Pregnant woman...MMR vaccine for child.

[littlec]

Would you suggest a child hold off on the MMR if the child's mom is pregnant? Why or why not?

I have a friend in this situation and told her I would hold off if she could because even though it's unlikely..her 4 year old could contract Rubella from the shot and then put her unborn child at a risk of CRS. However, once the baby is born, her older child could still contract and pass on any of those viruses to the newborn. I know it's not common, but in this case, isn't the potential risk to the new baby more than the protection the vaccine will offer the older child, especially since this is the second round of MMR.

Just to be clear, I told her my concerns and told her to look into it and talk to her doctor about it...I didn't' exactly say "don't do it!"

[EdnaMarie]

She can get her own titres checked. If they are high enough, then she doesn't need to worry about the child getting rubella or not. If they are not high enough, she and her child both need to be careful and avoid the recently vaccinated and unvaccinated.

I do think that at four, her daughter can safely put off the MMR for a year... we just did DD1's 4-year MMR and I asked about it and the nurse said that while a different booster was necessary (I forget, it's been busy), the MMR wasn't, but then she'd be in next year and it would be two additional rounds of shots because of scheduling (i.e. the four year ones, and then five-year ones because of delays, and then when the other ones came up in middle school, same thing).

[Otto]

Originally Posted by littlec

I have a friend in this situation and told her I would hold off if she could because even though it's unlikely..her 4 year old could contract Rubella from the shot and then put her unborn child at a risk of CRS.

I'm having no success in finding any documented cases. The Textbook of Pediatric Infectious Disease chimes in with this:

Although vaccine virus may be isolated from the pharynx, vaccinees do not transmit rubella to others, except in the case of a vaccinated breast-feeding mother.... Concern about potential transmission of disease from immunized children to susceptible contacts, including pregnant women, has not been supported by studies of susceptible household contacts.

(Pp. 3159-3160.)

[Pirogi]

I think it's generally recognized that a live attenuated vaccine can cause infection in the recipient (for rubella specifically, there have been documented cases of rubella in miscarried fetuses and passed via the breastmilk to an infant after vaccination). The CDC and others insist that a person who becomes infected from vaccination does not pose a risk for infection in others. They recommend that in this specific situation (of the OP's), a child does receive the vaccine. I guess it depends if you believe that the infected person doesn't pose a risk to others.

http://www.cdc.gov/mmwr/PDF/rr/rr4708.pdf

Rubella vaccine virus has been isolated from the aborted fetus of one (3%) of 35 rubella-susceptible women who received RA 27/3 strain vaccine during pregnancy.

Although a woman can excrete rubella vaccine virus in breast milk and transmit the virus to her infant, the infection remains asymptomatic (202–205 ).

[EdnaMarie]

Nobody would deny that rubella can be passed from the mother to the fetus or infant--indeed, that is what the whole hullabaloo is about in the first place, that very possibility!

I guess it depends if you believe that the infected person doesn't pose a risk to others.

Why would you think that they are lying about a live vaccine's risk to others? Do you know some sketchy people working at the CDC or something?

If anyone is that concerned, a titre test for mother and child is completely safe and easy and would put all minds at ease.

[Lisa1970]

The child can get any of those diseases from the shot. It is not worth the risk. My playgroup from when I had my 1 yr old was not that big, yet, a couple of those kids got measles or mumps (don't recall which) from the shot.

[orange_mommy]

Help! I am wanting to be in on this discussion because at this very moment I am a pregnant woman who is babysitting a 1-year-old child who just got both his 6-month and 1-year shots 3 days ago (the parents wanted only 6-months and the nurse decided to "catch him up" without mentioning it until after.)  I am in Canada and here is their recommended vaccine schedule:

http://www.phac-aspc.gc.ca/im/is-cv/index-eng.php#a 

Anyhow, this morning I am greeted at the door by the mom, the baby, and find out that he got these shots 3 days ago.  I am very concerned about my exposure to the viruses he has been vaccinated for.  I am 24 weeks pregnant and tested immune to rubella and chicken pox at the beginning of my pregnancy.  However I just read an article by Hilary Butler, who supposedly had high levels of immunity to rubella and still contracted rubella while pregnant:

http://www.whale.to/m/butler2.html

Not to mention all the other viruses they loaded into this poor child that I may also be exposed to.  His mom said he has had some diaper blowouts and obviously I am going to come in contact with feces and saliva, which is a major source of contamination for about 3 weeks after a shot.  I have an unvaccinated 6-year-old son who is constantly putting his fingers in his mouth without thinking, etc and I'm sure at some point he could be exposed to the viruses, which could then be easily passed on to me through living in the same household.  I'm scared, and I'm furious with our health system who is shoving vaccines on people, and then failing to educate them about the importance of quarantining themselves when they do!  I would REALLY appreciate hearing any info on this subject that anyone might have!

