Vaccine Education Center

Vaccines and antibiotics

Do vaccines contain antibiotics?

Antibiotics are present in some vaccines and are used to prevent bacterial contamination during manufacture. Because antibiotics can cause severe allergic reactions in children (like hives, swelling at the back of the throat, and low blood pressure), some parents are concerned that antibiotics contained in vaccines might be harmful. However, antibiotics most likely to cause severe allergic reactions (e.g., penicillins, cephalosporins and sulfa drugs) are not contained in vaccines.

Antibiotics used during vaccine manufacture include neomycin, polymyxin B, streptomycin and gentamicin. Only minute quantities remain in vaccines (see table below). However, these small quantities of antibiotics have never been clearly found to cause severe allergic reactions.

Therefore, the possibility that the trace quantities of antibiotics contained in vaccines cause severe allergic reactions remains, at best, theoretical.

Antibiotic content in vaccines licensed for use in the United States
Vaccine Trade Name Quantity  Neomycin (per dose) Quantity Polymyxin B
Measles, mumps, rubella MMR 0.025 mg  
Measles, mumps, rubella, varicella ProQuad < 0.016 mg  
Varicella (chickenpox) Varivax Trace quantities  
Zoster (shingles) Zostavax Trace quantities  
Rabies Imovax 0.15 mg  
RabAvert < 0.001 mg  
Influenza Fluvirin 0.025 mg < 0.00375 mg
Afluria 0.000003 mg 0.0000005 mg
Polio IPOL 0.000005 mg 0.000025 mg
Diphtheria, tetanus, pertussis, polio Kinrix 0.00000005 mg  
Pentacel < 0.000000004 mg  
Diphtheria, tetanus, pertussis, hepatitis B, polio Pediarix <0.00000005 mg  
Hepatitis A Havrix < 0.00004 mg  
Vaqta < 10 ppb  
Hepatitis A, hepatitis B Twinrix <0.00002 mg  

mg = milligrams; ppb = parts per billion

Other antibioitics found in trace quantities include: 

References

Goh CL. Anaphylaxis from topical neomycin and bacitracin. Aust J Dermatol. 1986;27:125-126.

Kwittken PL, Rosen S, Sweinberg SK. MMR vaccine and neomycin allergy. Am J Dis Child. 1993;147:128-129.

Leyden JJ, Kligman AM. Contact dermatitis to neomycin sulfate. JAMA 1979;242:1276-1278.

MacDonald RH, Beck M. Neomycin: a review with particular reference to dermatolgical usage. Clin Exp Dermatol. 1983;8:249-258.

Yunginger JW. Anaphylaxis. Curr Prob Pediatr. 1992;22:130-146.

Reviewed by: Paul A. Offit, MD
Date: May 2014

Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. You should not use it to replace any relationship with a physician or other qualified healthcare professional. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult your physician or, in serious cases, seek immediate assistance from emergency personnel.

 

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