concerns about shedding of MMR - pregnant and not-immune to rubella - help!

[Li27]

Hello,

I hope someone can help with this question. I'm 25 weeks pregnant and not immune to rubella - I had my titers checked before the pregnancy, they showed no immunity and I chose not to get immunized. I work with young children in close contact and one of them has just been vaccinated with the MMR vaccine. I saw him today (didn't know at the time). I'm pretty sure it's a live rubella vax - should I avoid him?

I read that the rubella virus has been found in individuals throat's between 7 - 28 days after vaccination, but there aren't documented cases of catching it. But, I'm worried. I have two more appointments with this child scheduled next week and am wondering if I should cancel?
Thoughts?

[EviesMom]

Sears' Vaccine Book says that if you were to catch Rubella that way, "Rubella is most risky to a fetus during the first trimester and only somewhat risky in the second trimester. There is no risk during the third trimester."

It sounds like you're almost to the third trimester, and clearly it's not a hard and fast line of "third trimester, no risk!" so I'd say you're relatively likely to be safe regardless.

I can't remember what the order is, but I know each of three elements of M-M-R are set up to "take effect" one after another and not all at once (matching the illnesses incubation periods I think).

But... If you will feel better cancelling seeing the child until you're past a "danger point", then I think there's no harm in that. So if Rubella is a 7-28 day one, then you might feel better not seeing him from days 7-28. Is that feasible or would it be a big difficulty?

[Unconventional1]

My son was 2 weeks old and SIL brought her DD over to see him on Christmas- she told us after the fact that her DD had the MMR a week and a half before- a little over a week later DS had rubella- so from my experience, there is risk of catching it.

[Emmeline II]

I would make sure you are taking in enough vitamin A.

[Bebegim]

I keep worrying about this! I never had rubella. My DD is unvaxed completely. But every other child i know (save one) is on the regular schedule.

Unconvential1, I would DEFINITELY say your little one caught it from his cousin! Rubella is very rare, so if your DS got it, I cannot imagine another source besides a recently vaccinated child!

Here's a link to the WHO data I input to a spreadsheet. I always look at this and remind myself how low the chances are, out of 317,000,000 people in the US, for me or my daughter to contract a VPD

I'd avoid him if I could. Better safe than sorry. Im now wondering when my best friends baby was vaccinated for MMR and if they should come over tomorrow. Im only 6 weeks pregnant!

[Bebegim]

Here's a quote from a main stream medical website on rubella and pregnancy:

"If rubella antibodies are not present, a rubella vaccine will be administered. The vaccine is a live virus vaccine and lasts at least seven years. You should not conceive within three months of receiving the vaccine, nor should you assume that vaccination guarantees immunity: the antibodies lose their effectiveness over time. If tests show that you are not immune to rubella and you are already pregnant, your doctor will probably advise vaccination immediately after the birth of your baby."
http://www.babypartner.com/guides/he...ns/rubella.php

OKAY... this website is confusing me. So, the vaccine only lasts for 7 years... which means, the only way to get life long immunity is to contract it. (not shocked) The website also says 85% of people get it as children and many never know it. So, were vaccinating for it, but only 15% of people dont get the disease? So, what the heck is the actual risk of getting it?

At the same time the WHO shows insanely low rubella rates for the US. So what is it? 85% or 200 cases a year? Thats a huge difference! I guess people get it so mild they never notice it and its not reported. Which makes me feel like pregnancy women who do not have titers for it (not that its 100% accurate either) would definitely be at risk. Although, how at risk is impossible to know... im really going to look into this!

[nia82]

I would choose to stay away from the recently vaccinated and get some good vitamin A (from cod liver oil). I don't remember where I read it, but there was research that suggested that rubella depletes vitamin A levels and a high level of it helps fighting it off. If someone knows what I am referring to, please link

I would absolutely refuse to get the MMR or R shot after delivery. It is a live vaccine! Even my vaccine happy MD sister back in Europe is shocked that live vaccines are administered to mothers of newborns in the US, she finds that rather crazy as there is a chance of shedding to your newborn. The docs here are set on it as they know for sure you're not pregnant after delivery, that's their argument. If you want to get the shot down the road, I would wait until after weaning.

[Emmeline II]

Originally Posted by Bebegim

I'd avoid him if I could. Better safe than sorry. Im now wondering when my best friends baby was vaccinated for MMR and if they should come over tomorrow. Im only 6 weeks pregnant!

The earliest the MMR should be given is 12mo.

Originally Posted by nia82

I would absolutely refuse to get the MMR or R shot after delivery. It is a live vaccine! Even my vaccine happy MD sister back in Europe is shocked that live vaccines are administered to mothers of newborns in the US, she finds that rather crazy as there is a chance of shedding to your newborn.

That, and rheumatoid arthritis is a tabled vaccine injury for the MMR; I've seen a number of posters here say that they developed RA after a postpartum MMR.

[Li27]

Thanks for all the responses. I think I'm going to avoid him for the 28 day period. Perhaps I am being paranoid, but I think any risk at this point is not worth it for me.

And I agree with the risks of getting this vaccine post-partum. I knew I was not immune my first pregnancy and made a choice not to get the vaccine, mostly because arthritis already runs in my family and I didn't want to chance it. It was a hard decision though - and has led to much worry and fear of catching it while pregnant!

Anyways, thanks again.