Reactions to MMR - how long do they last?

[MrsMoppetMama]

My DD (13 months) had her MMR 11 days ago, she had a bad reaction after about 3 days (high temp and trouble breathing) and we took her to urgent care center. Although this has now passed, she seems to be really out of sorts and has stopped sleeping through. Her normal routine was brilliant as she went down from about 7 - 7. Now she is waking every two hours and is very unhappy. Is this normal? is this because of her MMR or is it just a phase? She has also stopped taking her bottle before bed, is it likely that she has weaned herself? Help! It's been pretty easy going with her up to now so a bit stressed by all this.

Great post Elaine. You did indeed predict it.

Aside to Volcan: that's why I said "most". Can you think of a vaccine other than rubella for which the main motivation is to protect an unrelated third party? Flu jabs I would see as primarily to protect the vaccinee (does this term even exist?). Even with rubella, I vaccinated my DS to protect my (possible) future GC. I'm not worried if immunity wanes. It can wane with the real infection in any case and some immunity for some period is better than none. I accept that all vaccines are not perfect all the time - but they are better than the alternative - NONE.

More research, we all agree at least, is a good thing.

BFG - Other vaccine - yes, the plan to offer the nasal spray for flu to children between the ages of 2-14.

Health Secretary Nicola Sturgeon said: ?The evidence suggests that extending the vaccination programme to include children will help to reduce the spread of flu as children are more likely to spread the virus.?

I'm middle-aged, my children are older than that, and I don't have any grandchildren; as a result my contact these days with children is quite limited - I would imagine I am not untypical. Why not offer me the spray directly, if you are trying to reduce the spread in an older age group?

Rubella vaccine: why vaccinate a son - he is not going to get pregnant? If vaccines are not perfect all the time and the immunity has ceased, how is that better protection than no vaccine?

With measles & whooping cough I can see the logic of offering vaccination to children because the disease is more serious in them. Rubella - offering protection to babies in my opinion is more suspect because it sets up a false confidence that the protection is there. How many women do check their rubella status before they try to conceive? How many get pregnant accidentally?

Elaine As soon as you found an epidemioogical study which demonstrated vaccine damage (albeit from over 60 years ago on a vaccine no longer used) out it comes with nary a mention of the fact that this is a flawed epidemioogical study, you know, the ones that can't prove anything and are flawed.

Umm, but you were quite happy to provide us with a story about death from measles in 1962 in your attempt to convince us that measles is always more dangerous than vaccination. I saw saintly's post as one of historical interest rather than something which applied now. It can still be useful to learn from the past though.

Have you read my post? Flu is for the vaccinee primarily - there are side benefits for other age groups. Rubella: my SON is vaccinated to protect my future CHILDREN. This is my selfish contribution to herd immunity - I am more interested in protecting my own family than other unrelated people.

Just a quick link to show the at-risk groups with regards to flu. Quite a broad range of people. Everyone I know who's got the flu vaccine was to prevent themselves getting ill. Just because the disease is common and largely people fully recover, it can be easily to forget the levels of morbidity and mortality remain really high.

Eh? I haven't said anything about the study at all. I asked whether anyone could remember the research (because I had a vague inkling in my mind that there was some relationship between DTP and paralytic polio and I couldn't remember what that was. No-one responded, so I posted it here to show I had found it and for others to read who might be interested ).

I think there was some sort of association between cases of paralytic polio and tonsillectomies as well??? You may find this weird but I find it interesting.I actually find it fascinating that polio - which is usually a mild illness (is it 95% of cases a asymptomatic - which causes it's own problems of course?) can be triggered into a devastating disease by muscle damage ( I think, haven't read properly yet). Something that you (one) would think was unrelated. I think there were issues in some areas with epidemic polio giving antibiotics by injection (because parents thought it would work better) rather than giving equally effective oral antibiotics which was leading to injury provoked polio. And I think that might have been fairly recently, although tbh I can't remember.

You also appear to have totally misunderstood/misrepresented what I said about epidemiological studies. I said that in the case of autism and MMR the epidemiological studies carried out to date were flawed (because the MMR subgroup is too small and the studies to date have treated autism as one thing). I didn't mean that the whole methodology was flawed. I did actually link to some epidemiological studies that I thought looked promising. As I believe they noted one of the problem with autism is that no-one knows how many conditions you're actually dealing with.

You really do twist what I say to assume that I hold some sort of extreme viewpoint.

Oh okay. The JCVI minutes recognise that the reaction to vaccinating healthy children is likely to be mixed (and they include HCP's as well as parents in that) and the BBC says in the same way, extending flu vaccination to healthy children will provide most health benefits to others although I can't find a direct quote anywhere for that.

