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<p>I was wondering if anyone had more information about this.  I hear this claim being made a lot but haven't found anything to support the idea that the MMR sheds. </p>
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<p>Here is something from Pediatrics :</p>
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<p>"</p>
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<div style="font-style:inherit;margin-bottom:1.5em;margin-left:0px;margin-right:357px;margin-top:1.5em;padding-bottom:0px;padding-left:0px;padding-right:0px;padding-top:0px;text-decoration:inherit;">
<p style="font-style:inherit;margin-bottom:1.5em;margin-left:0px;margin-right:0px;margin-top:1.5em;padding-bottom:0px;padding-left:0px;padding-right:0px;padding-top:0px;text-decoration:inherit;">Viral shedding, in which someone becomes contagious and can pass a virus to someone else, is sometimes a concern when parents think about live vaccines.</p>
<p style="font-style:inherit;margin-bottom:1.5em;margin-left:0px;margin-right:0px;margin-top:1.5em;padding-bottom:0px;padding-left:0px;padding-right:0px;padding-top:0px;text-decoration:inherit;">Fortunately, viral shedding is not usually a problem because:</p>
<ul style="font-style:inherit;margin-bottom:1.5em;margin-left:0px;margin-right:0px;margin-top:1.5em;padding-bottom:0px;padding-left:0px;padding-right:0px;padding-top:0px;text-decoration:inherit;"><li style="font-style:inherit;list-style-type:disc;margin-bottom:0px;margin-left:18px;margin-right:0px;margin-top:0px;padding-bottom:0px;padding-left:0px;padding-right:0px;padding-top:0px;text-decoration:inherit;">the MMR vaccine doesn't cause shedding" </li>
</ul><p style="font-style:inherit;list-style-type:disc;margin-bottom:0px;margin-left:18px;margin-right:0px;margin-top:0px;padding-bottom:0px;padding-left:0px;padding-right:0px;padding-top:0px;text-decoration:inherit;"><a href="http://pediatrics.about.com/od/immunizations/a/live-vaccines.htm" target="_blank">http://pediatrics.about.com/od/immunizations/a/live-vaccines.htm</a></p>
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<p style="font-style:inherit;list-style-type:disc;margin-bottom:0px;margin-left:18px;margin-right:0px;margin-top:0px;padding-bottom:0px;padding-left:0px;padding-right:0px;padding-top:0px;text-decoration:inherit;"><span style="font-size:11px;">I also found this posted on a blog. It was an clip from from PediatricsinReview, an official journal of the American Academy of Pediatrics, called <em style="color:rgb(0,141,207);text-decoration:underline;"><a href="http://pedsinreview.aappublications.org/content/31/1/38.full" style="color:rgb(0,141,207);text-decoration:underline;" target="_blank" title="Comments">Vaccines in immunocompromised patients</a>. </em> It requires a subscription to see the whole thing but here is the relevant part : </span></p>
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<p style="font-style:inherit;list-style-type:disc;margin-bottom:0px;margin-left:18px;margin-right:0px;margin-top:0px;padding-bottom:0px;padding-left:0px;padding-right:0px;padding-top:0px;text-decoration:inherit;"> </p>
<p style="font-style:inherit;list-style-type:disc;margin-bottom:0px;margin-left:18px;margin-right:0px;margin-top:0px;padding-bottom:0px;padding-left:0px;padding-right:0px;padding-top:0px;text-decoration:inherit;"><span style="font-size:11px;">This is more out of curiosity than anything else, but does anyone have any information that either contradicts or confirms the idea that the MMR sheds? </span></p>
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I just hear on the regular of children having actual (presumably attenuated) measles after MMR. No idea if it is transmissible, but it happens fairly often to mothers (really their children) in my admittedly expansive social circle.
 

