to think it's not terribly helpful to keep referring to parents who haven't MMR'd as "whack jobs"...

[MsGillis]

..or morons, or unfit parents, or up there with people who drink and drive?

I appreciate that people have very strong feelings around the subject, but I think that we need to understand that there are a significant number of parents who didn't/haven't vaccinated, not because they are crystal waving nutjobs, but because they are actually scared shitless and paralysed into indecision?

Surely there are ways and means to communicate information, and arrogantly shouting about how one person is right and anyone who disagrees is all kinds of nobhead is not going to be conducive in opening up reasonable dialogue?

Widow - apparently 2 doses of MMR give 100% protection against rubella. So why would one of my daughters be a 'non responder'? The second dose should work, right?

As it is they will have them as singles and after the first dose I will get their immunity tested to make sure.

Cotedazur

www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1221202948790

Before rubella vaccine became available, an estimated 200-300 babies were born each year with CRS in the UK. In the ten years between 2002 and 2011 there have been 8 cases of CRS born in England and Wales, of whom 4 were infected abroad.

www.immunizationinfo.org/vaccines/rubella

"Before a vaccine was available, there was a rubella outbreak in the U.S. (1963 to 1964), during which 12 million people developed the disease. Because many of those infected were expectant mothers, 11,000 fetuses died and 20,000 babies were born with permanent disabilities as a result of exposure to the virus. The number of cases of rubella fell very sharply once the rubella vaccine was licensed in 1969; today there are fewer than 1,000 cases of rubella reported each year in the U.S. on average and less than 10 cases of congenital rubella syndrome.

Because of intense misinformation about MMR in the United Kingdom, MMR vaccine coverage has declined across Europe, resulting in outbreaks of measles and mumps in multiple countries, including the United States and Canada, and congenital rubella in the Netherlands and Canada. There were 42 cases of rubella among pregnant women with two fetal deaths and 12 affected infants. Ironically, one of the few known causes of autism was the congenital rubella syndrome, autism having occurred in 20% of rubella-affected babies prior to the licensure of rubella vaccine. MMR vaccine, therefore, protects against autism by preventing congenital rubella syndrome."

When - That's not fair

Of course, I care. I just don't feel that the onus is on my tiny baby to protect that hypothetical pregnant woman. Teenage girls should be tested for immunity and non-immune ones vaccinated at that point.

It might be a bit more expensive than the current system, but it is best for everyone. No premature vaccination for girls more than a decade before its time, no unnecessary vaccination for boys at all.

Widow - Why are you talking about "before rubella vaccine was available"? Are you just not getting what I am proposing, namely that teenage girls should be tested for immunity and vaccinated if found to be non-immune to rubella.

I thought you were going to find figures from when teenage girls were offered rubella vaccine.

Seriously, I'm beginning to think that you are being deliberately obtuse to waste my time.

I've read it all, Raspberry. Nevertheless, continuing to link MMR and autism is stupid. Your own conflicted feelings are understandable, if irrational, but writing it down like that is stupid. Strike outs are generally used to show the real truth over a polite fiction. This is the opposite of your usage.

cotedazur - what do you feel exactly is the risk for your tiny baby posed by the rubella vaccination?

And you say "it may be more expensive but is best for everyone". What healthcare services should be cut in your opinion to make up for the higher cost?

And this immature immune system thing. I would have thought that a baby would have a fantastically efficient and hard working immune system- it's in baby hood you need it most!

Cote, I replied to your first Game Theory post before I saw your second with the link, 95% is often used as the herd immunity level for measles as it has a social network rather than random diffusion which gives a higher chance of transmission, and its very dangeous, ergo it requires a higher degree of herd immunity.

I think you have used Game Theory quite cavalierly on this thread, but to simplify, the biggest differential in any game theory payoff is the probability of catching measles, as it is much, much, much, much, much, much, much more dangerous than vaccination.

If there is high herd immunity, there is little risk of catching measles and it is rational to not vaccinate. Problem is as more people therefore choose not to vaccinate, the herd immunity diminishes, and the chance of catching measles rises. And it's not linear, as herd immunity reduces below a threshold risk rises very fast.

