine recommendations in pregnancy and lactation. J Am Pharm Assoc (2003). 2019 Jan - Feb;59(1):137-140. Abstract
  9. Lawrence RA, Lawrence RM. Breastfeeding. A guide for the medical profession. Eighth Edition. Philadelphia: Elsevier; 2016
  10. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  11. Schlaudecker EP, Steinhoff MC, Omer SB, McNeal MM, Roy E, Arifeen SE, Dodd CN, Raqib R, Breiman RF, Zaman K. IgA and neutralizing antibodies to influenza a virus in human milk: a randomized trial of antenatal influenza immunization. PLoS One. 2013 Abstract Full text (in our servers)
  12. Centers for Disease Control and Prevention. Pregnant Women Need a Flu Shot. Facts Sheet 2013 Full text (in our servers)
  13. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Sep;132(3):e796-809. Abstract Full text (link to original source) Full text (in our servers)
  14. Munoz FM. Maternal immunization: an update for pediatricians. Pediatr Ann. 2013 Abstract
  15. Raney EC, El-Ibiary SY. Immunizations and pregnancy: an update for pharmacists. J Am Pharm Assoc (2003). 2012 Abstract
  16. CDC. National Center for Immunization and Respiratory Diseases. General recommendations on immunization --- recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011 Abstract Full text (in our servers)
  17. Centers for Disease Control and Prevention Influenza vaccine and Pregnant women Public Health Service 2011 Full text (in our servers)
  18. Tanaka T, Nakajima K, Murashima A, Garcia-Bournissen F, Koren G, Ito S. Safety of neuraminidase inhibitors against novel influenza A (H1N1) in pregnant and breastfeeding women. CMAJ. 2009 Abstract Full text (link to original source) Full text (in our servers)
  19. Zaman K, Roy E, Arifeen SE, Rahman M, Raqib R, Wilson E, Omer SB, Shahid NS, Breiman RF, Steinhoff MC. Effectiveness of maternal influenza immunization in mothers and infants. N Engl J Med. 2008 Abstract Full text (in our servers)
  20. Schmidt JV, Kroger AT, Roy SL. Report from the CDC. Vaccines in women. J Womens Health (Larchmt). 2004 Abstract
  21. López-Alarcón M, Garza C, Habicht JP, Martínez L, Pegueros V, Villalpando S. Breastfeeding attenuates reductions in energy intake induced by a mild immunologic stimulus represented by DPTH immunization: possible roles of interleukin-1beta, tumor necrosis factor-alpha and leptin. J Nutr. 2002 Abstract Full text (in our servers)
  22. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  23. Pickering LK, Granoff DM, Erickson JR, Masor ML, Cordle CT, Schaller JP, Winship TR, Paule CL, Hilty MD. Modulation of the immune system by human milk and infant formula containing nucleotides. Pediatrics. 1998 Feb;101(2):242-9. Abstract
  24. Pabst HF, Spady DW, Pilarski LM, Carson MM, Beeler JA, Krezolek MP. Differential modulation of the immune response by breast- or formula-feeding of infants. Acta Paediatr. 1997 Abstract
  25. [No authors listed] Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 1997 Abstract Full text (in our servers)

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