Would you get the rubella vax in this situation?

[Li27]

Hi,
I found out I didn't have immunity to rubella during my previous pregnancy and was told to get the vax after giving birth to my DD. My DD is now 14 months and I haven't gotten the vax. I'm considering getting pregnant again soon, but am torn about this. On the one hand, I'm nervous about not having immunity (I work in elementary schools some of the time), but on the other, I don't like what has been suggested as a link to arthritis reactions (my Mom has arthritis and my sister has some issues as well). I also had bad joint pain in my hands for about 9 months after my DD's birth and still have joint pain in my hip - doctor said it was related to the pregnancy/hormones?????

And if you would get it, how long should I then wait to get pregnant?

Thanks for any advice.

[MyBoysBlue]

I keep reading on here that it is linked to arthritis but where is everyone reading this? I have a friend who isn't even 30 who has arthritis. I want to ask if she got the rubella vax recently but I want to be able to back this up with a study to point her too. I'm hoping it will put her on the path to questioning vaxes.

Personally Rubella is one of the vax's that was easy for me to rule out. I figured that if I hadn't got it in the 20+ years since I was born; how likely was it that I would get it in the few weeks that it is dangerous to the fetus while pregnant. Since I was already vaxed for it and it didn't take the first time would it even work the second either?

This is my reasoning. I actually don't know my immunity status.

[4evermom]

I almost got the rubella vax when I got married. Then I discovered you weren't supposed to get pregnant for something like 6 months afterward. I ended up not getting it. I had actually been on the lookout for opportunities to catch it since I was about 12 and never came across one. I'm 39, now.

Catching rubella during early pregnancy does have some risks to the baby. But it isn't that huge of a risk. I don't remember the statistics but I found them reassuring at the time. It's not like it's 100% that the baby will have a problem. And the odds are against getting exposed at that precise time, anyway.

[Delicateflower]

Yes, I would get it. Several children at my elementary school were deaf from congenital rubella. I'd want to avoid that.

The odds of it happening are higher than the odds of things I consider quite risky, like having an epidural. Rubella is endemic, but we don't see much congenital rubella these days because women of childbearing age are mostly immune.

You need to wait four weeks after the vax to get pregnant. And it would be nice to check your titres and make sure it's taken. If you're a non-responder you'll want to be very careful, make sure all your friends with kids know you're not immune. I've had rubella and it was so mild I didn't even miss school until we realised what I had, so I was spreading it far and wide, riding buses, pushing shopping carts.

[Sileree]

Originally Posted by MyBoysBlue

I keep reading on here that it is linked to arthritis but where is everyone reading this?

If you look on the CDC's website, it's listed as a side effect for adult women. Though they claim it is always temporary.

[katiesk]

I've had rubella and it was so mild I didn't even miss school until we realised what I had

given the fact that rubella is so mild...and that the chances of contracting it during one specific time period are so low...and that you should wait at least six months before ttc...and that the vax is linked to arthritis...and that the vax may not confer immunity anyway...i would most certainly not get it.

[MyBoysBlue]

Originally Posted by Delicateflower

The odds of it happening are higher than the odds of things I consider quite risky, like having an epidural. Rubella is endemic, but we don't see much congenital rubella these days because women of childbearing age are mostly immune.

What exactly are the odds of getting it in the few weeks where it is risky during pregnancy? I don't think it is even comparable to epidural risks. Even when there was no vax for rubella the risks were low because most women got rubella as a child.

Added: You might want to read through this recent thread on Rubella.
http://www.mothering.com/discussions....php?t=1068928

[Magali]

No I wouldn't get it.

[TanyaS]

I would not get it. Again.

Baby #1 - I was not immune to rubella and got the vax after birth.
Baby #2 - Three years post vax, I was not immune to rubella. Was given the vax after birth.
Baby #3 - 18 months post vax, once again, not immune to rubella. I did not get the vax this time, and will not in the future.

