MMR/Chicken Pox Vax while pg, what to do?

[megan sacha]

My DS will be 3 in a few weeks and was scheduled to have his MMR then. And, he has not had the chicken pox vax which we were leaning toward doing. Part of the reason I wanted to do chicken pox now is to protect the new baby we are expecting in August as it would be terrible for a newborn to get CP. I just had my titers checked for CP and it appears I have no antibodies, despite getting a round of 2 vax for it myself around 10 years ago. All this time I thought I was immune. So, I don't want to get that one for him now since I'm pregnant and probably not immune. I have had my titer checked for rubella and I do have antibodies for that but what about mumps and measles. Should I be concerned about those shedding while pg? I don't really want to wait another year to get him the MMR, but maybe that's most prudent?

Also, how long should you wait after a new baby is born before vaxing someone else in the family? I think I would like to get the CP vax again myself as I surely don't want that at my age. And, when would it be safe to vax DS?

I know many of you on here are very anti-vax and I'm not looking to hear that, but more comments based on what I'm saying I want to do. Please don't try to sway me. I'm all for delaying vax and skipping some, but these are decisions we've already made about these vax.

[2boyzmama]

Well, I was about to post that I've never heard of chicken pox being dangerous to newborns, in fact many (most?) babies younger than a year either won't get sick at all, or will have very mild cases. But then I remembered that the reason for that is because baby is born with placental immunities and then also gets antibodies from mom's breastmilk. And you are evidently not immune.

SO...I'm not sure how that changes things. It is possible that you are in fact immune, that's the problem with titers...some people are immune with low titers, some people need much higher titers before they're clinically immune. Drs don't understand why that is, so they make cut offs for the levels that they consider people to be immune, knowing that some people with lower levels will still be immune. Does that make sense?

I would think that it would be safer/more prudent to wait until the new baby is over a year old before vaxing your older son. Does wild chicken pox circulate heavily in your area? It's hard to find it here in my area, and when it does pop up, all of us non-vaxers scramble to get our kids exposed! So the chances of your older son catching wild chicken pox and exposing the baby are rather slim to begin with.

Same thing with MMR...none of those diseases circulate much anymore, so the chances of him catching any of those diseases in the next year are rather slim.

[carriebft]

Well, mumps has been pretty bad this year and it seems to have spread out of NY now, as there are cases in OH and TX. The vaccine is only 95% effective here though (at best); one dose might only get 77% effectiveness. So, if you get 100 vaccinated kids and expose them all to mumps, about 10-30 of them are gonna get the disease. Nearly 100% of unvaccinated kids who are exposed will get it.

But also a thing to consider is the low risks associated with mumps as well.

[Tracy]

Nearly 100% of unvaccinated kids who are exposed will get it.

not so sure that is so definitive.

God, knows I was exposed to it when I was a kid. Kids in my class had it growing up. I was not vaxed for it.

[carriebft]

It is not *as* contagious as measles but it is up there. But, unlike measles, you have a high rate of people with the disease exhibiting no symptoms-- something like 10-15%. measles, chicken pox and mumps were those *childhood illnesses* because most people got them when exposed, so they spread far and wide.

Also-- When I mean exposed, I mean you get 100 vaccinated kids and have someone with mumps cough on them or something- 10-30 will get it. Do the same to 100 unvaccinated kids and 90 or more will get it.

But even with that, the disease is pretty mild.

[Tracy]

Originally Posted by carriebft

It is not *as* contagious as measles but it is up there. But, unlike measles, you have a high rate of people with the disease exhibiting no symptoms-- something like 10-15%. measles, chicken pox and mumps were those *childhood illnesses* because most people got them when exposed, so they spread far and wide.

Also-- When I mean exposed, I mean you get 100 vaccinated kids and have someone with mumps cough on them or something- 10-30 will get it. Do the same to 100 unvaccinated kids and 90 or more will get it.
But even with that, the disease is pretty mild.

That's just it, I'm not so sure one can say 90 percent will get it.....

My age and older than me were not vaxed for it. So, my whole class/grade was not vaxed. 90 percent of us did not get it. I remember it was always the big "news" ...'Kurt got mumps." "ohhhhh." There were occassional cases but like I said not 90 percent of us.

[claddaghmom]

On the varivax vaccine, I absolutely would not expose my child to that while I was pregnant. I've seen and heard enough cases of children getting chickenpox after vaccination for it to feel like a risk. Especially if you are not sure about immunity (although I agree that titres don't mean much) that means you are taking a definite risk during pregnancy.

Even having had a good case of the chickenpox, I would be wary exposing myelf to chickenpox during pregnancy, b/c the immunocompromised state could increase the risk of shingles. We know that chickenpox can cause congenital defects and other complications, so to me it seems like a really bad idea, regardless of pro/anti stance.

It seems you want to vaccinate your son to protect your newborn, because you feel that chickenpox in a newborn/infant is dangerous. Although not a fun situation, I don't know that chickenpox is decidedly more dangerous for infants. And if breastfeeding, your baby might not even get them, or might get such a "light" case that he has to get them later. This happened to my sister. She was breastfeeding when we all got chickenpox and had just a few light pink spots. I don't think she even had a fever.