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<p>My sister contracted measles 10 days after her daughter got vaccinated with the MMR and so did the daughter. So she shed the vaccine.</p>
 

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<p>Well, it's not possible to tell whether the measles was from the vaccine shedding or from other contact with the virus. Some studies have been done with mumps, for instance, when folks got the disease right after getting the vaccine --- they were able to compare DNA and figure out whether folks got the illness from the vaccine or from a wild bug. Frequently it is indeed the wild bug. <a href="http://journals.cambridge.org/action/displayAbstract;jsessionid=BF36876A4BC45FBC567147998152A3E1.journals?fromPage=online&aid=39917" target="_blank">http://journals.cambridge.org/action/displayAbstract;jsessionid=BF36876A4BC45FBC567147998152A3E1.journals?fromPage=online&aid=39917</a></p>
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<p>Everything I've read says that the measles component of MMR doesn't shed. The mumps does (<a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2268349/" target="_blank">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2268349/</a>). The rubella doesn't. Had a hard time finding studies. </p>
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<p>The thing with shedding is, IF it sheds (the varicella, live flu vaccines, and rotavirus vaccines DO shed, certainly) is that:</p>
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<p>a) It's shedding the attenuated form of the virus. </p>
<p>b) It's shed mainly through stool. </p>
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<p>The takeaway lesson, and what the CDC etc recommends, is that shedding is only really a risk for immunocompromised folks. So I wouldn't let my friend with leukemia see my new baby within 7 days of my baby receiving the rotavirus vax. (<a href="http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2808%2970231-7/abstract" target="_blank">http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2808%2970231-7/abstract</a> and <a href="http://www.sciencedirect.com/science/article/pii/S0264410X08009353" target="_blank">http://www.sciencedirect.com/science/article/pii/S0264410X08009353</a>) For example. </p>
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<p>For ordinary family members I wouldn't worry. If they catch measles from the vax, it'll be mild measles. </p>
 

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<p>Teacozy, I wish you would edit your original post to fix the formatting. It's getting cut off on the edge. </p>
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<p>I dunno about that page from about.com. I was just looking at information about shedding from the nasal flu vaccine and there was something like an 0.5% risk of an unvaccinated kid catching some flu-like symptoms off a vaccinated kid in a daycare setting, so I don't think their statement about that is accurate. </p>
 

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Discussion Starter #6
<div class="quote-container">Quote:
<div class="quote-block">Originally Posted by <strong>erigeron</strong> <a href="/community/t/1389972/mmr-shedding#post_17485503"><img alt="View Post" src="/community/img/forum/go_quote.gif" style=""></a><br>
 
<p>Teacozy, I wish you would edit your original post to fix the formatting. It's getting cut off on the edge. </p>
<p> </p>
<p>I dunno about that page from about.com. I was just looking at information about shedding from the nasal flu vaccine and there was something like an 0.5% risk of an unvaccinated kid catching some flu-like symptoms off a vaccinated kid in a daycare setting, so I don't think their statement about that is accurate. </p>
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<p>Ok I think I fixed it.  Can everyone see it now?</p>
 

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<p>I'm still having the same problem, and I tried in two browsers. I wonder if a mod would be able to fix it if you flag your post. </p>
 

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Discussion Starter #8
<div class="quote-container">Quote:
<div class="quote-block">Originally Posted by <strong>erigeron</strong> <a href="/community/t/1389972/mmr-shedding#post_17485858"><img alt="View Post" src="/community/img/forum/go_quote.gif" style=""></a><br>
 
<p>I'm still having the same problem, and I tried in two browsers. I wonder if a mod would be able to fix it if you flag your post. </p>
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<p>Lets see if I copy and paste it into a reply if that does anything? </p>
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<p style="font-style:inherit;list-style-type:disc;margin-left:18px;text-decoration:inherit;">I also found this posted on a blog. It was an clip from from PediatricsinReview, an official journal of the American Academy of Pediatrics, called <em style="color:rgb(0,141,207);text-decoration:underline;"><a href="http://pedsinreview.aappublications.org/content/31/1/38.full" style="color:rgb(0,141,207);" target="_blank" title="Comments">Vaccines in immunocompromised patients</a>. </em> It requires a subscription to see the whole thing but here is the relevant part : </p>
<p style="font-style:inherit;list-style-type:disc;margin-left:18px;text-decoration:inherit;"> </p>
<p style="font-style:inherit;list-style-type:disc;margin-left:18px;text-decoration:inherit;">"MMR, varicella, and rotavirus vaccines, although live viral vaccines, are recommended for immunocompetent household contacts because transmission of the virus is rare. <strong><span style="text-decoration:underline;">The lack of viral shedding with MMR eliminates concern regarding transmission. "</span></strong></p>
<p style="font-style:inherit;list-style-type:disc;margin-left:18px;text-decoration:inherit;"> </p>
<p style="font-style:inherit;list-style-type:disc;margin-left:18px;text-decoration:inherit;">Bolding mine. </p>
<p style="font-style:inherit;list-style-type:disc;margin-left:18px;text-decoration:inherit;"> </p>
<p style="font-style:inherit;list-style-type:disc;margin-left:18px;text-decoration:inherit;">Did that work? I can see the quote in the OP just fine on my computer so I'm not really sure how to fix it =/ </p>
 