[Delicateflower]

Originally Posted by katiesk

given the fact that rubella is so mild...and that the chances of contracting it during one specific time period are so low...and that you should wait at least six months before ttc...and that the vax is linked to arthritis...and that the vax may not confer immunity anyway...i would most certainly not get it.

Well, they're not facts, for a start. You need to wait 1-3 months, not six, rubella is not mild for the baby of a pregnant woman, rubella is around, it's airborne and the person who gives it to you isn't sick enough to stay home, plus they're contagious for up to two weeks before the symptoms start. With vax rates for rubella at record lows, the risk is higher than it's been in decades.

Even when there was no vax for rubella the risks were low because most women got rubella as a child.

Yes, making them immune the way the vax does, or not, if they're a non-responder.

But I don't know that the 30,000 children born blind, deaf or both, and the 20,000 fetuses who were miscarried in the 1964 epidemic considered the risk low?

[MyBoysBlue]

Do you have a link about this 1964 epidemic? This is the first I've heard of it.

Added: I did some looking around and I can't find anywhere near the numbers you quoted. Is there a site that mentions those numbers?

[Delicateflower]

Originally Posted by MyBoysBlue

Do you have a link about this 1964 epidemic? This is the first I've heard of it.

Added: I did some looking around and I can't find anywhere near the numbers you quoted. Is there a site that mentions those numbers?

You haven't heard of the 1964 epidemic? Wow, you should do some research about rubella, it's equally inspiring and horrifying. What used to happen and how quickly we turned it around with the vaccine.

The rubella virus was isolated in 1961, and following a world-wide outbreak in 1964-65 (20,000 cases of congenital cataract in the USA alone), vaccines were developed, the first licensed in 1969 - the shortest time period from virus identification to vaccine ever.

http://www.patient.co.uk/showdoc/40024887/

Rubella tends to arrive in epidemics, with major epidemics every six to nine years. The virus that causes rubella was first discovered in 1962, which helped scientists to learn a great deal by studying the 1964 epidemic.

There were 1.8 million people known to be sick with rubella in that epidemic. There were 20,000 known fetal deaths and about 30,000 infants born with severe birth defects.

An intense, worldwide effort to develop a rubella vaccine began in 1965.

Immediately after the introduction of the rubella vaccine in 1969, epidemics virtually disappeared in the U.S. Since then, there have been fewer than 120 cases of congenital rubella syndrome reported each year in the U.S., a reduction of well over 99 percent.

In the U.S., most women who get rubella are unimmunized women who catch the disease during an outbreak at a college campus.

Epidemics still occur in many countries around the world, only one plane flight away. Rubella is most common in the late winter and early spring (March, April, and May in the northern hemisphere) both during epidemics and in the off years. Only humans get rubella.

http://www.drgreene.com/21_1176.html

http://books.google.com/books?id=GOX...sult&resnum=10

http://nationaldb.org/ISSelectedTopi...&topicCatID=29

[katelove]

Congenital Rubella Syndrome is a concern for 16 weeks, although the risk is significantly lower in the last four. If a pregnnat woman is infected by rubella in the first 12 weeks there is a 90% chance that CRS will occur.

"Congenital rubella syndrome in the first 16 weeks of pregnancy causes intrauterine growth restriction (sometimes termed intrauterine growth retardation), intracranial calcifications, microcephaly, cataracts, sensorineural defects, cardiac defects, hepatosplenomegaly, osteitis, or miscarriage. If rubella virus infection occurs in the first 12 weeks of pregnancy, up to 90% of patients have some manifestations of the congenital rubella syndrome. For infection at 12-16 weeks, the risk is approximately 20%.1 " http://emedicine.medscape.com/article/235213-overview

In Australia, we recommend that a woman wait 2 months before getting pregnant but there have been no documented cases of CRS among women who have been inadvertantly vaccinated while pregnant.

