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To wonder why adults are not at the centre of an MMR vaccination campaign?

(21 Posts)
Questioning Tue 23-Apr-13 16:49:57

Mumps, measles and rubella are the most dangerous when caught by a adult, not by a child.
And the MMR, just like any other vaccines does wear off with time. Most people aren't protected 10 years or more after their last jab. That's why if you have an accident, you will always have a tetanus jab in A&E. Doctors assume that your vaccination doesn't protect you any more. Here is a nice list of long you will be protected for by different vaccines here which shows 15 years on and you are likely not to be protected (I wouldn't take a 'likely to be protected' as good enough tbh)

So knowing that adults in the 20~35yo age group are likely NOT to have had any of these illnesses and that their vaccination isn't protecting them any more, why are we not trying to vaccinate the adults more than the children?

Why is all the emphasis on the children when there is a bigger and bigger category of people who will be likely to get the illness and spread it anyway?

We have campaigns for the flu and over 60s. We have campaigns for the HCP, carers etc... but nothing for women who wants to get pregnant (and for example work in busy environment such as a school a hospital, an airport). Why are we not checking the immunity of women who want to be pregnant re mumps, measles and rubella before they get pregnant so they can have the MMR and be protected?

I don't quite understand.

Sidge Tue 23-Apr-13 17:05:03

Adults in the 20-35 year age group are likely to have been vaccinated, at least against measles and rubella. Over that age they are likely to have been vaccinated or been exposed to natural disease.

Adults tend to have more robust immune systems, unlike children.

Unvaccinated adults are eligible for MMR vaccine should they want it, or if they are found to be non-immune. Women found to be non-immune to rubella in pregnancy are offered MMR vaccine after delivery.

I imagine we don't check immunity for all women prior to getting pregnant due to the cost implications, however if a woman thought she was unlikely to have been vaccinated as a child then she could ask her GP to check her antibody levels.

Vaccines are offered opportunistically to adults, but again I assume cost is the reason why campaigns aren't scheduled - the cost of mass vaccination for diseases that don't tend to cause much morbidity and mortality in adults may outweigh the benefits.

Questioning Tue 23-Apr-13 17:10:42

Yes but that's the thing. Most adults would be non-immune.

And why on earth vaccinating women after delivery? They need to be vaccinated before conception.

Adults might have a more robust immune system but they much more ill from these illnesses and therefore and more dangerous for them.

Look on the MMR threads, the people who have had some real issues are mainly adults.

Sidge Tue 23-Apr-13 17:19:45

Most adults aren't non-immune. They have either been vaccinated or been exposed and developed immunity.

As I said - identifying and vaccinating women pre-pregnancy may not be viable or cost effective. Relatively few women of child-bearing age are non-immune.

Yes of course non-immune adults should be offered the vaccines - and they are, as and when they are identified.

ShadowStorm Tue 23-Apr-13 17:20:43

I think women non-immune to rubella are offered the MMR after delivery simply because rubella immunity is routinely tested during pregnancy, so that's when non-immunity is most likely to be picked up.

Obviously it'd be better for these women to be immunised before TTC, but I guess that's something the individual woman would have to ask the GP about?

I was given an MMR jab a few months ago. I only went in for a Hep B booster but got the MMR as well.

ShadowStorm Tue 23-Apr-13 17:24:35

Incidentally, if you know you've not been immunised against one of the components of the MMR - mumps, in my case - can you just walk into the GP surgery, ask for the MMR, and get it?

Assuming you're not currently pregnant.

Sidge Tue 23-Apr-13 17:38:14

ShadowStorm - yes you can.

Questioning Tue 23-Apr-13 18:00:51

Sidge have you looked at my link?
Vaccinations do wear off. A vax for flu is only valid one year. it use to be that tetanus should be done every 10 years (And people who were more at risk did have the vax every 10 years). They think the MMR is only valid for about 15 years so after that people who have had the vaxs are likely NOT to be immunized.
That's why I say that a big part of the adults aren't protected.

Questioning Tue 23-Apr-13 18:03:36

But even then, people who are at risk, such as women who want to conceive are not told about it. None is asking them to check if they've had the MMR (it's just an after thought).

The message is that adults are portected which imo is wrong (And why aduklst are badly affected by measles atm). We should, as an individual, be taking the right steps to protect ourselves but none is going to do it if you don't know about it.

WowOoo Tue 23-Apr-13 18:07:20

I don't know much but I could guess that the NHS would go under if every adult in the country were to get tested for immunity and then those who aren't to be immunised.

noblegiraffe Tue 23-Apr-13 18:09:05

Measles immunity has been shown to last at least 30 years post-vaccination.

Questioning Tue 23-Apr-13 18:10:24

We've received some letters at school for the children, In them, they say that you can immunized for MMR just if you think you might not be fully immune, wo doing a test.

If infos on that was actually given publicity as well as MMR before conception (as you have for folic acid) or for immuno depressed people, parents who have young dcs and are worried they might be ill etc etc, the it would give the choice to people.

I am not sure that it would cost more that the campaign they are doing with children atm where they go into schools etc...

MyDarlingClementine Tue 23-Apr-13 18:11:08

I was told this week by a doctor that any immunity I have had would have probably worn off and there was no point him checking my records.

However I was pregnant recently, they do check rubella?

I must have been immune to that still and would maybe still be immune to others?

pickledginger Tue 23-Apr-13 18:13:48

It's worth checking your rubella immunity before getting pregnant. I've had measles and mumps.

Sidge Tue 23-Apr-13 18:14:48

Yes I did look at your link. It's from a New Zealand travel health website. It states how often some vaccines are recommended, rather than the absolute duration of immunity.

Flu vac doesn't 'wear off', it's just the strains that change yearly. Some vaccines eg typhoid are not terribly effective so where risk is sustained then boosters are advised. We no longer routinely vaccinate for tetanus every ten years, it's only now done if one sustains a tetanus-prone wound, as some immune memory remains but the risk is considered high so a booster is recommended.

The jury is still out on how long measles, mumps and rubella immunity lasts for, but it is considered long term. Where uptake of MMR vaccine is good and the risk of disease is low in the population then adults don't usually need revaccinating. Outbreaks are monitored and recommendations for vaccination are based on risk assessment and local disease prevalence.

recall Tue 23-Apr-13 18:17:42

The Flu doesn't wear off, its just that it covers different strains of the Flu virus, which tends to change each year.

ShadowStorm Tue 23-Apr-13 18:21:21

* MyDarlingClementine* - yes, they definitely check rubella immunity in pregnant woman.

I'm currently pregnant, and have been tested for that as routine. And I'm still immune to it smile

MyDarlingClementine Tue 23-Apr-13 18:34:55

Does that mean perhaps we are also still immune to measles and stuff?

ShadowStorm Tue 23-Apr-13 19:14:38

No idea, Clementine.

PP has said that measles immunity can last 30yrs post vaccination, but I guess the only way to be sure would be to have your immunity checked via blood tests.

CwtchesAndCuddles Tue 23-Apr-13 20:13:18

If you look at the stats on the public health wales website you will see that only approx 10% of cases have been in the 30 + age group.

Adults in schools and healthcare are being targeted and I know lots of parents who have had or about to have the MMR themselves. The main focus is IMO rightly on the younger age group.

http://www.wales.nhs.uk/sitesplus/888/page/66389

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