The Basics
What is Diphtheria-Tetanus-Pertussis Vaccines?
Vaccine that helps immunity to three deadly diseases caused by bacteria: diphtheria, tetanus, and whooping cough (pertussis).
Brand names for Diphtheria-Tetanus-Pertussis Vaccines
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How Diphtheria-Tetanus-Pertussis Vaccines is classified
Vaccines
Diphtheria-Tetanus-Pertussis Vaccines During Pregnancy
Diphtheria-Tetanus-Pertussis Vaccines pregnancy category
Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Diphtheria-Tetanus-Pertussis Vaccines while pregnant
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Taking Diphtheria-Tetanus-Pertussis Vaccines While Breastfeeding
What are recommendations for lactation if you're taking Diphtheria-Tetanus-Pertussis Vaccines?
The Centers for Disease Control and Prevention and several health professional organizations state that vaccines given to a nursing mother do not affect the safety of breastfeeding for mothers or infants and that breastfeeding is not a contraindication to DTP vaccine.[1][2][3] Women are recommended to received Tdap with every pregnancy.[4] Those vaccinated after 20 weeks of gestation have higher antipertussis IgA levels in their breastmilk than those who were not vaccinated. Women, including nursing mothers, who have not received acellular pertussis vaccine with tetanus and reduced diphtheria toxoids (Tdap) previously should be vaccinated with Tdap immediately postpartum.[4][5] After vaccination, antipertussis antibodies appear in breastmilk within 1 to 2 weeks; however, conflicting results have been reported on whether breastfed infants are protected from pertussis.[6][7] Breastfeeding appears to reduce infant side effects associated with routine childhood immunization. Breastfed infants should be vaccinated according to the routine recommended schedules. A study of 67 colostrum samples that underwent Holder pasteurization (62.5 degrees C for 30 minutes) found that overall IgG amounts decreased by 34 to 40%. Immunoreactivity against tetanus toxoid decreased by 8 to 20%.[8]
Maternal / infant drug levels
The Centers for Disease Control and Prevention and several health professional organizations state that vaccines given to a nursing mother do not affect the safety of breastfeeding for mothers or infants and that breastfeeding is not a contraindication to DTP vaccine.[1][2][3] Women are recommended to received Tdap with every pregnancy.[4] Those vaccinated after 20 weeks of gestation have higher antipertussis IgA levels in their breastmilk than those who were not vaccinated. Women, including nursing mothers, who have not received acellular pertussis vaccine with tetanus and reduced diphtheria toxoids (Tdap) previously should be vaccinated with Tdap immediately postpartum.[4][5] After vaccination, antipertussis antibodies appear in breastmilk within 1 to 2 weeks; however, conflicting results have been reported on whether breastfed infants are protected from pertussis.[6][7] Breastfeeding appears to reduce infant side effects associated with routine childhood immunization. Breastfed infants should be vaccinated according to the routine recommended schedules. A study of 67 colostrum samples that underwent Holder pasteurization (62.5 degrees C for 30 minutes) found that overall IgG amounts decreased by 34 to 40%. Immunoreactivity against tetanus toxoid decreased by 8 to 20%.[8]
Possible effects of Diphtheria-Tetanus-Pertussis Vaccines on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Diphtheria-Tetanus-Pertussis Vaccines
None listed
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Gruslin A, Steben M, Halperin S et al. Immunization in pregnancy: No. 220, December 2008. Int J Gynaecol Obstet. 2009;105:187-91. PMID: 19367691
2. American Academy of Pediatrics Committee on Infectious Diseases, Kimberlin DW, Brady MT et al. Red Book: 2015 Report of the Committee on Infectious Diseases. 30th ed. Elk Grove Village, IL: American Academy of Pediatrics. 2015.
3. General recommendations on immunization — recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011;60 (RR-2):1-64. PMID: 21293327
4. Anon. Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) in pregnant women–Advisory Committee on Immunization Practices (ACIP), 2012. MMWR Morb Mortal Wkly Rep. 2013;62:131-5. PMID: 23425962
5. Murphy TV, Slade BA, Broder KA et al. Prevention of pertussis, tetanus and diphtheria among pregnant and postpartum women and their infants. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2008;57 (RR-4):1-51. PMID: 18509304
6. Pandolfi E, Gesualdo F, Carloni E et al. Does Breastfeeding Protect Young Infants from Pertussis? Case-Control Study and Immunologic Evaluation. Pediatr Infect Dis J. 2017;36:e48-e53. PMID: 27870812
7. Bellido-Blasco J, Guiral-Rodrigo S, Miguez-Santiyan A et al. A case-control study to assess the effectiveness of pertussis vaccination during pregnancy on newborns, Valencian community, Spain, 1 March 2015 to 29 February 2016. Euro Surveill. 2017;22. PMID: 28598324
8. Rodriguez-Camejo C, Puyol A, Fazio L et al. Antibody profile of colostrum and the effect of processing in human milk banks: Implications in immunoregulatory properties. J Hum Lact. 2017. PMID: 28586632
9. Halperin BA, Morris A, Mackinnon-Cameron D et al. Kinetics of the antibody response to tetanus-diphtheria-acellular pertussis vaccine in women of childbearing age and postpartum women. Clin Infect Dis. 2011;53:885-92. PMID: 21946190
10. Abu Raya B, Srugo I, Kessel A et al. The induction of breast milk pertussis specific antibodies following gestational tetanus-diphtheria-acellular pertussis vaccination. Vaccine. 2014;32:5632-7. PMID: 25148774
11. De Schutter S, Maertens K, Baerts L et al. Quantification of vaccine-induced anti-pertussis toxin secretory IgA antibodies in breast milk: Comparison of different vaccination strategies in women. Pediatr Infect Dis J. 2015;34:e149-52. PMID: 25719454
12. Pabst HF. Immunomodulation by breast-feeding. Pediatr Infect Dis J. 1997;16:991-5. PMID: 9380478
13. Perin MC, Schlindwein CF, de Moraes-Pinto MI et al. Immune response to tetanus booster in infants aged 15 months born prematurely with very low birth weight. Vaccine. 2012;30:6521-6. PMID: 22959983
14. Pisacane A, Continisio P, Palma O et al. Breastfeeding and risk for fever after immunization. Pediatrics. 2010;125:e1448-52. PMID: 20478932
15. Lopez-Alarcon M, Garza C, Habicht JP et al. 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;132:1293-8. PMID: 12042449
16. Hahn-Zoric M, Fulconis F, Minoli I et al. Antibody responses to parenteral and oral vaccines are impaired by conventional and low protein formulas as compared to breast-feeding. Acta Paediatr Scand. 1990;1979:1137-42. PMID: 2085099
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
