Ethics and Rubella Vax - Mothering Forums

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Old 07-23-2008, 11:28 AM - Thread Starter
 
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Long; I apologize in advance!
DD (16 mos) was vaxed fully (except for rota) because of my ignorance up until 6 mos. After research, I opted to skip the last doses of Dtap, PCV7, and Hib, and to delay the MMR until 4 years (then spread it out) so that she will only need one dose. School attendance is not an issue.

I feel very comfortable with our decision and would be happy for her to have chicken pox, comfortable with treating measles/mumps. Regarding rubella, though, I am having a lot of second thoughts.

This is a difficult ethical issue for me because

1) I do not wish to support medical research the involves aborted babies, and even if I were not anti-abortion, I would still be "anti-injecting-human-tissue" into my DD. (I hope that mentioning this is not a UAV; I understand that others feel differently, but this is my ethical position as it directly relates to the vaccines). I think the Catholic church's position on this (via a link from this board) is that using the vaccines is an "evil," but perhaps an unavoidable one and therefore permissible if coupled with sincere attempts to pursue/encourage alternatives.

2) Rubella is not a disease that would even harm by daughter; I would be putting her at risk to possibly protect unborn babies of women I may not even know (or it could affect me and her unborn siblings; there is no way to know, but morally, this should not affect my decision)

3) Vaccinating my daughter is not the only protective measure possible; adult women could check titers/get the vaccines (or, if vaccines were really so great, they could still be immune from their own childhood vaccines)...but then the same "evil" would be being done, just by someone else.

So: as of now, I believe it is my moral obligation** to vax my daughter for rubella only, probably at 18 mos, because otherwise I will have no way of knowing (short of periodically checking titers) if she even *has* rubella and if she has infected any pregnant women. I know that the chances of this are very small, but if I contracted rubella during pregnany, I know I would be irate and heartbroken.

** I am not saying this to convince anyone else; far from it. I wish I didn't feel this way, and I hope someone can convince me that I am wrong.

Can anyone talk me down from this?

Thank you!!

Bethany

Aspiring to 1 Thessalonians 4:11.Wife to Dh, 2004. Mother to DD 3/07.
So thankful for our healthy baby boy, born Easter morning, 2010!
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Old 07-23-2008, 07:39 PM
 
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I'm a bit worried about this issue too, for similar reasons. I haven't made up my mind yet... I do have a boy, he's 2.5 - we haven't given it yet.

My current thoughts - I think I maybe heard somewhere that there might be a rubella shot that wasn't involved with abortion? It might be hard to confirm this, and I haven't looked into it yet... but it would be worth knowing.

Also, someone just posted that if you wait until age 4, you only need one dose. I don't know if that affects your decision at all.

Sorry this isn't very helpful, have to run!
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Old 07-23-2008, 08:32 PM - Thread Starter
 
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I'm a bit worried about this issue too, for similar reasons. I haven't made up my mind yet... I do have a boy, he's 2.5 - we haven't given it yet.

My current thoughts - I think I maybe heard somewhere that there might be a rubella shot that wasn't involved with abortion? It might be hard to confirm this, and I haven't looked into it yet... but it would be worth knowing.

Also, someone just posted that if you wait until age 4, you only need one dose. I don't know if that affects your decision at all.

Sorry this isn't very helpful, have to run!

Thank you-- it's nice to know that other people are thinking about this.
Right now, it is my plan to delay the M/M/R until 4 at the youngest. *but* if I decide that giving the R portion is morally okay, should I go ahead and give a dose of it now so as not to run the risk of her infecting a pregnant woman in the next three years? This is a difficult one, because my reasons for vaxing/not vaxing are very different than for the other vaccines. (though, of course, the deleterious side effects of the vax are still at issue)

by the way-- what a cool birth story! Ina May herself!

Bethany

Edited to add: my understanding is that the only rubella vax right now is from aborted fetal tissue; they have tried to come up with others (various animal tissues), but they have 1) not worked and 2)caused severe allergic reactions.

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Old 07-23-2008, 08:49 PM
 
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*For ME* ethically, I can not put my child at any risk for potentially protecting someone else.

