Vaccinations for mom during bfing?

[DrSally]

Hi, when I was pregnant with DS, I guess I came up only "borderline" immune to rubella. So, ped suggested an MMR booster after I gave birth. I asked my internist last year, and he didn't know anything about MMR during bfing, but said to wait just to be sure. Well, thinking about TTC and am DS is not weaned and am not planning on it anytime soon. Does anyone know anything about getting an MMR during bfing? I don't think it's a live vaccine, and DS has had his MMR already??

[o_mom]

MMR is a live vaccine. It also has a known history of causing arthritis in women when given after puberty. I would really research it in depth before you commit. You can get another titre done, too, before you decide. If you have had two MMRs, it is unlikely that a third would induce immunity - even the CDC will say this.

[MegND95]

It was discovered when I was pg with #2 (how it was missed the first time, I don't know) that I was not immune, and I was given the MMR while in the hospital after the birth. I was bf at the time, and the Dr's did not seemed concerned. But, I did not do any research prior...certainly seems like it would be worth investigating.

[DrSally]

Thanks for the info. I've prob had at least 3 MMR's, so it was weird that it came up borderline. My first step was going to be getting another titre, so I will do that first.

[DrSally]

Thanks for sharing your experience. I am looking for a new internist, so maybe the next one, or my new ob (new insurance) will have more info as well. It would be horrible to get rubella while pregnant even if the chances are slim.

[Laurel]

I refused when they pushed it on me in the hospital hours after giving birth to DD and then forgot to get my booster before getting pregnant again. Oops. I will refuse again while bf'ing this child because:
1. I don't plan on another pregnancy and as I understand it the main point of the booster is to protect future fetuses. Rubella isn't all that harmful to most people and extremely rare.
2. If you go to the CDC's website you will find less than 20 cases reported of in-utero rubellea a year in the US! I think there were ZERO cases in the last year we have data for. The risk just isn't high enough for me to have the vax while brestfeeding.

I have read noting about dangers of this vax while B'fing, but I also would worry more about having it than not, KWIM?

[JBaxter]

http://www.merck.com/product/usa/pi_circulars/m/mmr_ii/mmr_ii_pi.pdf

Scroll down to page 5 in the Precaution section

Transmission of the rubella vaccine virus via breast milk has been documented

There is a nursing mothers section on page 6.

[brittone2]

There is a significant percentage of women that will never develop immunity no matter how many times they are vaxed for Rubella. This is one of the arguments antivaxers have for natural disease vs. the vax. You'll always have breakthrough cases of Rubella in the community because the vax isn't going to take in 100 percent of the population. Rubella itself contracted in childhood is generally not very serious, and confers lifelong immunity vs. the vax which doesn't take in a percentage of women.

It is live as the PPs said, and I agree...good chance it wouldn't take even if you get another one, but obviously only you and your doc can make that decision.

[o_mom]

If you have had 3, then it is unlikely that a 4th would do anything more. The second dose in the series is only to catch the 5% or so who didn't respond the first time, it doesn't do anything extra for the ones who did. CDC does not recommned a third dose if you have not responded after two.

Here are some FAQ from the CDC that may be helpful, including negative titers in women with two or more documented doses:

http://www.cdc.gov/nip/vaccine/mmr/mmr-faqs-hcp.htm

I personally would be comfortable with the 'borderline' result. It probably means that your body has the ability to produce antibodies if it encounters rubella, but just doesn't keep them circulating at a high enough level to detect with the standard test.

[Radosti]

For some reason, pregnancy wipes out immunity to rubella in certain women. I would definitely get a booster before you become pregnant with the next kiddo because if you do come in contact with rubella during pregnancy, it will cause birth defects if you aren't immune. On the other hand, most people are immune to rubella, so you could rely on herd immunity instead.

You might need another booster after your next pregnancy if that pregnancy also wipes out your immunity.

I would not worry about BF and this immunization as most kids get this shot while they are still BF anyway.

[JBaxter]

My sister has had 2 childhood MMR's one after the birth of her first child and one before entering nursing school. When she had her 2nd child she also came up not immune but refused any more shots.

[Elilly]

Not to cause more vaccine drama, but there is no way that I would ever transmit a live virus to a neonate. There's a reason that peds wait until 12-18 months to give the MMR.
http://www.garynull.com/Documents/autism99b.htm
FWIW, I had the rubella booster when Graham was 2 days old and regret it every day.

[Radosti]

I am under the assumption that her DS is over a year old, actually 16 months I believe. Not really a neonate. I wouldn't give that advice with a newborn.

[DrSally]

Thank you for all the info!! I had wild measles as a child when I was in an orphanage. I did have the 2 childhood MMR's after coming to the states and then when I was 24, my doctor gave me another booster b/c I was going to Europe. That makes me mad that she didn't at least check my immunity with bloodwork first. Luckily, when I was going overseas several years later, another doctor checked my immunity (to measles at least) first so I didn't get yet another booster. If you have a link about the arthritis--MMR connection, I would like to take a look at that! Thanks again for all the info. This may be why my ob changed his mind and told the nurses not to give me the booster after DS was born (he never told me why he changed his recommendation and I was too out of it to ask).

ETA: DS is 16 months old and I was considering the booster for the sake of future pregnancies and fetuses, not necessarily concerned about my own rubella resistance.

[o_mom]

Your rubella resistance is the same as the risk of getting it for future pregnancies. If you are immune to it, then it cannot affect your preganancies (in theory). At this point, if you have had three immunizations, a fourth will not likely do you any good (see the CDC questions above).

I would be less worried about your DS, as rubella in a 16 mo is normally a very mild disease (though you still have measles and mumps to think about unless you get just the rubella vaccine). I would look more at the effects on yourself and the proposed benefits and risks.

In the CDC link above, there was a question about the arthritis connection. It is a 'tabled' injury under the Vaccine Injury Compensation Program. That means that they do not dispute that it is a known effect of the vaccine (see section IV):

http://www.hrsa.gov/vaccinecompensation/table.htm

ETA:

Here is another link:

http://www.immunizationinfo.org/vaccineInfo/vaccine_detail.cfv?id=24

"About 15% of women who receive the rubella vaccine or MMR will develop acute arthritis or swelling of the joints. This condition is usually very short-lived."