Breastfeeding & mama's vaxes. - Mothering Forums

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#1 of 20 Old 04-21-2007, 03:45 AM - Thread Starter
 
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Before I start nursing school this August, I need to get my vaccinations up to date. I need the Hep B vax, which I have never had, and I need to update my tetanus shot.

It's OK to still nurse after getting these, right? DD#2 is partially vaxed; DD#3 hasn't had any yet. As far as I know I should be fine--I know the flu vax is OKed for nursing mamas--but my mother thought there might be an issue. Of course, my mother's not exactly the breastfeeding guru of the world.

Sabra: Mama to Bobbie (3/02), Linda (1/04), Esther (10/05), Marie (11/10), & Douglas (11/12)

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#2 of 20 Old 04-21-2007, 11:59 AM
 
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I would NEVER accept the hep b vax. And I would not nurse after being vaxed. You can get out of the vaxes - claim a religious objection.

-Angela
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#3 of 20 Old 04-21-2007, 01:20 PM - Thread Starter
 
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You do realize this is to nursing school, right? I can say I don't want the vaxes & they can say they don't want me. They're hardly bound to take me no matter what. At any rate, I don't recall asking if I should get the vaccines or not.

Sabra: Mama to Bobbie (3/02), Linda (1/04), Esther (10/05), Marie (11/10), & Douglas (11/12)

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#4 of 20 Old 04-21-2007, 02:17 PM
 
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There is always a way to get out of them. If it's through a university, that university gets federal $$ and therefore they can't discriminate on the basis of religion.

Hep b is a HIGHLY reactive vaccine and has a very poor track record as far as efficacy.

As for tetanus- there is no evidence of efficacy at all- CDC admits they just "assume" it works.

Vaccines are full of all sorts of chemicals and such that I wouldn't want to pass to my nursling- and of course no research has been done on if they do or not.

-Angela
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#5 of 20 Old 04-21-2007, 02:31 PM
 
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Wait, aren't we always hearing that it's OK to nurse while taking powerful psychiatric drugs? I'm sure unless the evil "mainstream" warns you off it too, it's fine to nurse after being vaccinated. As for effectiveness, maybe I'm a freak but I got the hep B series 10 years ago and my blood titers show immunity.
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#6 of 20 Old 04-21-2007, 02:46 PM
 
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if you are planning to work in the medical field, you should get the vax. i work in the lab, poking people who are hep+, and it would be silly to take a chance of contracting hep.

i'm sure if you REALLY want to get out of it, you could find a way. but why? if you're going to be around hep+ patients, you need to protect yourself... and your baby!
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#7 of 20 Old 04-21-2007, 06:02 PM
 
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I work with many people in the medical field who are not vax'd at all. Some have egg allergies, some latex, some have already had adverse reactions and are contraindicated (such as myself).
We do not require our medical staff to vax if they are contraindicated. Yes, you could run the risk of HepB but I also find it interesting that the warning label of the HepB vax says you could actually contract HepC and other unknown viruses, as the vax is made from human plasma which is not actually screened. So you run the risk of getting sick from the vaccine too.
Personal decision for you.
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#8 of 20 Old 04-21-2007, 08:05 PM
 
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Originally Posted by Racecarma View Post
Yes, you could run the risk of HepB but I also find it interesting that the warning label of the HepB vax says you could actually contract HepC and other unknown viruses, as the vax is made from human plasma which is not actually screened. So you run the risk of getting sick from the vaccine too.
Hep B vaccines made with plasma are no longer available in the US and haven't been for quite some time, I think since the late 80's early 90's. The Heb B vaccines currently used in the US are genetically engineered and do not contain blood products.

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#9 of 20 Old 04-21-2007, 08:22 PM - Thread Starter
 
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Again, I AM NOT ASKING IF ANYONE THINKS I SHOULD GET THE VACCINE OR NOT. Let me quote myself, as there is apparently some confusion:

Quote:
It's OK to still nurse after getting these, right? DD#2 is partially vaxed; DD#3 hasn't had any yet. As far as I know I should be fine--I know the flu vax is OKed for nursing mamas--but my mother thought there might be an issue.
If you want to debate the efficacy/advisability of the Hep B vaccine, we've got an entire forum devoted to dissing them. It's OK if no one knows the answer to this question, but I thought this was the site with the most-knowledgable mamas when it comes to breastfeeding.

Sabra: Mama to Bobbie (3/02), Linda (1/04), Esther (10/05), Marie (11/10), & Douglas (11/12)

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#10 of 20 Old 04-21-2007, 08:53 PM
 
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Originally Posted by Sagesgirl View Post
Again, I AM NOT ASKING IF ANYONE THINKS I SHOULD GET THE VACCINE OR NOT....