Yes, I read your post and was asking a question. I will draw my own conclusions as to your use of capitals to shout at me. I thought your response would be 'herd immunity.'

I have read your link and the high risk groups are those I thought they were. Young children are not fully defined, but under 5 are specified as being at high risk, so that seems a reasonable definition. No one describes a 14 year old as a 'young child'. So why is a flu vaccine going to be offered to primary and secondary school children from 2014? Not primarily for their own benefit, it would seem.

Rubella - is it wise to rely on 'herd immunity'? I have just asked my adult daughter whether she knew if the immunity could wear off and she answered no.The old policy of offering vaccination to girls just before puberty seemed quite sensible - it would offer protection at the time when some would soon become sexually active and whose future children might be at risk. It would be a good idea to offer boosters to those going away to university, but do they?

Argh...going in circles here!

The capitals were to repeat what I'd said in the previous post as from your reply I can assume you didn't notice. No shouting going on, promise.

Why wouldn't 5-14yo benefit directly from the flu jab? They may be less at risk, but that doesn't imply no risk. In fact, the 1918 flu outbreak killed predominately the young.

If you can only argue rubella and flu as vaccines used primarily for herd immunity, then your on weak ground - find some other examples. Rubella certainly has strong herd immunity arguments, espcially as immunity wanes. But I'm only partially going to accept that. Someone else with much better understanding of vaccinations (probably Elaine on another thread) said that the policy of vaccinating teenage girls only (although logical) was not effective. Only when everyone was vaccinated did we see some really inway into preventing congential rubella - thank goodness. If the rubella vaccine gave 100% immunity throughout the childbearing years, then vaccinating teenage girls only would of course be the most sensible, and cheapest, option. Hopefully, they will develop this vaccine.

My original point is that most vaccines are in the interest of the individual being vaccinated. The point still stands.

If you can only argue rubella and flu as vaccines used primarily for herd immunity, then your on weak ground - find some other examples.

I read this as being your argument, it's certainly not mine.

If the policy of only vaccinating teenage girls was deemed not to be fully effective, it implies that vaccination is not as effective as the staunch 'vaccinate at all costs' people would try to convince us.

To put this dog to rest: We were discussing risk factors, you Volcan brought in herd immunity "Some people do appear to be damaged by vaccines - is it an acceptable risk if the greater good of the general population is served?", I argued this was not a main factor motivating an individual to vaccinate, though if often quoted for flu and rubella. You said, ahh, but what about flu and rubella? Let's leave this shall we?

About your second point, I'm glad you're bringing this up as it's one of my bugbears. So many anti-vaxers (sorry if you don't like the term, it's just easier to write) will say that an incompletely effective vaccine is as good as none at all. If the current vaccines are so poor, why don't we see more cases of congential rubella? I just read this shocker. It makes me all the more certain to post on these pages if it can incentivise some people to go and vaccinate.

I know you don't like me linking to papers LeBFG, but there are some potential issues with imperfect vaccinations.

The Read lab has a lot of papers available online in full. If you're interested in vaccination definitely worth reading, some really interesting papers - not just on vaccination (and I don't think the work on vaccination could remotely be described as an anti-vaccination, quite the opposite).

I grew up living next door to someone who had congenital rubella syndrome. And I had to tell someone who was in her first trimester that she had been exposed to rubella. That experience and her reaction 'oh don't worry, I checked my rubella status before ttc; I'm immune' was actually what made me check mine a few years later. I hadn't actually realised until then that you could request a check at the GP's.

Now there too saintly I'm glad you posted that link. It seems to be a favoured topic of yours. I very much like the work done on vaccine selection pressures. Clearly a promising path for the improvement of vaccines. As you are aware, antibiotics and viral drugs all have the same problems. For years we're known about mosquiotos developing resistance to DDT. But what do you do if the weapon works for a while and then turns out not to be as effective? You improve the weapon. With the vaccine research, the problem appears to be with vaccine reponses that allow the pathogen to grow slowly in the host rather than just blitzing it. The worst culprits being malaria and anthrax vaccines. Really good vaccines in this respect include smallpox, polio and measles.

I appreciate your rubella argument, but many women get pregnant by accident. I didn't TTC my DS and only found out my immunity status after getting pregnant. THis is why I think it's 'idealist' (to an extreme) to expect this strategy to work to eradicate congenital rubella.

Yes, you're right, it is a favourite topic of mine. I have been very interested in the evolution of resistance since about ooh 1994 when I attended a talk where John Maynard Smith was talking very passionately about antibiotic resistance and how it had been avoidable. John Maynard Smith was always a bit of a hero of mine (even more so after getting to talk to him in a small group of prostgrad students - a remarkably lovely man as well as a complete and utter genius) so he sparked a bit of an interest there. Actually, thinking about it, I really should read what he wrote about the evolution of human language (another interest of mine, especially as ds1's language development is bonkers).