Originally Posted by Lisa1970 

The child can get any of those diseases from the shot. It is not worth the risk. My playgroup from when I had my 1 yr old was not that big, yet, a couple of those kids got measles or mumps (don't recall which) from the shot.

Yes, and I used to attend a playgroup when ds was younger where several of the kids got their 1-year shots around the same time, and one of the unvaccinated babies came down with a rash shortly after and her pregnant mother miscarried.  It could be a coincidence but maybe not.

[EdnaMarie]

My feeling is... The CDC is a large organization, and it agrees with many other organizations dedicated to public health, and the multiple studies they post suggest that if your titres are above a certain level, you are highly unlikely to get rubella.

Unlikely =/= impossible.

If you are uncomfortable with it, ask mom to find another caregiver for now to minimize your exposure this week.

I'm not sure why you're worried about your 6-y-o... isn't the point of not vaccinating to gain natural immunity, that these diseases aren't that big of a deal?

[orange_mommy]

Thanks for your reply! 
 

Originally Posted by EdnaMarie 

I'm not sure why you're worried about your 6-y-o... isn't the point of not vaccinating to gain natural immunity, that these diseases aren't that big of a deal?

I'm sorry, I must not have explained that part very well!  My concern is not for my 6-year-old's health, in fact if I was not pregnant I would be fine with having the exposure because at his age you are right, those diseases are not a big deal to the average child who is eating properly and has no major health issues!  However, if my son is exposed, then my likelihood of being exposed goes WAY up, due to our close contact (we cosleep and he breathes in my face, etc and are around each other 24/7), hence the concern for my baby.

I definitely don't have as much faith as you in the complete sincerity of all large government organizations due to many things I've seen them engage in in the past.  That's not knocking how you feel... we all have different reasons for our trust and mistrust in people/organizations, etc.  I could go into way more detail but I want to keep this as close to the original topic as possible.  Thanks again for your response!

[EdnaMarie]

I see.  I was recently vaccinated against rubella (about five years ago) so if it were ME, knowing my titres, I wouldn't worry.  I don't know when you were vaccinated or had it.

The CDC says that they cannot be transmitted:

http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/mmr/faqs-mmr-hcp.htm

Should we give an MMR to a 15-month-old whose mother is 2 months pregnant?

Yes. Measles, mumps, and rubella vaccine viruses are not transmitted from the vaccinated person, so MMR does not pose a risk to a pregnant household member.

Can I give MMR to a child whose sibling is receiving chemotherapy for leukemia?

Yes. MMR and varicella vaccines should be given to the healthy household contacts of immunosuppressed children. Oral polio is the only vaccine that should not be given to a healthy child if an immunosuppressed person resides in the household.

Now, I know you don't trust the CDC.  But you trust Hilary Butler? 

Go with your guts, knowing that this mom may really be put out and choose another care provider.

[Evergreen]

Originally Posted by littlec 

Would you suggest a child hold off on the MMR if the child's mom is pregnant? Why or why not?

I have a friend in this situation and told her I would hold off if she could because even though it's unlikely..her 4 year old could contract Rubella from the shot and then put her unborn child at a risk of CRS. However, once the baby is born, her older child could still contract and pass on any of those viruses to the newborn. I know it's not common, but in this case, isn't the potential risk to the new baby more than the protection the vaccine will offer the older child, especially since this is the second round of MMR.

Just to be clear, I told her my concerns and told her to look into it and talk to her doctor about it...I didn't' exactly say "don't do it!"

After researching I have decided I feel comfortable with my kids getting MMR while I am pregnant. I should get my blood work back on Friday, though, and if I am not immune to rubella I will postpone their visit until I am in my 3rd trimester.

[Skippy918]

I was wondering about the same thing.  I'm almost 17 weeks pregnant and DS hasn't had the first MMR yet either.  I think my titers are okay, otherwise I'm sure my doctor would have said something.

 

and if I am not immune to rubella I will postpone their visit until I am in my 3rd trimester.

Is it best to wait till the third trimester?  I think I would be more nervous with him getting the shot and having a newborn in the house.

[Evergreen]

Originally Posted by Skippy918 

I was wondering about the same thing.  I'm almost 17 weeks pregnant and DS hasn't had the first MMR yet either.  I think my titers are okay, otherwise I'm sure my doctor would have said something.

 

and if I am not immune to rubella I will postpone their visit until I am in my 3rd trimester.

Is it best to wait till the third trimester?  I think I would be more nervous with him getting the shot and having a newborn in the house.

Just because of the risks of getting rubella while pregnant. After 20 weeks the risks of birth defects are virtually nil so I just figured the longer I could wait the better since the rubella portion of the vaccine has the theoretical possibility of shedding.