What happens when our unvaxed girls are of childbearing age? (re: Rubella)

[Amila]

My son may have recently had Rubella, and I made sure him and my DD shared a LOT of saliva, lol. I hope she catches it now, and I don't have to worry about it later, but what will you do if your daughter isn't exposed to it by the time shes ready to have a child? Would you think the MMR is indicated in that circumstance? Thoughts??

[Lisa1970]

There was no MMR when I was born. It came out in the mid 70's. People who were not vax'd got the illnesses and most were fine for childbirth. Catching Rubella while pregnant was extremely rare. Then along come the children who were vaxed. These vaccinations wore off by the time they were ready to have children. They never got it for real so they are not immune. Some got it for real when their vax wore off, but many did not. Then they got pregnant. Now they have a problem. Now, because they were vax'd as children, they are potentially wide open to getting it as adults when it is worn off.

Childhood diseases were meant for childhood. All the vaccinations has done is leave a bunch of adults immune deficient and needy.

[Lisa1970]

I think if your daughter is ready to have a baby, and only then, she should go in and have the usual work up for pre-prenatal which will include the titers. If it shows she is not immune at that time (most vaccinated people will show not immune) then get the vax if she wants. But that would be when she is an adult and ready to have babies. I would not do it before then. It would be her choice then of course.

[emma1325]

Originally Posted by Lisa1970

I think if your daughter is ready to have a baby, and only then, she should go in and have the usual work up for pre-prenatal which will include the titers. If it shows she is not immune at that time (most vaccinated people will show not immune) then get the vax if she wants. But that would be when she is an adult and ready to have babies. I would not do it before then. It would be her choice then of course.

{jumping in}

Just out of curiosity, would you personally get the shot yourself if you were in this situation?

[emma1325]

I had one lady tell me she got the rubella vaccine 3 times before attempting to get pregnant b/c she never showed immunity.

BTW, even after the third, she still did not show immunity. But I guess 3 was the max amounts of times they would give her the shot. She's very pro-vax and was very concerned about her lack of immunity to rubella. (but she went through with the pregnancy and didn't have a problem with rubella.)


Gosh, it would concern me to get 3 vaccines and then become pregnant shortly after, much more so than a low antibody result.

[the_lissa]

I personally wouldn't. I wasn't immune in my first pregnancy, and no one was concerned even when there was a rubella outbreak in my area.

[chaoticzenmom]

I will probably get my daughter vax'd for the mmr when she's mid-teens.

[roxyrox]

I would check titres at about 12 or so (just before puberty) and if they weren't immune I would do a single Rubella vax then. That is what used to happen here (UK) until about 10 yrs ago...when I was at school all girls got a Rubella vax at 14 if they hadn't had it naturally. This is a much more sensible approach (imo). By changing to MMR at 12 months and a 4 year "booster" we probably have more women of childbearing age *NOT* immune to Rubella.

[Jwebbal]

I had my titers checked, and still had my vax immunity. If it were my daughter, I would suggest she get hers checked when she might want to or end up pregnant.

[FernG]

Originally Posted by chaoticzenmom

I will probably get my daughter vax'd for the mmr when she's mid-teens.

I received an initial MMR vaccine and the follow up booster that was added to the schedule. I was revaccinated with 2 doses of MMR for college b/c I had lost my vaccine records. Only 7 years later, I had no detectable immunity to rubella. That's after 4 doses of the vaccine!

I choose not to be re-revaccinated postpartum. When DD is an adult, she can make her own decisions about this vaccine.

[brightonwoman]

So, just noting before I begin my story that I am a selective/delayed vaxer...not anti-vax by any means (we actually do most of the 'required for school' ones, and skip the newer and 'optional' ones)

Originally Posted by Lisa1970

I think if your daughter is ready to have a baby, and only then, she should go in and have the usual work up for pre-prenatal which will include the titers. If it shows she is not immune at that time (most vaccinated people will show not immune) then get the vax if she wants. But that would be when she is an adult and ready to have babies. I would not do it before then. It would be her choice then of course.