-Angela
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Old 07-23-2008, 09:15 PM
 
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As for issue #2 and #3: I believe that ethically it is the responsibility of women of childbearing age to protect themselves. Similarly, I believe that if people are concerned about pertussis among the general population, then they (adults) should get the vaccine, being the most likely reservoir (arguments about prevention of transmission aside).

We will talk with our daughter about getting the rubella vax when she gets to be about 12.
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Old 07-23-2008, 09:51 PM
 
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Haven't really decided how I feel about this, but from what my dr. told me, some women, myself included, are unable to develop immunity from rubella. I think I remember it being 1 out of 7 women. I've had boosters as an adult, but still will not ever be immune. My oldest is vaxed, but unsure about what I'll do with the new one.
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Old 07-23-2008, 11:45 PM
 
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Well, since you're asking to be talked down from giving the vax, you may also consider your DD's position in the grander scheme of world health. DD isn't the reservoir of disease causing some poor pregnant woman's pain. Much more is at work here. DD got her hypothetical rubella from *somewhere*, just as many vaxed people do. Those people took precautions against getting rubella (getting the vax) and DD did too (checking titers, staying away from people while sick, hand washing).
1. Why are the vaxed people's precautions more morally legit than yours?
2. How is the bigger, general circulation of disease your DD's fault or yours? You probably wouldn't morally blame her for going into Toys R Us and contracting rubella while there. She's part of a system just like the pregnant woman.
3. Isn't the possible sacrifice of your DD's health for the sake of the pregnant woman's health a sort of anti-Catholic sentiment? (Warning: I'm gleaning this info from The Thorn Birds, in which the bishop says that in the case of a difficult birth, neither child nor mom should be legitimately sacrificed for the other. This is hardly doctrine, hehe).

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Old 07-24-2008, 12:09 AM
 
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Another thought- if we're out to protect pregnant women- be sure to keep your children home for at least a couple of weeks, possibly as long as a month, after being vaccinated for rubella. It's a live vax and has been shown to shed in some cases.

-Angela
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Old 07-24-2008, 12:49 AM
 
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Have you checked out www.cogforlife.org Some of your questions may be answered there.

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Old 07-24-2008, 10:41 AM - Thread Starter
 
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*For ME* ethically, I can not put my child at any risk for potentially protecting someone else.

-Angela
Obviously, this argument appeals to me pretty strongly. However, I think this is a matter of degree; I would put my child to some *minimal* risk if it were necessary to protect someone else from great harm (so, for example, I might leave her unattended in a stroller if someone were choking and I were the only one who could help). I am not sure at this point whether I should classify the rubella vax as a minimal risk or not. Probably not (?)

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Haven't really decided how I feel about this, but from what my dr. told me, some women, myself included, are unable to develop immunity from rubella. I think I remember it being 1 out of 7 women. I've had boosters as an adult, but still will not ever be immune. My oldest is vaxed, but unsure about what I'll do with the new one.
Does this mean 1 in 7 post-pubescent women, or 1 in 7 of all females?

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Well, since you're asking to be talked down from giving the vax, you may also consider your DD's position in the grander scheme of world health. DD isn't the reservoir of disease causing some poor pregnant woman's pain. Much more is at work here. DD got her hypothetical rubella from *somewhere*, just as many vaxed people do. Those people took precautions against getting rubella (getting the vax) and DD did too (checking titers, staying away from people while sick, hand washing).
1. Why are the vaxed people's precautions more morally legit than yours?
2. How is the bigger, general circulation of disease your DD's fault or yours? You probably wouldn't morally blame her for going into Toys R Us and contracting rubella while there. She's part of a system just like the pregnant woman.
3. Isn't the possible sacrifice of your DD's health for the sake of the pregnant woman's health a sort of anti-Catholic sentiment? (Warning: I'm gleaning this info from The Thorn Birds, in which the bishop says that in the case of a difficult birth, neither child nor mom should be legitimately sacrificed for the other. This is hardly doctrine, hehe).
Ah, the Thorn Birds! I don't think sacrifice per se is an anti-catholic sentiment; I do very much wish that in their response to this subject the Vatican had addressed the vaccine side effects and not simply the abortion question. Maybe even the Vatican isn't quite that brave, though Aside from the abortion question, if I *knew* that, unvaxed, my daughter would contract rubella, would infect a pregnant woman, and that woman's baby would be born deaf and blind as a result of congenital rubella, I would probably accept the risk of the vaccine-- but you are right, this would not occur in a vacuum; someone else (maybe a vaxed person!) would have given it to my daughter first.

