to not give DS an early MMR booster

[blossombath]

Genuinely confused here so any advice welcome.

DS is 14mo, has had his first MMR jab at the usual time. There has recently been a case of measles at his nursery, and also another case in a mums and baby group I go to.

DS has been a bit poorly so last week I called the doc for advice about whether to avoid young babies for risk of infection and whether there is any need to give him the booster early (in our area this is given three months after first jab as standard).

At first GP said booster can be given 4 weeks after first jab; then wasn't sure so rang off to check her books and called me back in a few minutes to say that the guidance is now to wait 3 months therefore we should just wait and call back if DS got worse. Agreed with me that DS is likely to be getting immune support from me as he is bf and I have had measles.

Few days later I had a missed call from practice nurse and eventually got message from receptionist that the practice nurse had spoken to doc and wanted me to bring DS in for his booster jab early. Bit confused, but booked appointment hoping to discuss with nurse in person. Appointment turned out to be with a different nurse who refused to give DS the MMR without speaking to the doc (who it turned out was a locum so not about anymore) or the other practice nurse. She was very scepitcal about giving booster so early as its against the red book and her guidance - 'I'm a mum as well as a nurse, and it's too much for him' - and advised that I come back another day to talk to the other PN.

DS no longer ill and since it was a bit uncertain anyway DH and decided to leave it and just give booster at usual time.

Today received call from PN who said the GP had re-checked her notes after speaking to me, and the booster can definitely be given after 4 weeks. She advised giving the booster since DS has been exposed to the virus, and may not be fully protected from first jab. She dismissed my concerns that it might overload his system - but surely there must be a reason why the guidline is to wait three months from first to second injection?

I should add that I am 'pro-vaccine' and would not have considered not getting him vaccinated at all; it just feels like we're being given confusing advice and can't get a clear picture of whether its a greater risk to give him the second jab or just wait. Its only a few weeks either way but feels like there's a big responsibility to make the best choice for him.

Anyone had experience of this, or know about the guidelines?
WIBU to ignore the doc and PN and leave his booster until the usual time?

[WafflyVersatile]

Well you are certainly being given confusing advice.

Summing up the advice seems to be that 3 months is standard but it is thought safe to give the booster after a minimum of 4 weeks if thought prudent when other risk factors are considered (ie exposure to the virus)

How long has it been since his first one?

[blossombath]

Five, nearly six weeks - would be six weeks by the time I could get him to the docs for a jab.

You're right it's the other risk factors part which changes it. And I'm not sure how great the risk is, with just one case in close proximity to him - the nursery one - and another where he hasn't been in contact with that child for a good month or so.

[WafflyVersatile]

No idea what to advise. Lots of children get the measles and are fine, of course. I spent the 2nd week using mum and dad's bed as a trampoline, IIRC.

Was measles confirmed in those two cases?

The professionals can look at statistics or directives but with individual babies it's a judgement call, impossible to accurately weigh up your DC's precise balance of risk. Hence the differing views I expect. The booster will probably be fine at 6 weeks. He probably won't be exposed to measles in the next 2 months, and if he did get measles he will probably be fine after a couple of weeks. Try not to stress too much either way.

If he was exposed to measles already then surely the booster will be too late to stop him getting it in two weeks time? ?

[missingmumxox]

Used to be 3 weeks between jabs and only because if you are Having jabs so close to each other they are possibly different vaccinations, The reason being that if there is a reaction you cannot easily tell which vaccination Coursed it.
I do agree that if you are breastfeeding then you are passing on your immunity, However if measles is in your area I would have the second vaccination early.
But that is me

[CatHackney]

It's nothing to do with being "too much" for the child. It's about leaving enough of a gap to be effective. So, 4 weeks is fine.

[blossombath]

Thanks missing and Cat, that helps to allay my fears about 'overloading him'.

Waffly, the measles hasn't been confirmed but I guess that would take a week or so for lab reports to come back. WRT the timings yes I think you're right if he's already infected then the booster won't help (not sure though, maybe it includes the antibodies as well as the dead virus? ) I'm assuming that the reason docs want to give it is so that he is protected if he comes into contact with measles again which might be likely if it's now in our area.

Part of me does think - he'll probably be fine even if he gets measles as he's healthy generally - but I know that is a bit of a cavalier attitude and don't want to be irresponsible about this.

Think I will call docs and ask to speak to one of the GPs I actually trust and understand.

[badguider]

All guidelines are a balance of risk of doing it vs risk of not doing it... so although they could be 'ideally don't give till four months later' they could also say 'if exposed it's better to give it early'.

Just like in pregnancy many medicines should be avoided if possible but not if the mother really needs them as then the benefits outweigh the risks.

Try googling for 'nice guidelines on mmr boosters' or similar and see if you can read the advice yourself... ?

[badguider]

found this "Before school or preschool (3 years 4 months to 5 years of age) administer: The MMR vaccine can be given earlier in some circumstances, for instance if there is an outbreak of measles. However, if it is given within 3 months of the primary immunization, an extra booster should be used before entry into school." on cks.nice.org.uk/immunizations-childhood#!scenariorecommendation:12

[badguider]

so it looks like there's no problem for your LO having it early, but he'll need another before school/pre-school to make sure it's still effective then.

[DeafLeopard]

You might have been better posting in the Vaccines section rather than AIBU.

You might get more traffic in AIBU but IME there are some extremely knowledgeable people on the Vaccines bit.

[CloudsAndTrees]

The second MMR isn't a 'booster' in the sense that the second one is needed to make the first one fully effective.

If the first one worked as it was intended to, as it does in about 95% of children, then there is no need for the second jab to be given at all. The second jab is only given because in around 5% of children, the first one doesn't work effectively, so a second is given just in case. After the second jab, it is thought that around 98% of children are protected, but by far the vast majority were already protected before.

Unfortunately, the only way to tell if a child actually needs the second jab is to do a blood test, which is not routinely offered on the NHS.

Personally, I would wait, as it is likely that your ds is already fully protected anyway.