Originally Posted by emma1325

Just out of curiosity, would you personally get the shot yourself if you were in this situation?

So, I had the MMR series as a child/teen, and my midwife never checked my titer on my first couple of pregnancies (which resulted in miscarriages--though no, they were not rubella-related). When I got pg with DS I opted to go with a different provider for insurance reasons, and that provider did take my titer, and said that I was not immune to rubella, and should get the shot after the baby was born. I thought it over, talked with DH, and decided to get the vax.

Here is what they did not tell me:
1-the rubella vax is live (which I knew)
2-it can give you an actual case of rubella (I kinda knew this, but having had other live vaxes before, and never having had a reaction, I didn't think about what this really meant)
3-it can go to your baby via breastmilk (this I did not realize, though I guess I should have...but if the vax isn't approved for under 12m old, why on earth would you want your newborn getting it via nursing?! )
4-they actually have no idea how long it stays in your system. My OB was on the conservative side, and his recommendation was to avoid future pregnancy for a full year. He said that other doctors say 6 or even 3 mo, but that he feels 12 is safer. It's a guessing game, not a science.

OK, so, I got the rubella vax (not MMR, just rubella).
Guess what, I caught rubella from it. I had rashes and intense itching over most of my body. It was so bad I called the doctors office and asked them what I should do, and they responded as though this were normal (?!?!?!?!?!!!!!!!) and recommended a benadryl cream. Um, the cream said to not use it on more than 10% of my body, but I had itching (wake-me-up-at-night itching) on about 80% of my body. It was horrible.
I also had arthritis in my hands/wrists (a common and well-documented side-effect of the vax) for several months. It's a frightening thing when your hands/wrists are so weak that it hurts to pick up your 8lb baby to nurse him.

So, if a future provider wants to check my titers, fine, whatever, I don't care. But will I ever get the shot again? NO! Not even if my titers come up negative forever (which, hopefully they wouldn't since now I've had it....but still...)


FYI, did you know that the greatest risk of catching rubella comes from recently vaccinated children? In other words, if a pregnant woman (or her family members) associate with a recently vaxed child, THAT is where the danger to her comes from. And, as I'm sure you know, the danger is not actually to her, it is to her unborn child. Yes, rubella causes miscarriages and deafness. I know those are not little things....on the other hand, I know deaf children, and I've had miscarriages, and I've also had rubella on top of the arthritic symptoms that come from the vax...and I tell ya what, I will avoid that vax with all my power.

(I'd be happy to discuss this at more length if you want to PM me)

[Fyrestorm]

Originally Posted by brightonwoman

When I got pg with DS I opted to go with a different provider for insurance reasons, and that provider did take my titer, and said that I was not immune to rubella, and should get the shot after the baby was born. I thought it over, talked with DH, and decided to get the vax.

I guess this is another captive audience - stab 'em when you can thing...If the biggest threat of R is to a first trimester fetus, why give it to a woman who has just given birth...the only danger at that point is the danger of shedding the vaccine to her newborn...

[SoCaliMommy]

Originally Posted by Lisa1970

I think if your daughter is ready to have a baby, and only then, she should go in and have the usual work up for pre-prenatal which will include the titers. If it shows she is not immune at that time (most vaccinated people will show not immune) then get the vax if she wants. But that would be when she is an adult and ready to have babies. I would not do it before then. It would be her choice then of course.

The bolded isn't true
I was vaxed (my mother is very pro vax) and i'm immune to rubella.

[Gitti]

Surprise -

Congenital rubella births have always been extremely low. The MMR vaccine has not made any difference in that way (thank heavens).

The chance of having a cong.rubella baby is the same (extremely low) in fully vaccinated vs. non-vaccinated.

[Fyrestorm]

Originally Posted by SoCaliMommy

The bolded isn't true i'
I was vaxed (my mother is very pro vax) and i'm immune to rubella.