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Another thought- if we're out to protect pregnant women- be sure to keep your children home for at least a couple of weeks, possibly as long as a month, after being vaccinated for rubella. It's a live vax and has been shown to shed in some cases.

-Angela
Thank you-- this is a very good point. Do you have any idea where I can find out the percentage of cases in which the rubella vax sheds? The next time I am pregnant I will tell all my vaxing friends that I can't be around their recently vaxed kids...

So ethically-- the very best thing to do would be to skip the vax entirely, find a wild case of rubella, expose myself and DD, and then just lay low until we're not contagious anymore?

Thank you all SO much for the thoughtful replies!

Bethany

Aspiring to 1 Thessalonians 4:11.Wife to Dh, 2004. Mother to DD 3/07.
So thankful for our healthy baby boy, born Easter morning, 2010!
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Old 07-24-2008, 10:48 AM - Thread Starter
 
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I do think that people have an ethical responsibility to avoid spreading their diseases to others if at all possible. We have family who insisted on bringing their child to Thanksgiving when he had mono; my sister and I were in the middle of college, and a case of mono would have been financially and academically disastrous for both of us... They all acted offended when we insisted that they at least wash their hands (!).

So I definitely believe that if, for example, a child has Fifth Disease and his mother knowingly takes him out into public anyway, she *is* responsible if he gives the disease to a pregnant woman (despite the fact that he caught the disease from some else who may or may not be culpable). If I knew that my DD had rubella, we would live in quarantine for a long time... I just worry about the not knowing.

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Old 07-24-2008, 12:41 PM
 
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Another thought- if we're out to protect pregnant women- be sure to keep your children home for at least a couple of weeks, possibly as long as a month, after being vaccinated for rubella. It's a live vax and has been shown to shed in some cases.

-Angela
Similar to what I was going to say. But according to the CDC shedding is a pro of vaccinating with live virus vaccines. : Who cares if the person possibly contracting the virus may be pregnant, immune compromised, under a year, or elderly. Back when I was ignorant my ds was vaccinated with the varicella vax after I declined it. They snuck it in with his other vaxes. I had no idea until much later, yes I said I was ignorant at the time. Both of my children got chickenpox, who knows who they may have given it to before I realized they had it and kept them home. Course because I was so ignorant about vaxes anyway I wouldn't have known it was live and could shed. Most doctors won't be informing patients about this, nor much of anything else except whether or not your insurance will cover that script.

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Old 07-24-2008, 12:46 PM
 
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Thank you-- this is a very good point. Do you have any idea where I can find out the percentage of cases in which the rubella vax sheds? The next time I am pregnant I will tell all my vaxing friends that I can't be around their recently vaxed kids...

So ethically-- the very best thing to do would be to skip the vax entirely, find a wild case of rubella, expose myself and DD, and then just lay low until we're not contagious anymore?

Thank you all SO much for the thoughtful replies!

Bethany
I've never seen a % quoted. I would expect they have no idea. Not a lot of big money people to pay for that research- ya know?

-Angela
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Old 07-24-2008, 12:55 PM
 
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It is MY responsibility as a woman to take care of my unborn baby. It's not your responsibility to do it for me. If I am not immune to rubella, then I have to chose what I'm going to do about it before getting pregnant!!! Please don't inject your baby with harmful materials to protect me....your number one obligation is to your own child.

BTW, my son had rubella over thanksgiving and it only lasted 3 days!! He had a rash, and we kept him out of public places so we didn't spread it around. We made sure everyone that might come visit knew he had it as well.

