Pg and being near child after recent MMR?

[heatherh]

OK, I know this info is out there somewhere, but the whole package is complicated so I'm having a hard time *finding* the info.

Here's the deal. I'm 11w4d pg and BFF's daughter was vaccinated today with MMR. My understanding is that the rubella portion is a live vaccine and according to inside vaccines, can shed through saliva and I think it said 7 - 28 days. That wouldn't worry me so much with an average child, but I'm close to this one so there is likely to be much hugging and kissing and whatnot when I see her next

Rubella is dangerous for pregnant women, esp in the first tri. It sounds like the risks drop around 14 weeks, but we're still talking very high rates of effects if I were to contract rubella.

What I would like to figure out is the approximate level of risk for my child if I were to be around the vaccinated child (we're supposed to spend Thanksgiving together). I suspect I am likely *too* worried, if anything, but I think it's reasonable to assess.

So I guess I need to know what are the odds of getting rubella from a shedding vaccine? I was vaccinated for MMR when I started college, so sometime in the fall of 1993. I guess rubella protection tends to wear off in time, so even if it was effective then, what are the chances it's providing me any protection any more?

If you were in my shoes, would you be willing to go to Thanksgiving dinner with this child? If not, how long would you avoid her before feeling safe again?

[MaterPrimaePuellae]

I have read before that some ob/gyns check for rubella immunity in the pregnancy blood work up. This is not always accurate, and they may not have checked, but you could ask. My guess is that it would be pretty weak after 15 years.

My understanding is that rubella shedding through the vax is theoretically possible but not documented. There was a thread about this a few months ago, and I don't remember any real consensus.

Varicella, OTOH, sheds and/or causes "breakthrough" chicken pox all the time. Just read the VAERS reports. It's shocking how many "chicken pox like" rashes kids get after the varivax Did she get the varivax shot? Because Cp can be dangerous in pregnancy, too. If you had CP then it's no concern, but if you were only vaxed, your immunity from that has probably waned, too.

Sorry I don't have better info for you. The odds of harming your baby seem small to me-- very little chance of it shedding, and a pretty small chance of your baby being harmed even if it does.

[heatherh]

Thanks for your reply. No worries for CP - I had a nasty case of it.

According to the insert info at http://www.merck.com/product/usa/pi_...mmr_ii_pi.pdf:
Excretion of small amounts of the live attenuated rubella virus
from the nose or throat has occurred in the majority of
susceptible individuals 7 to 28 days after vaccination. There is
no confirmed evidence to indicate that such virus is transmitted
to susceptible persons who are in contact with the vaccinated
individuals. Consequently, transmission through close personal
contact, while accepted as a theoretical possibility, is not
regarded as a significant risk.

So in my book, that confirms that it sheds from most people. The question is, can I get rubella from that shedding? Obviously my idea of a significant risk is different than Merck's

I did realize after my post that rubella immunity is often tested with the basic bloodwork. I haven't done that yet this pregnancy, but I did have some blood tests run during my first pregnancy, so I'm going to check if that was included and what the results were. Does anyone know how reliable that test is?

[MaterPrimaePuellae]

Heather,
Sorry, you're right, of course, about the shedding; I was remembering that there were no confirmed cases of others catching R from the shedding.
You would have to have it youself for it to get to the baby-- I don't think there are any cases of it skipping the mother (so you just being around the shed vax would not be of any concern beyond the remote chance of you developing rubella yourself).
The incidence of CRS has dropped dramatically since the vax was introduced, and pregnant women are around recently vaxed kids all the time (probably almost never realizing it, too).... I'm not saying I support the vax, but I do think the risk if very small.

Could you not just avoid close contact and/or wash your hands frequently?

[CookAMH]

Another angle is, say she can shed rubella, what is the likelihood you would actually contract it? Are you healthy? Can you dose up on D and C NOW in these few days before Tgiving, and just be careful with washing hands, drinking enough water, etc?

[Emmeline II]

Even if you happened to contract Rubella, congenital rubella syndrome in any form is still rare.

You could take some natural vitamin a to protect against contracting it at all (I use Carlson's cod liver oil).

http://www.*********/m/butler2.html

[heatherh]

The issue in this particular case is I can't reasonably expect to avoid the child since we're very close. I can wash hands frequently, drink lots of water, and boost my immune system (good theory!). That seems like a good idea in general this time of year.

