I spoke by phone to a representative Center for Disease Control in Atlanta on
Friday.  There is conflicting information on the CDC website concerning
vaccinating breastfeeding women for smallpox, and I wanted it clarified.  A
document that was updated just last month stated that all vaccines, live
vaccines or not, were safe for breastfeeding mothers, including the smallpox
vaccine.  However, on another information page, it is stated that
breastfeeding women should *not* receive the vaccine.

The representative said that new information and new guidelines are still
being formulated; but for now the guidelines are for breastfeeding women NOT
to receive the vaccine.  The representative stressed that the milk would not
be affected in any way, however, it is the close proximity of the vaccination
site to the vulnerable baby that is the main concern.  They are suggesting
that women who absolutely need to receive the vaccine at this time (military
and certain health workers) could pump their milk and have someone else feed
the baby.  Of course, I immediately wondered if other options such as
covering the vaccine site with extra dressing, receiving the vaccine on the
upper thigh, etc might be helpful.  I also wondered if there were guidelines
for bottle-feeding mothers seeing that they are suggesting that breastfeeding
mothers that they have someone else give the baby the expressed milk.

The vaccine is contraindicated for children under 12 months of age.
The Advisory Committee on Immunization Practices (ACIP) advices against
non-emergency use of smallpox vaccine in persons younger than 18 years of
age.

For other contraindications, see the following. <A HREF="http://www.bt.cdc.gov/agent/smallpox/vaccination/contraindications-clinic.asp">CDC Smallpox | Smallpox
(Vaccinia) Vaccine Contraindications (Info for Clinicians)</A>

The most frightening part of the information is the following reminder on the
website information:  "REMEMBER: There are no contraindications to the
smallpox vaccine if someone has been exposed to the smallpox virus!"

Ruth Scuderi, RLC, IBCLC
Westfield, MA






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