....If you want to debate the efficacy/advisability of the Hep B vaccine, we've got an entire forum devoted to dissing them.
You know you can't ask a vax question anywhere around here and not get fight going. : I think there is actually a rule here that when a vax question is asked, a debate must ensue.

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Originally Posted by Sagesgirl View Post
It's OK to still nurse after getting these, right?
According to the CDC, yes. According to me, yes.

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#11 of 20 Old 04-21-2007, 09:38 PM
 
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I've never heard that it wouldn't be okay to nurse after those.

Heck, "they" want infants to have the HepB, which I do think is nuts even though I'm not against vaxing in general. If it can be given to the baby directly, there'd be a serious logic disconnect for "them" to say you couldn't nurse after having it.

"What will you do once you know?"
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#12 of 20 Old 04-21-2007, 10:49 PM
 
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Hi Sagesgirl -

Here is the CDC's page on breastfeeding and vaccinations:

http://www.cdc.gov/breastfeeding/rec...ccinations.htm

It's a table giving recommendations vaccine by vaccine. You'll notice that just as for many medications, not much data is available on the effects in human milk. It says that Hep B is not contraindicated for nursing mothers; however, the wrong link is given for a reference (sigh) - click the link given for the Hep A recommendation directly above. Not that there's much info there either.

The package insert for Recombivax-HB states "It is not known whether the vaccine is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when the vaccine is administered to a nursing woman."

http://www.merck.com/product/usa/pi_...ombivax_pi.pdf

The package insert for Engerix-B states, nearly identically: "It is not known whether ENGERIX-B is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when ENGERIX-B is administered to a nursing woman."

http://us.gsk.com/products/assets/us_engerixb.pdf

What to make of this? It's hard to say given that drug makers will package nearly everything they make with warnings for pregnant and lactating women even when drugs are fairly well known to be safe for nursing mothers. It's CYA syndrome. Many of us have had the experience of being told to pump and dump so we can go on meds when the truth is that it isn't necessary. Usually Thomas Hale (http://neonatal.ttuhsc.edu/lact/index.html) is the go-to guy for info on medication and lactation, but I don't think he's got anything on vaccination. You could check, though.

As for tetanus, the same chart I referenced above shows no contraindications for breastfeeding mothers, but the link the CDC provides is not particularly satisfying here, either, as it is merely a general safety statement without many details:

"Neither inactivated nor live vaccines administered to a lactating woman affect the safety of breast-feeding for mothers or infants. Breast-feeding does not adversely affect immunization and is not a contraindication for any vaccine....Although live vaccines multiply within the mother's body, the majority have not been demonstrated to be excreted in human milk. Although rubella vaccine virus might be excreted in human milk, the virus usually does not infect the infant. If infection does occur, it is well-tolerated because the viruses are attenuated (127). Inactivated, recombinant, subunit, polysaccharide, conjugate vaccines and toxoids pose no risk for mothers who are breast-feeding or for their infants."

The language regarding nursing mothers in the tetanus vaccine package inserts is very similar to that in the Hep B inserts, so I won't bother quoting.

What I make of this is that (1) there isn't a whole lot of data, (2) the medical community generally thinks that tetanus or Hep B vaccination for nursing mothers is fine, and (3) the drug makers want to play it safe, just in case.

Good luck thinking things through!
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#13 of 20 Old 04-22-2007, 03:39 AM
 
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If you're getting tetanus, I would get the individual dose as the multi-dose vial has full strength mercury.

-Angela
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#14 of 20 Old 04-22-2007, 12:10 PM
 
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Originally Posted by Sagesgirl View Post
Again, I AM NOT ASKING IF ANYONE THINKS I SHOULD GET THE VACCINE OR NOT.
If you want to debate the efficacy/advisability of the Hep B vaccine, we've got an entire forum devoted to dissing them. It's OK if no one knows the answer to this question, but I thought this was the site with the most-knowledgable mamas when it comes to breastfeeding.
Sagesgirl, I'm sorry you took my post as a debate - it was not intended that way at all, hence my last statement about being a personal decision.

I was merely trying to let you know that there are many people in the medical field who for one reason or another cannot vax and they are not penalized or kicked out for it. Here where I live, we have a serious shortage of nurses and we're willing to take anyone, pretty much.
My thinking was if you wanted to opt out, delay until after you're done BF or even take partial vaxes, you probably could.

Riverscout is right...current Heb B is yeast-based _ I have old insert in my file. Although a current Tetanus vax (from last summer) does have that exact warning.

Anyway, I wish you the best with school!
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#15 of 20 Old 04-22-2007, 02:05 PM
 
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Originally Posted by Racecarma View Post
Although a current Tetanus vax (from last summer) does have that exact warning.
Is that warning from a tetanus immune globulin (TIG) vaccine? As far as I know, that is the only tetanus vaccine that is derived from plasma. I believe this is usually only used as a post-exposure prophalaxis. Most of the time adults would receive either the adult tetanus diphtheria toxoid (Td) or possibly even the tetanus toxoid (TT) as a booster, neither of which are derived from plasma.