I am pretty generally healthy but haven't been getting as much exercise as usual since I've been so tired and nauseous.

So CookAMH, you specifically suggested dosing up on D and C. Any particular reason for *those* vitamins? I know C is a good all around immune system enhancer, but what about D?

Originally Posted by Emmeline II

Even if you happened to contract Rubella, congenital rubella syndrome in any form is still rare.

You could take some natural vitamin a to protect against contracting it at all (I use Carlson's cod liver oil).

http://www.*********/m/butler2.html

This article was interesting - it was stating much lower #s for defect rates than I was seeing yesterday. What I saw was more like 70%+ in the first tri and > 50% for the first part of 2nd tri.

So I do take CLO - 4 of the Nordic Naturals capsules, so that would be 1200IU vit A, 16IU vit D. That amount of vitamin D doesn't seem like very much.

Thanks for the replies - it's good to have many perspectives on this. I'll be bugging my midwives today, too. But still good to get multiple POV.

[myfairbabies]

Originally Posted by heatherh

So CookAMH, you specifically suggested dosing up on D and C. Any particular reason for *those* vitamins? I know C is a good all around immune system enhancer, but what about D?

Be careful about vit C, I wouldn't take any (at least not at this point in pregnancy). If you are thinking about it, do some research about it first or ask your midwife!

[CookAMH]

Vit D is good to help your immune system, especially in the winter. I take 2 cold liver oil pills a day, and it's 500 IU natural Vit D. Most people are deficient in the winter because we're in the sun less, and there are many who say the reason the flu is big in the winter is partly because of that reason.

I take this kind, as recommended by many on MDC. It also contains safe levels of natural A.

Here is an article from the Weston Price Foundation on it.

Here's an article on D deficiency for pregnant women and children.

As for C, I wouldn't just *not* take as the pp said. there is C in your prenatal, but perhaps since you're in your first tri, you would be more cautious. Here is some info from a midwife in this post. Check with your midwife. Check with your m/w on the D too.

As with any supplement, you should strive for a natural form or source.

[Nic24]

I have a question to go a long with the initial post because I will soon be in a similar situation. What if I had a rubella vacc 1 year ago . Would I then be pretty safe from worry about the shedding to myself and unborn child?

[runes]

Originally Posted by Nic24

I have a question to go a long with the initial post because I will soon be in a similar situation. What if I had a rubella vacc 1 year ago . Would I then be pretty safe from worry about the shedding to myself and unborn child?

Vaccination is not foolproof, so it is possible that even though you just got the vaccine recently, you might not be immune. As mentioned previously, rubella immunity testing is usually done with prenatal lab work, so the only way to know would be to get your rubella titre.

[newmum35]

I have a question now. IF you do get rubella from the shedding mmr of this child (however unlikely that might be), would this be equal to getting rubella naturally (and thus, conferring a greater immunity to you in the coming years) or would it be like getting another mmr, and wear off quickly?

My OB tested me when I went for my 1st visit (around 8 weeks I Think?) in the standard blood tests. I'd ask for the test, (or call and ask for test results - they might have done it) I got copies of all my labwork, thats how I knew it was on there, otherwise they never discussed it with me.

[heatherh]

Originally Posted by Nic24

I have a question to go a long with the initial post because I will soon be in a similar situation. What if I had a rubella vacc 1 year ago . Would I then be pretty safe from worry about the shedding to myself and unborn child?

The vaccine manufacturer says that the virus sheds for 7 - 28 days. One year later, it should not be shedding.

Originally Posted by newmum35

I have a question now. IF you do get rubella from the shedding mmr of this child (however unlikely that might be), would this be equal to getting rubella naturally (and thus, conferring a greater immunity to you in the coming years) or would it be like getting another mmr, and wear off quickly?

I wondered this, too but I haven't found any answers. I suspect that getting rubella from a shed virus would be at least somewhat different that getting it in the wild since the virus has been altered.

[Nic24]

[QUOTE=heatherh;12960319]The vaccine manufacturer says that the virus sheds for 7 - 28 days. One year later, it should not be shedding.


I'm sorry, I didn't mean the rubella vacc that I personally got after I had my baby, I am afraid of the rubella shot that my ds will soon get shedding.