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<p>I think there is some evidence that the measles portion can "shed".  For example:</p>
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<p>Rota et al. 1995. Detection of measles virus RNA in urine specimens from vaccine recipients. <a href="http://jcm.asm.org/content/33/9/2485.long" target="_blank">http://jcm.asm.org/content/33/9/2485.long</a></p>
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<p>Kaic et al. 2010. Spotlight on measles 2010: Excretion of vaccine strain measles virus in urine and pharyngeal secretions of a child with vaccine associated febrile rash illness, Croatia, March 2010 <a href="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19652" target="_blank">http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19652</a>  <em>(I'm a little confused by this title because in the results it says RNA was not detected in the throat swabs, only in the urine.)</em></p>
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<p>Morfin et al. 2002. Detection of measles vaccine in the throat of a vaccinated child  <a href="http://www.sciencedirect.com/science/article/pii/S0264410X01004959" target="_blank">http://www.sciencedirect.com/science/article/pii/S0264410X01004959</a></p>
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<p>However, there have been no verified cases of measles transmission due to the vaccine.  From Hau et al. 2013. Local public health response to vaccine-associated measles: case report  <a href="http://www.biomedcentral.com/1471-2458/13/269" target="_blank">http://www.biomedcentral.com/1471-2458/13/269</a> :</p>
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<div>Vaccine-associated measles cases are rare and only one clinical case report of possible transmission has been published to our knowledge [<a href="http://www.biomedcentral.com/1471-2458/13/269#B14" target="_blank">14</a>], however this case of potential transmission was based on a clinical diagnosis and was not microbiologically confirmed to be due to vaccine strain measles virus. It is uncertain if cases have not been reported because vaccine-associated measles strains are not transmissible or because of extremely low infectivity. Alternatively, susceptible contacts of these cases could have been infected, but were not detected because they had subclinical disease. Vaccine-associated mumps in close contacts of children who had received primary vaccination with MMR have been reported [<a href="http://www.biomedcentral.com/1471-2458/13/269#B3" target="_blank">3</a>] so transmission of vaccine-associated measles seemed theoretically possible.</div>
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<p>None of the studies mention the viral load in the samples collected.  And at least one study was unable to culture the virus from the samples.  I don't know how difficult it is to culture measles normally, but it suggests to me that either there is not much virus to culture in these samples or that despite the presence of RNA, the viruses themselves are significantly degraded and unable to replicate.</p>
 

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<p>Albeit rare it can happen, but I only remember reading about rubella cases passed from MMR vaccinated mom to her newborn (if given after delivery).</p>
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<p>That being said,  when my kids got the MMR vaccine my PhD MD sister refused to see us for 28 days so her 7 months old infant can't catch it from us. It's the same doctor that said shedding never happens until she has an unvaccinated infant and recently vaccinated cousins hahahaha. She was especially wary of my DD who had a fever and facial rash at day 7 and developed swollen groin lymph nodes at week 2 that lasted for 2-3 weeks, She said it is widely known among doctors that the lymph node swelling is a common side effect to the mumps portion and that DD is shedding at a higher rate due to that. Whatever. After exactly 28 days, we were allowed to see them.....</p>
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<p>That being said, we only drew DS's titers as he's over 4 for the school to proof immunity (he is immune). We won't give DD another MMR but run titers on her 4th birthday to satisfy school requirements. She showed a moderate level of antibodies on her RAST to eggs so our doctor refused anyways to give her any egg containing vaccines (she's a very careful doctor).</p>
 
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