VACCINE, HAEMOPHILUS B CONJUGATE

Drugs in Pregnancy and Lactation.

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Name: VACCINE, HAEMOPHILUS B CONJUGATE
Class: Vaccine
Risk Factor:    CM

Fetal Risk Summary

Commercially available Haemophilus b conjugate vaccine is a combination of the capsular polysaccharides or oligosaccharides purified from Haemophilus influenzae type b bound with various proteins including tetanus toxoid, diphtheria toxoid, meningococcal protein, or diphtheria CRM197 (1). Two reports (2,3) and a review (4) have described the maternal immunization with the capsular polysaccharide vaccine of H. influenzae type b during the 3rd trimester of pregnancy to achieve passive immunity in the fetus and newborn. No adverse effects were observed in the newborns.

Breast Feeding Summary

Women who were vaccinated with Haemophilus b conjugate vaccine at 34–36 weeks' gestation had significantly higher antibody titers (>20-fold) in their colostrum than either nonimmunized women or those who were vaccinated before pregnancy (5). Breast milk antibody titers were also significantly higher (>20-fold) than the comparison groups at 3 and 6 months after delivery.

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References

  1. American Hospital Formulary Service. Drug Information 1997. Bethesda, MD: American Society of Health-System Pharmacists, 1997:2574–81.
  2. Amstey MS, Insel R, Munoz J, Pichichero M. Fetal-neonatal passive immunization against Haemophilus influenzae, type b. Am J Obstet Gynecol 1985;153:607–11.
  3. Glezen WP, Englund JA, Siber GR, Six HR, Turner C, Shriver D, Hinkley CM, Falcao O. Maternal immunization with the capsular polysaccharide vaccine for Haemophilus influenzae type b. J Infect Dis 1992;165(Suppl 1):S134–S6.
  4. Linder N, Ohel G. In utero vaccination. Clin Perinatol 1994;21:663–74.
  5. Insel RA, Amstey M, Pichichero ME. Postimmunization antibody to the Haemophilus influenzae type B capsule in breast milk. J Infect Dis 1985;152:407–8.

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