viral shed rate/time for MMR

[queencarr]

I have a medically (mostly) non-vaxed 3yo. He is has LTA to egg, including contact, ingestion, and airborne. His allergist and ped both recommended no vax at all due to egg ingredients or possible cross contamination with egg ingredients, and so he only had a few that were given prior to his adoption (Hep B, Dtap, IPV) and allergy dx. However, in January I will have a medical externship for graduate school at a healthcare facility. They are requiring proof of my vax status. Except that my Mom and I do not have a copy of it (long story involving lost medical records by the dr). So I had titres drawn, hoping to show immunity, and they show I am negative to measles and equivocal to mumps.

When I had originally looked up CDC guidelines, they suggested no live virus vax in family members of unvaxed kids. But now, it looks like the recommendation is to give the vax regardless. Our ped will not ok this, as I have already talked to him about the 5yo's MMR booster and he said absolutely not. However, I am out of town, and away from my kids, for 5 weeks. Is there enough time for me to get the vax and not be potentially contagious through viral shedding when I go home? I thought I read/heard 12 weeks, but can find no documentation at this point. (I am not excited to get it, especially with the risk of side effects for adults, but have to have this externship to graduate and would run into this problem at any medical site, not just this one.)

The alternative at this point is letters from the ped, the health dept, and an "action plan" in the event of an outbreak that I wll have to present to HR and hope that they will ok it. If I were being hired, they apparently could not require it, but because I am in an externship contract, they can make it a requirement.

Any other brilliant thoughts or suggestions?

[Marnica]

Can you file a religious exemption? I would think they cannot discriminate against you based on your religious beliefs.

as for the MMR and shedding check these out:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC228449/

Overall, measles virus RNA was detected in 10 of 12 children during the 2-week sampling period. In some cases, measles virus RNA was detected as early as 1 day or as late as 14 days after vaccination. Measles virus RNA was also detected in the urine samples from all four of the young adults between 1 and 13 days after vaccination. This assay will enable continued studies of the shedding and transmission of measles virus and, it is hoped, will provide a rapid means to identify measles infection, especially in mild or asymptomatic cases.

and here: http://www.ncbi.nlm.nih.gov/pubmed/1...t=AbstractPlus


seems like maybe rubella may shed longer than measles: http://www.mmrthefacts.nhs.uk/resour.../MMRII_SPC.pdf

look at section 4.4


I think if you can't get out of it somehow then 5 weeks would seem like enough time. I have never read that live virus vaccines, let along the MMR sheds for 3 months!

[queencarr]

Thanks for the links to studies!! That is exactly the kind of info I was looking for to make a decision. I will ahve to read it in detail later this week--deep into a two weeks class.

Unfortunately, a religious exemption will not work either--they simply have to make it a condition of contract between the legal teams that I be vaxed (medical even if it was me that had the medical issue is not a valid exemption either). Paid externship would be different, because then it is specific to me. But unpaid, nope, according to my supervisor because it is contractual to any student coming in. But again, thank you!

[ASusan]

But...you're at risk for shedding the VIRUS(es), right? Not the egg-ingredients that are injected as a part of the vaccination, I would think.

Or are you concerned for your son getting the measles (mumps, rubella) from your shedding? Yeah, that might concern me a *little* bit, but I think the risk would be SO slight. (He is probably around children in the public/classroom that are recently vaxed, and I would think they pose a similar - although maybe lesser - risk.)

[queencarr]

Yes, my concern is for viral shedding--me being contagious--since he is completely nonvax. He also has respiratory compromise (dysphagia--he aspirates), so the potential is for him to get more sick than others.

[ASusan]

So here's a question - Where are you actually shedding FROM, when you are shedding virus following a vax? If you wore a facial mask (covering mouth and nose), would that reduce the risk? Or are you shedding fecally...through any body orafice...or is is just oozing out of your flesh somehow?

It seems like it would have to be somewhat airborne and you could reduce risk by wearing a face mask, washing hands frequently, and/or having DH do most of the close child care. (helping with dressing, bathing...) and maybe food prep...and not co-sleeping for that time.