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#16 of 20 Old 04-22-2007, 05:36 PM
 
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I asked this question regarding me getting Tdap after my baby had DTaP, and this was the reply I got:

"Although I don't know of any specific data addressing your question, the
quantities of FHA, PT, and fimbrial antigens present in Tdap are low
(actually lower than contained in DTaP). Even if these proteins were
excreted intro breast milk (which would presumably be in much smaller
quantities than that injected) they would be unlikely to survive
denaturation in stomach acids, proteases, and hydrolases. Therefore,
ingested pertussis antigens would be unlikely to be immunogenic.

So, in short, I don't see a problem with you receiving Tdap while
nursing your baby. Good luck with your new family member."

This was from someone biased in favor of vaccines, and isn't the vaccine you asked about, but maybe the explanation of physiology would be helpful to you.

However, when I signed up to become a milk donor, they did ask if I've received any vaccines recently. I haven't, and I don't know what it is they were worried about.
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#17 of 20 Old 04-22-2007, 08:03 PM
 
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The new Tetanus for adults contains Pertusis vaccine, unless you specifically say no and double check, this is what you will get. I do not know if it is safe while nursing, it is new on the market and previously the aP was not approved for use in persons over 7 years old.

If you are working in the health field, if the vax is effective, then it's probably a wise choice given that infants are not immune to Pertusis until they have had at least 3 doses of DTaP themselves which on a normal schedule is 6 months old. And adults are no longer immune do to the vax wearing off thus infecting infants who are not immune either. So, you could carry Pertusis home to your children, if you came in contact with someone while working who had Pertusis and very often it is over looked by doctors and labeled Brochititus, Asthma, a virus or a cold.

The alternative to the Pertusis portion of the new tetanus for adults is -- a mom who had Pertusis as a child or adult and is breastfeeding -- that would be my children b/c I was the lucky child who got Pertusis despite being fully vaxed. A vaxed mother does not pass vaccine immunity to her child, naturally acquired immunity is passed in theory.

Now, I don't know if vaccines affect bm or not. I do know I would not take any vaccine while pregnant (or ever again for that matter, but that is another topic). I also know that prenatal vitamins have a warning on the label that state not to take them if you are pregnant or nursing without consulting your physician - hmm, vitamins carry a warning label, yet vaccines don't??? Someone has messed up here big time. Just food for thought, I think it is hillarious frankly that my prenatal vitamins carry such a label.

As stated the Hep B vax is very reactive in some individuals and you won't know until you take it. I do have this vax, I worked in health care in the military community.

It is my opinion that there is no 100% guarrantee that a vaccine is safe or that it even is effective. I think it is a gamble that you must weigh the information in on and choose wisely.

Public institutions can not discriminate against religious or race, etc. they usually receive public funding. So in that case your choice should not be made out of fear of not getting in or being kicked out. If it's a private institution, they can say and do what they please.

Bottom line, please make your decision with as much information as you need to make an informed choice. Forcing a person into a position of get vaxed or we're kicking you out of the program just does not sit well with me. Patients deserve informed choice, as much as those servicing patients.

I do hope you find the answers you need to make an informed choice. The package inserts linked in a pp reply are probably what I would refer to if I were in your position.

We need more nurses, good for you for getting in, it isn't easy! Congrats on your baby too.
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#18 of 20 Old 04-22-2007, 11:10 PM
 
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If you are working in the health field, if the vax is effective, then it's probably a wise choice given that infants are not immune to Pertusis until they have had at least 3 doses of DTaP themselves which on a normal schedule is 6 months old. And adults are no longer immune do to the vax wearing off thus infecting infants who are not immune either. So, you could carry Pertusis home to your children, if you came in contact with someone while working who had Pertusis and very often it is over looked by doctors and labeled Brochititus, Asthma, a virus or a cold.
The pertussis vaccine is not designed to prevent transmission. People fully vaccinated for pertussis can still transmit it.

-Angela
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#19 of 20 Old 04-23-2007, 01:56 PM
 
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I got my updated tetanus shot when DD was 5 months old. My doctor checked with our pedi to make sure it was okay because DD was nursing. I also did some research online and found a list of which vaccinations were safe to get while breastfeeding. I don't know about the Hep.B. DD is getting all of her vaccinations on schedule so I didn't have to worry about that.
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#20 of 20 Old 04-23-2007, 03:45 PM
 
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Originally Posted by riverscout View Post
You know you can't ask a vax question anywhere around here and not get fight going. : I think there is actually a rule here that when a vax question is asked, a debate must ensue.
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