Oh I don't think it could eradicate congenital rubella, far from it, but I think there should perhaps be more encouragement given to women to check rubella status if they think they might be ttc soon. It might prevent a few cases and some heartbreak.

Ditto perhaps chickenpox status. I was exposed to chickenpox while pregnant and hadn't had it. Cue a few weeks of panic from me until I found out I was immune anyway.

Yes, I've met him too. To be fair, in the paper you link to (which at least I have a hope of understanding), the case is still very strong to maintain high vaccination rates. It's only at low vaccination rates on one type of vaccine where mortality increases with vaccination coverage (from 0 to about 20%) and thereafter declines. You say this points to "some potential issues with imperfect vaccinations." As far as I'm concerned ALL vaccines are imperfect (e.g. the new polio vaccine is less effective than the older one as it was made safer). Does this mean they don't have great benefits? We should strive to develop new and better vaccines than trying to deny the immense positive impact they have had on public health.

And for someone who has had these scares and personal experiences of rubella for example, I'm surprised you aren't more pro-vaccine. My nudge came after I bought DS home (born 7 weeks early) and met the neighbour. Her kids that week developed measles and were hospitalised. I swore a lot at the selfish attitude that she didn't want to vaccinate her precious DC for fear of vaccine damage when she came so close to exposing my very small and vulnerable baby. It brings it home when we think the 'at risk' group never includes us - then suddenly realise we are.

Oh I agree, I just like their approach to various different questions. John Maynard Smith (iirc - and it was a long time ago) was of the opinion that it would have been far better to have avoided the problems with antibiotic resistance in the first place by applying some common sense to their use, and I wonder whether the same is true, in some cases with vaccination. Of course it's going to vary from vaccination to vaccination. And while the advantages of vaccinating against something like polio are very clear and obvious, I'm not so sure that's the case for something like mumps.

Although I have moved far from the field now I am, at heart, an evolutionary biologist. I always will be. I can't help but find their approach to a wide range of topics interesting.

As someone who hasn't vaccinated some of her children due to their own personal risk/benefit analysis it's obviously of a lot of interest to me if a vaccination policy is likely to lead to more severe disease in unvaccinated individuals. The reverse is true as well - if a policy leads to lower virulence which it may do. Both outcomes have the potential to affect my decisions for my children (or my advice to them as they grow older). It's still ultimately guesswork, but another piece of information to plug into their individual analysis.

LeBFG. I'm really am not anti vaccination. Nor do I under estimate the impact childhood diseases can have. As I have already said my mother is deaf in one ear from measles. But, I live daily with severe autism. It has affected every aspect of my family's life and has far reaching consequences that will continue to affect the people I love after I die. I keep as up to date as I can with research into the development of autism and I make the best decisions I can for my children by taking into account our family history and current research.

I would never tell someone to vaccinate or not vaccinate. Whilst I have no issue with vaccination itself I do have issues with the way mass vaccination policy is decided and delivered and the ways in which potential adverse reactions are dealt with. It's therefore imo an entirely individual decision. I would never tell someone they should risk the disease, or the vaccination - that's their choice to make, certainly not mine.

My unvaccinated baby ds2 was exposed to whooping cough by two unvaccinated children. At the time I wasn't sure whether he was going to be vaccinated or not, I'd just delayed at the time because he had been very ill at 6 weeks.

TBH I didn't feel the way you describe about your neighbour. At the time ds1 was just post regression (pre-dx) and having a terrible time and I had no idea what to do, I could fully understand why people might have concerns.

As it happens ds2 didn't catch whooping cough until a few years later when he caught it from a vaccinated child (it was never diagnosed as such, but I'm fairly certain it was WC, it fitted the symptoms exactly).

Saintly What you were saying about vaccination being halted during outbreaks of polio is talked about in Richard Halvorsen's book.
Piglet From the same book, he says that, from the 1970s onwards, the OPV used in the UK caused more cases of paralysis that the disease.

I don't know the author you mention, and I don't know his credentials.

If, as you suggest, it is true that "from the 1970s onwards, the OPV used in the UK caused more cases of paralysis that the disease" this fact is presumably sourced from official documentation and statistics that I can easily access. Can you tell me where I should look, please? Is it published by the WHO, the NHS, the Lancet or some other mainstream source?

p.s.
since you raised the point, can you answer my previous question please
"Do you believe that the number of cases it caused were greater, or less, than the number of cases it prevented? By a factor of what? A hundred? A thousand? A million?"

adc.bmj.com/content/78/6/571.full
Read some of that, although the ref in Halvorsen's book is different.
I'll type that up in a minute. You'll have to find the document yourself if it isn't online.
Richard Halvorsen is a GP, by the way.