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Old 07-24-2008, 01:02 PM
 
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2) Rubella is not a disease that would even harm by daughter; I would be putting her at risk to possibly protect unborn babies of women I may not even know (or it could affect me and her unborn siblings; there is no way to know, but morally, this should not affect my decision)

3) Vaccinating my daughter is not the only protective measure possible; adult women could check titers/get the vaccines (or, if vaccines were really so great, they could still be immune from their own childhood vaccines)...but then the same "evil" would be being done, just by someone else.

So: as of now, I believe it is my moral obligation** to vax my daughter for rubella only, probably at 18 mos, because otherwise I will have no way of knowing (short of periodically checking titers) if she even *has* rubella and if she has infected any pregnant women. I know that the chances of this are very small, but if I contracted rubella during pregnany, I know I would be irate and heartbroken.

** I am not saying this to convince anyone else; far from it. I wish I didn't feel this way, and I hope someone can convince me that I am wrong.

Can anyone talk me down from this?

Thank you!!

Bethany
I will inform my daughter that for her own unborn baby's health, she might want to get the rubella vaccine before getting pregnant. It is the body of each individual pregnant woman that might contract Rubella. So, only that individual need be immune to it. It is not her responsibility, nor is she able to prevent other mothers from contracting Rubella, whether she is vaxed for it or not. So, no, there is no social responsibility for getting the Rubella vaccine.

I absolutely feel no social responsibilty when it comes to vaccines. It's an individual thing.

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Old 07-25-2008, 01:14 AM
 
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I do think that people have an ethical responsibility to avoid spreading their diseases to others if at all possible. We have family who insisted on bringing their child to Thanksgiving when he had mono; my sister and I were in the middle of college, and a case of mono would have been financially and academically disastrous for both of us... They all acted offended when we insisted that they at least wash their hands (!).

So I definitely believe that if, for example, a child has Fifth Disease and his mother knowingly takes him out into public anyway, she *is* responsible if he gives the disease to a pregnant woman (despite the fact that he caught the disease from some else who may or may not be culpable). If I knew that my DD had rubella, we would live in quarantine for a long time... I just worry about the not knowing.
Rubella only lasts a few days....its also known as the 3 day measles.

Heather married to my highschool sweetheart 6/7/02 :cop: Mother to Dani age 14 and Timmy age 10 Nadia 1/29 :
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Old 07-25-2008, 09:52 AM - Thread Starter
 
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Rubella only lasts a few days....its also known as the 3 day measles.
But it is contagious before marks are visible, right (not that I would know at that point...)? And I was including the "incubation period" in case i caught it from her and was initially not aware.
agh. again, I should have paid more attention in health class....

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Old 07-25-2008, 02:58 PM
 
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But it is contagious before marks are visible, right (not that I would know at that point...)? And I was including the "incubation period" in case i caught it from her and was initially not aware.
agh. again, I should have paid more attention in health class....
According to the CDC's pink book

Quote:
Rubella is only moderately contagious. The disease is most
contagious when the rash first appears, but virus may be
shed from 7 days before to 5–7 days or more after rash onset.

Infants with CRS shed large quantities of virus from body
secretions for up to 1 year and can therefore transmit rubella
to persons caring for them who are susceptible to the disease.

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Old 07-25-2008, 03:28 PM - Thread Starter
 
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Thanks, MissRuby!

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So thankful for our healthy baby boy, born Easter morning, 2010!
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Old 07-25-2008, 05:20 PM
 
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So ethically-- the very best thing to do would be to skip the vax entirely, find a wild case of rubella, expose myself and DD, and then just lay low until we're not contagious anymore?
Bethany
That's what I'd prefer to do. But how do you find someone with rubella to share? I'm having enough trouble finding CP. Too bad you can't just order a vial of it to sniff or something. Even apart from the vaccine issues, it would be nice to expose myself before getting pregnant again, to make sure that my old vaccine from when I was a child hasn't worn off.

And phooey about the non-abortion-connection rubella vaccine not existing. *sigh* I would really have liked to sidestep the issue. I guess there is the possibility of checking titers before vaccinating and just hoping that maybe the kid ran into rubella at some point without noticing.

