Last update Nov. 9, 2023

Diphtheria-Tetanus Vaccine (DT)

Compatible

Safe product and/or breastfeeding is the best option.

The diphtheria vaccine contains the Corynebacterium diphtheriae toxoid. It is not a live organism vaccine.

Tetanus vaccine contains Clostridium tetani toxoid. It is not a live organism vaccine.

High molecular weight both toxoids (Pappenheimer 1940) hinders excretion in breast milk.

Several medical societies and expert authors consider safe to use this vaccine during lactation. (CDC 2023 y 2011, Red Book 2021-2024 p108-9, CAV-AEP 2019, Lawrence 2016 p402, Taylor 2003, Briggs 2015, Sachs 2013, Raney 2012, Chen 2010, WHO 2002)

VACCINES AND BREASTFEEDING:

(RedBook 2021-2024, CDC 2023, 2011 y 2000, Taylor 2019, Lawrence 2016 p402, Sachs 2013, Munoz 2013, Raney 2012, Perin 2012, Gall 2012, Chen 2010, Pisacane 2010, Schmidt 2004, López 2002, Pickering 1998, Pabst 1997, Hahn 1990)

Vaccines are compatible with lactation, both live attenuated microorganisms and killed, inactivated or formed by parts or toxoids of the same or generated by recombinant technology.

They do not pass into milk, except for rubella, which does not usually infect the infant or only mildly, and do not cause problems in infants, except for yellow fever in infants under 6 months of age. 

Breastfeeding may improve the antibody response of vaccines and cause fewer side effects such as fever or anorexia. 

Immediate postpartum is the best time to vaccinate measles-rubella-mumps and varicella in women who were not immunized.

Breastfeeding women can and should be protected with the recommended vaccines as other adults.

Breastfed infants should be immunized according to the appropriate immunization schedule.

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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Other names

Diphtheria-Tetanus Vaccine (DT) in other languages or writings:

Group

Diphtheria-Tetanus Vaccine (DT) belongs to this group or family:

Tradenames

Main tradenames from several countries containing Diphtheria-Tetanus Vaccine (DT) in its composition:

Pharmacokinetics

Variable Value Unit
Molecular weight Dift: 62.000 / Tet: 150.000 daltons

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. Zullo F, Di Mascio D, Berghella V. Evidence-based labor management: postpartum care after vaginal delivery (part 6). Am J Obstet Gynecol MFM. 2023 Jul;5(7):100977. Abstract
  3. 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)
  4. (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
  5. 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)
  6. Taylor CM, Shelton CM. Vaccine recommendations in pregnancy and lactation. J Am Pharm Assoc (2003). 2019 Jan - Feb;59(1):137-140. Abstract
  7. Lawrence RA, Lawrence RM. Breastfeeding. A guide for the medical profession. Eighth Edition. Philadelphia: Elsevier; 2016
  8. Munoz FM. Maternal immunization: an update for pediatricians. Pediatr Ann. 2013 Abstract
  9. 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)
  10. Gall SA. Prevention of pertussis, tetanus, and diphtheria among pregnant, postpartum women, and infants. Clin Obstet Gynecol. 2012 Abstract
  11. Perin MC, Schlindwein CF, de Moraes-Pinto MI, Simão-Gurge RM, de Mello Almada Mimica AF, Goulart AL, dos Santos AM. Immune response to tetanus booster in infants aged 15 months born prematurely with very low birth weight. Vaccine. 2012 Abstract Full text (in our servers)
  12. Raney EC, El-Ibiary SY. Immunizations and pregnancy: an update for pharmacists. J Am Pharm Assoc (2003). 2012 Abstract
  13. 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)
  14. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (in our servers)
  15. Pisacane A, Continisio P, Palma O, Cataldo S, De Michele F, Vairo U. Breastfeeding and risk for fever after immunization. Pediatrics. 2010 Abstract Full text (in our servers)
  16. Murphy TV, Slade BA, Broder KR, Kretsinger K, Tiwari T, Joyce PM, Iskander JK, Brown K, Moran JS; Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). 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 Abstract Full text (in our servers)
  17. Schmidt JV, Kroger AT, Roy SL. Report from the CDC. Vaccines in women. J Womens Health (Larchmt). 2004 Abstract
  18. 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)
  19. 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)
  20. 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
  21. 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
  22. Hahn-Zoric M, Fulconis F, Minoli I, Moro G, Carlsson B, Böttiger M, Räihä N, Hanson LA. Antibody responses to parenteral and oral vaccines are impaired by conventional and low protein formulas as compared to breast-feeding. Acta Paediatr Scand. 1990 Abstract

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