The bit of game theory I don't understand is the strategy of the anti-vaxers, I'd have thought if you don't want to vaccinate you're better off persuading everyone else to vaccinate like mad, to keep that herd immunity up.

seeker - How do I know that I can't have measles again?

Um.. because I already had it. I have the antibodies. I'm immune. I can't have it again.

Do we have to talk about the basics here? (Please say "no")

cotedazur have a look at the graph of the HPA link

"n 1970 a schoolgirl rubella immunisation programme was introduced in the UK. This selective policy was effective in reducing the number of children born with CRS (see graph) but rubella continued to circulate and any remaining non-immune women were often exposed via their own or other young children. Measles, mumps and rubella (MMR) vaccine was introduced in 1988 for all children in the second year of life, with the aim of interrupting circulating rubella.

In 1994, a national measles/rubella vaccine campaign targeted all school aged children (5 to 16 years) in 1994 and the schoolgirl vaccination programme was discontinued. A routine second MMR immunisation at 4 years of age was subsequently introduced in 1996,"

You can see the really quite sharp drop of CRS cases once the MMR was introduced compared to the schoolgirl vaccination program.

cote sorry you don't think it's fair but all you trot out is rubella isn't serious unless you are pregnant. You make no allowances for (the thankfully few) women who are not able able to be vaccinated.
I guess those women should just not breed.

LazyJane - I think your problem is that you just don't read posts well enough before you reply to them. My children have had measles vaccination and my posts were never about avoiding the measles vaccine nor have I ever questioned its necessity.

"all you trot out is rubella isn't serious unless you are pregnant"

... which is correct, as we all know by now [hopeful]

"You make no allowances for (the thankfully few) women who are not able able to be vaccinated. "

Ah, those hypothetical creatures again I asked you who those women are and you didn't answer. Here:

CoteDAzur Fri 26-Apr-13 15:16:07
Who are these women who can't be allowed to have such a mild and brief disease as rubella as children, cannot possibly have the rubella vaccination, presumably have a very weak immune system but can socialise with children and are perfectly capable of being pregnant and having babies? I'm genuinely curious.
And how many of them are there in the UK at any given time?

cardi to be fair to raspberry I think she means that mmr has been falsely linked to autism and that is why she is nervous of it inspite of knowing there isn't actually any risk.

So to recap for the dumb

Getting the vaccination does not necessarily mean that you will not get measles?
We don't know how many of those now with measles were vaccinated
Getting the vaccination does not necessarily protect you against rubella?
You can test for rubella immunity and if you don't have it vaccinate at that point?
We can't buy a single vaccine for reasons unexplained

Is the rubella a particularly side effect prone element of the MMR?

"rubella continued to circulate and any remaining non-immune women were often exposed via their own or other young children"

Wasn't there a policy of testing for rubella immunity during pregnancy at that time?

I answered this. Here:

CoteDAzur Fri 26-Apr-13 17:02:06
"...vaccinating children against rubbella, the main outcome was that it protected the vaccinated children's own younger siblings more than any other group."

"Younger siblings" as in DC2 in the womb? This doesn't even make sense. When you were pregnant with DC1, you would be tested for rubella immunity. If found non-immune, you would surely get the vaccine yourself after DC1 was born. So by the time your are pregnant with DC2, you would be immune so there would be no need to vaccinate DC1 against rubella to protect the fetus.

They don't have to have a weak immune system, just a hypersensitivity to the components of the vaccine. These women (no idea how many but I grant you it's not many) are perfectly able to lead normal lives maybe best to avoid eggs though

so do you think the HPA just made the figures up, which showed that the school girl vaccination program wasn't as effective? Why would they?

Raspberry it is too important to pander to spurious sensitivity. It is stupid to think MMR and measles are linked. I live near Swansea, if that adds any context for you.

Transplant patients are one group who can't have mmr but have lowered immunity. I'm not sure of the numbers of childbearing age transplant patients but I'm sure you could look them up.

can you have a child whilst awaiting a transplant?

My irritation around the policy of the rubella vaccination is that they don't tell you that the immunity can wane. Yes, they test you when you are pregnant, but it could be too late then. Where is the public health policy to tell women to check their rubella status? I have asked this once before and no-one seems to have an answer.