I just checked my records...I got 3 MMRs and am not immune. At the time I was married, our state required blood tests for syphilis and rubella for all woman. (I also chose not to get the vax and never even gave it a second thought when I was pregnant)

[charleysmama23]

Originally Posted by Jwebbal

I had my titers checked, and still had my vax immunity. If it were my daughter, I would suggest she get hers checked when she might want to or end up pregnant.

Ditto. I had the MMR as a kid and then had my titers checked (multiple times as I went through nursing school and then got my first nursing job) and was still immune. I hadn't heard about losing immunity with MMR (I know that happens with the chicken pox vaccine, which is a reason we're skipping that one).
Anyway, I would get her titers checked when she hits puberty (since we may hope our daughters wait to have sex until they're older or whatever, but they may not) and go from there. Then you can include her in some these decisions.

[Gitti]

Originally Posted by charleysmama23

Ditto. I had the MMR as a kid and then had my titers checked (multiple times as I went through nursing school and then got my first nursing job) and was still immune. I hadn't heard about losing immunity with MMR ...

No vaccine offers life long immunity. Only the natrual infection offers core immunity. Vaccine immunity wanes from the time it is injected. That goes for ALL vaccines.

And I bet your immunity was due to secondary infection(s). At least for rubella.

[brightonwoman]

Originally Posted by Fyrestorm

I guess this is another captive audience - stab 'em when you can thing...If the biggest threat of R is to a first trimester fetus, why give it to a woman who has just given birth...the only danger at that point is the danger of shedding the vaccine to her newborn...

right, but the rationale is that she's pregnant now so we can't do it now, but if she ever wants to have other kids we'd better protect her before she gets pregnant again...and one way to make srue someone isn't pregnant is to catch them the day after they give birth

[gr8blessings]

Originally Posted by Gitti

The chance of having a cong.rubella baby is the same (extremely low) in fully vaccinated vs. non-vaccinated.

I hope you don't mind if I put this statement into perspective.

Since rubella has been eliminated from the US due to vaccination, the risk of rubella infection is extremely low. ( http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5411a5.htm) and in this regard, I think it is fair to say that the chance of having a baby with CRS is the same in fully vaccinated vs. non-vaccinated woman since both have a practically zero chance of getting rubella in the US.

The above statement is only true as long as rubella does not return. In Canada, there have been outbreaks of rubella in non-immunized populations. (http://www.phac-aspc.gc.ca/im/vpd-mev/rubella-eng.php) and given the trend not to vaccinate, I wouldn't be too confident in the lack of rubella in the US lasting.

Assuming rubella returns to the US:

If a vaccinated woman is infected with rubella*, the chance of the baby having CRS is 8% if the infection happens at less than 12 weeks into the pregnancy, 0% after 12 weeks.

If an unvaccinated woman is infected with rubella, the chance of the baby having CRS is 90% if the infection happens at less than 11 weeks into the pregnancy, 33% 11-12 weeks, 11% at 13–14 weeks, 24% at 15–16 weeks, and 0% after 16 weeks.

http://www.sogc.org/guidelines/docum...203CPG0802.pdf

*Several reports indicate that viremic reinfection following exposure may occur in vaccinated persons who have low levels of detectable antibody. The frequency and consequences of this phenomenon are unknown, but it is believed to be uncommon. (http://www.cdc.gov/vaccines/pubs/pin...ubella-508.pdf)

If rubella is endemic in the community or there is an epidemic, vaccinated women have a lesser chance of having a baby with CRS since vaccinated women are less likely to become infected and if infected, the baby has a lesser chance of having CRS compared to an unvaccinated women. Furthermore, the vaccinated women are out of the woods sooner, with the risk of CRS dropping to 0% at 12 weeks vs. 16 weeks for the unvaccinated women.

Note: I'm defining unvaccinated as no previous immunity to rubella. A woman that has recovered from rubella would have the same immunity as a vaccinated woman.

HTH,
gr8blessings

[Treece]

I'm fully vaxed. With ds1, titer showed no R immunity. Had the MMR. DS2, I think they offered it again, but I refused all vaxes except Rhogam. So, vaxing does not always confer immunity, esp in this case. I know for a fact I am a fully vaxed kid of the 80's.