Worrying about exposing pregnant women is a difficult issue. I tend to agree with the other people, that MY child is my responsibility more than other people are, but... I'm still not 100% happy about it. I know a lot of pregnant women right now, not that we visit with them much.
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Old 07-25-2008, 05:22 PM
 
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Thank you-- it's nice to know that other people are thinking about this.
Right now, it is my plan to delay the M/M/R until 4 at the youngest. *but* if I decide that giving the R portion is morally okay, should I go ahead and give a dose of it now so as not to run the risk of her infecting a pregnant woman in the next three years? This is a difficult one, because my reasons for vaxing/not vaxing are very different than for the other vaccines. (though, of course, the deleterious side effects of the vax are still at issue)

by the way-- what a cool birth story! Ina May herself!

Bethany

Edited to add: my understanding is that the only rubella vax right now is from aborted fetal tissue; they have tried to come up with others (various animal tissues), but they have 1) not worked and 2)caused severe allergic reactions.
Heh, we can all bang our heads over this issue together.

And thanks, I really like my birth story too.
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Old 07-25-2008, 06:01 PM
 
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That's what I'd prefer to do. But how do you find someone with rubella to share? I'm having enough trouble finding CP. Too bad you can't just order a vial of it to sniff or something. Even apart from the vaccine issues, it would be nice to expose myself before getting pregnant again, to make sure that my old vaccine from when I was a child hasn't worn off.
.

The rubella vax must not work very well, since just about every kid I've known has had rubella.

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Old 07-29-2008, 04:27 AM
 
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In some cases, being vaxed doesn't stop you from being a carrier. This is true of, I believe, IPV and pertussis. (This is based on info I read here.) Even if your DD were vaxed, could she still carry it? And, even if she were vaxed, she might not "benefit" from the vax anyway, as vaxes aren't 100% effective.

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Old 07-29-2008, 12:17 PM
 
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The rubella vax (if it "takes") prevents transmission.

Unlike IPV and pertussis.
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Old 08-04-2008, 03:47 PM
 
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For me, I do feel that I need to give my kids the rubella vax ethically. But, I've had five miscarriages. None were caused by rubella since I've had rubella myself. (And it was very mild). If I hadn't experienced so many losses, I might think differently and just got DD vaxed around puberty. However, they don't get the 1/2 year dose. I wait until around 5/6 to avoid a dose.
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Old 08-04-2008, 04:07 PM
 
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For me, I do feel that I need to give my kids the rubella vax ethically. But, I've had five miscarriages. None were caused by rubella since I've had rubella myself. (And it was very mild). If I hadn't experienced so many losses, I might think differently and just got DD vaxed around puberty. However, they don't get the 1/2 year dose. I wait until around 5/6 to avoid a dose.
Since your reason for doing this vax is protecting others- how long do you keep them quarantined after? How severe of a quarantine? (only away from pregnant women, away from women who may be pregnant, totally stay home, etc)

-Angela
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Old 08-04-2008, 05:58 PM
 
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Originally Posted by kohlby View Post
For me, I do feel that I need to give my kids the rubella vax ethically. But, I've had five miscarriages. None were caused by rubella since I've had rubella myself. (And it was very mild). If I hadn't experienced so many losses, I might think differently and just got DD vaxed around puberty. However, they don't get the 1/2 year dose. I wait until around 5/6 to avoid a dose.
I don't get it. If you truly felt you were needing to protect others by vaccinating your children what about those unvaccinated 4/5 years? At any point in that time they could have Rubella and pass it on. According to the CDC up to 50% of cases in children are subclinical or asymptomatic. Also since this vax the case load has shifted dramatically towards 15-39 year olds, at around 70% of cases. The ones who need immunity the most do not have it because of the vax.

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Old 08-06-2008, 02:15 PM
 
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What about those unvaxed years? It's all about benifits vs risks. I feel that the risks are too great to give my kids the MMR as babies. Babies bodies don't metabolize drugs the same as adults. I approach all the vax's with risks vs benifits which is why I don't vax on schedule. Plus, by waiting, I can skip one round of MMR vax completely.

I will quarantine after the MMR. I'll do it during a time of year when we don't get out all that much, like the summer so we will stay at home. (The summer is dreadfully hot here, too hot to go to the park). It's not just pg women. My DH had cancer and he wasn't supposed to be around people who had any live vaccines when he had chemo.
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