The seroconversion rate varies a bit dependng on which vaccine is used and at what age it is given but the average is around 90%.

I hope that helps you with your decision.

Regards
Kate

[MyBoysBlue]

I didn't look deeper than the number of cases now. It is no longer the 19 60's

Fewer than 25 reported rubella cases each year since 2001 (that means everyone, not just pregnant women)
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5411a5.htm

During 1995-2000, an average of five CRS cases was reported annually; since 2001, an average of one CRS case has been reported annually.
http://wwwn.cdc.gov/travel/yellowbook/ch4/rubella.aspx

I do remember reading about the 1964 thing now, just the few lines on the CDC site. It was a while ago. I didn't look too deeply into it. The number of more recent cases was enough for me to dismiss this vax as uneeded.

[Gitti]

I don't think you'll get infected with rubella in grade school. Usually by that age kids are immune either from the vaccine, from the natural infection. or both.

The chances of getting rubella exactly during the first 3 months are very slim. And then you would have to have it severe enough to affect your child.

The chance of having a child with rubella syndrome is the same for titer proof "immune" moms as for titer proof "non-immune" moms (Swiss study).

Also titers don't really equate with immunity. No one can say for certain whether a person is immune to an infection or not. Titer reliability is very questionable.

If you know that you have been exposed to rubella I would suggest vita A such as in Cold liver oil, C, eat healthy, and get plenty of sleep.

btw, I bet you are immune.

[Gitti]

Originally Posted by Delicateflower

But I don't know that the 30,000 children born blind, deaf or both, and the 20,000 fetuses who were miscarried in the 1964 epidemic considered the risk low?

Please can you provide a source for that?

The highest number the CDC ever quoted in a year was 64 and that was before the vaccine was on the market.

[Gitti]

Originally Posted by katelove

If a pregnnat woman is infected by rubella in the first 12 weeks there is a 90% chance that CRS will occur.

This is absolutely NOT fact. Could you please post the sentence which made you believe that?

[ammiga]

To the OP- no, I would not get the vax. I have very early onset arthritis (sounds like you do too). I don't think the toxins in the vaccines outweigh the possible benefit of the immunity that you may or may not get from the vaccine. And, by the time you even find out if you are pregnant, you are over a third of the way through the "danger" time. I'd skip it.

[MyBoysBlue]

"The last major epidemic of rubella in the United States occurred in 1964 and 1965 when millions of rubella cases led to 20,000 cases of infants born with CRS."

From the CDC site: http://wwwn.cdc.gov/travel/yellowbook/ch4/rubella.aspx

But the story is very different now. With very few cases. That was over 40 years ago.
___________

The only sourse I could find about the statics of CRS during pregnancy.
"If the woman becomes infected within the first 11 weeks of pregnancy, her chance of giving birth to a baby with Congenital Rubella Syndrome (CRS) may be as high as 85- 90%. Infants with CRS may be born deaf or blind. They may have damage to their hearts or mental disabilities. Miscarriages are also common.

At 12-20 weeks of pregnancy, there is a 10-20% risk of CRS. Infection during this part of pregnancy mainly results in deafness. After 20 weeks, the risk of abnormalities in the baby is almost zero."

http://www.healthunit.com/article.aspx?ID=11481
Not the best source but I couldn't find better.
_________

One link said 85% for the first 8 weeks then it drops down to 25%.
http://books.google.ca/books?id=hR6G...esult&resnum=1
http://www.healthunit.com/article.aspx?ID=11481

I think it sounds like the chances of CRS with infection during pregnancy are a bit of a guess. One problem mentioned is that it is so mild at times that it causes no problems and women don't even know they were exposed and it caused no problem with the fetus so if those mild cases aren't inculded in the numbers it throws off the percentages.

[alegna]

I would not. From my reading, it seems that a large percent of non-immune, vaccinated women simply don't covert. They get dose after dose and never show immunity.

-Angela