The second issue w/ vaccinating to "cocoon" is that you mention only vaccinating your son. What about you? And if you choose to receive a vaccine, that just seems to double the risk of contraction, and still doesn't eliminate the risk of exposing your newborn.

Anyways, here is the varivax ingredient list:

Varivax, refrigerator-stable formulation (varicella)

A minimum of 1350 plaque forming units (PFU) Oka/Merck varicella virus
18 mg sucrose
8.9 mg hydrolyzed gelatin
3.6 mg urea
2.3 mg sodium chloride
0.36 mg monosodium L-glutamate
0.33 mg sodium phosphate dibasic
57 micrograms potassium phosphate monobasic
57 micrograms potassium chloride
Residual components of MRC-5 cells including DNA and protein
Trace quantities neomycin
Trace quantities bovine calf serum
(no preservatives)

A preparation of the Oka/Merck strain of live, attenuated varicella virus. The virus was obtained from a child with wild-type varicella, then introduced into human embryonic lung cell cultures, adapted to and propagated in embryonic guinea pig cell cultures and propagated in human diploid cell cultures. Further passage of the virus was performed in human diploid cell cultures.

[claddaghmom]

Originally Posted by carriebft

Well, mumps has been pretty bad this year and it seems to have spread out of NY now, as there are cases in OH and TX. The vaccine is only 95% effective here though (at best); one dose might only get 77% effectiveness. So, if you get 100 vaccinated kids and expose them all to mumps, about 10-30 of them are gonna get the disease. Nearly 100% of unvaccinated kids who are exposed will get it.

But also a thing to consider is the low risks associated with mumps as well.

I recall reading that the CDC says the vaccine effectiveness for one dose of MMR is 70-80% and 80-90% for two doses. But I don't have my links with me at this computer.

As for the mumps portion, the CDC noted that

"During the outbreak in 2006, when many mumps cases occurred in those who had been vaccinated, two doses of the vaccine were estimated to be 79% – 88% effective in preventing mumps."

(Of course, Mumps has been in the news lately since that outbreak where 85% were vaccinated).

[Emmeline II]

So, you had CP as a child and had the vax as recently as 10 years ago and do not "show" immunity?

What makes you think another vax would change that? There may be a reason you are "dropping" immunity to CP.

[serenbat]

On the varivax vaccine, I absolutely would not expose my child to that while I was pregnant. I've seen and heard enough cases of children getting chickenpox after vaccination for it to feel like a risk. Especially if you are not sure about immunity (although I agree that titres don't mean much) that means you are taking a definite risk during pregnancy.

Even having had a good case of the chickenpox, I would be wary exposing myelf to chickenpox during pregnancy, b/c the immunocompromised state could increase the risk of shingles. We know that chickenpox can cause congenital defects and other complications, so to me it seems like a really bad idea, regardless of pro/anti stance.

Why would you want to even risk your health, even with a fever? Have you spoken to your MW or OB about it? What did they advise you?

I had a very bad case of CP as an adult and my OB said NO way, stay far away from any children that you know have been recently vaced and any one with the shingles-simple fact, unlike you, with adults they simply don't keep records of us and they have no clear way of know how I would / could react-granted I did have CP, but even risking a slight fever not to mention what else could happen to you, I question why you are willing to take that risk now?

[megan sacha]

If you read my original post, I said I've decided not to do the CP now for DS because I show no immunity. The whole reason I checked my titers was to make sure I was immune before vaxing him so that I wouldn't risk my health and myself contracting CP while pg. So, that part is mostly just a bummer. And yes, there's no reason to vax him for it when I could pass it onto the baby if I contracted it anyway.

I don't think I ever did contract CP as a child or if I did it was such a light case my parents didn't notice. That's why I decided to get the vax as an adult when it came out.

I haven't fully discussed this with my midwife yet as I just found out. I am a little nervous to have DS get the MMR now without having my measles and mumps titers checked as I haven't had that vax since I was a child.

[claddaghmom]

Originally Posted by megan sacha

If you read my original post, I said I've decided not to do the CP now for DS because I show no immunity. The whole reason I checked my titers was to make sure I was immune before vaxing him so that I wouldn't risk my health and myself contracting CP while pg. So, that part is mostly just a bummer. And yes, there's no reason to vax him for it when I could pass it onto the baby if I contracted it anyway.

I don't think I ever did contract CP as a child or if I did it was such a light case my parents didn't notice. That's why I decided to get the vax as an adult when it came out.

I haven't fully discussed this with my midwife yet as I just found out. I am a little nervous to have DS get the MMR now without having my measles and mumps titers checked as I haven't had that vax since I was a child.

Sorry to have missed that!

On the MMR, I turn to the Rubella portion before mumps and measles. Although it would be mild for your son (swollen nodes, fever, maybe a sore throat) again, it's the pregnancy part that worries me.

It would be the same if the MR/RM or MMR was offered during pregnancy to you. Someone else was posting a quote about the potential activation of the R portion in the fetus and subsquent implication of autism. I didn't save it in my documents grr...maybe they will see your thread and share it.


ETA: and I just wanted to say, I feel for ya...I know the what ifs that pop up when pregnant. Especially if you have an active older child who is out and about in the community. I had the MMR and Rubella and my panel came back that I wasn't immune to it. Actually, there's a few threads dedicated to this problem. It's a darned if you do, darned if you don't situation.