Herd immunity, unvaccinated family?

[coxsorangepippin]

Hi. We are expecting our first child this spring and will vaccinate them. But a lot of family members are unvaccinated - they've relied on herd immunity and been lucky. So I'm wondering what to do while our DC is too young for vaccines. We also live in an area of London with fairly low vaccination rates.

Can anyone point me to research or proper advice? Loads of HCPs on MN so hopefully someone can All I can find online re exposing babies to unvaccinated people is a lot of 'personally I wouldn't hun', rather than science! I am trying to work out whether the vaccination rate in the whole society is what matters or whether a low rate among your personal 'herd' is dangerous, etc.

I am wondering about:

• requesting to have the 8 week vaccines a bit early and not seeing unvaccinated family til then (premature babies have them at 8 weeks unadjusted, so I figure that might be ok?)
• just asking family (vaccinated or not) not to come round if they're ill

Would love any pointers to research / resources.

I don't see any point in keeping them away until 8 weeks. Have a look at what that vaccine covers. All important vaccinations to have but things you would be statistically unlikely to pick up from a healthy family member. Things like eg measles are not covered until later on the schedule (12 months).

I'm not sure if you would be able to vaccinate early. I was told it was due to exposure to the world rather than development, which is why premmies have it early (by adjusted age).

Thanks eurochick, interesting re exposure to the world vs age

The earliest vaccines can be given is 6 weeks and this is usually for a travel reasons. Remember that your baby will have immunity for some diseases via you, the whooping cough vaccine is given for a this exact reason.

Your family members can get missed vaccines on a catchup schedule for free from GP if they wish.

Good luck.

Thank you idefix, it's useful to know about the six weeks just in case.

Personally I don't think anyone who is ill - not even something mild should be near a newborn baby - unless there's no choice because they live in the same household.

Assuming you're in the UK the main risk to an 8 week old from the diseases that are vaccinated against at 8 weeks is pertussis. Presumably you wil be having that in pregnancy? You're more at risk from adults (whether vaccinated or not) with that one anyway.

Unless your family travel to places witness circulating diphtheria or polio they're really not going to be carrying those.

TBH OP I'd be most fierce about cold sores with a newborn. I don't even visit a newborn if I can feel a tell tale tingle in my lip. An early herpes infection caused havoc in this house.

The 8 week immunisations inclusive whooping cough (it's part of the 5-in-1)

So whereas you would (of course) pick up nothing from a 'healthy family member' you are unlikely to know if their cough is whooping cough, or if it's going around in their area. And yes, it is circulating, and the deaths in 2012 of 14 babies too young to be immunised themselves led to the programme in pregnant women designed to transfer some antibodies via the placental.

Only you can decide if you will rely on that (assuming you had the jab).

The protective effect of the whooping cough vaccine does wane, btw. So those you know to be unimmunised are not necessarily posing a greater risk to you infant than those whose immunisations have worn off.

I seem to remember one of my friends babies having a TB vaccine in the hospital before the baby went home because members of the extended family were travelling back and forward to Asia.

I would only ask that anyone who was ill- including a cold/cough- stay away until better.

Some London boroughs (where TB levels are creeping up) offer TB shots routinely to all newborns. This has been the case for about 20 years.

You'd probably get one for a newborn anywhere if you said there was particular reason, which could include exposure to people of unknown vac status travelling from high risk areas.

I'd ask anyone ill to stay away until better.

I doubt they'd let you have vaccs early. Both my DCs had theirs late including premature DS as the NHS are so busy in our area they couldn't fit us in.
If baby is term and healthy they should have some immunity from you for the first few months.

I lived in an area of London with a high TB rate. My baby got the vaccination at 6 weeks.

It's really helpful to learn both that the whooping cough vaccine wears off and that it's the one a baby is most likely to catch. So we should definitely avoid visits from people with coughs for that reason, as well as not wanting an ordinary cold in a newborn. I will be getting the whooping cough vaccine shortly, in this area they do it towards the end of the recommended 20-32wk period.
I hadn't even thought about cold sores as I've never had one so good pointer there!
And I will ask at my next appointment about TB vaccines in our area.
Thank you all, this is really helpful

If you breastfeed that's also a way to boost your baby's immune system as antibodies are passed in breast milk.

Antibodies are only passed in breastmilk if they are actively circulating in the mother at the time. So that only happens if you (and probably your baby too) have been exposed to the disease. And whether they get enough is moot - there is some protective effect of you look at the population as a whole, but you cannot be sure if it will work well enough for that particular infant

(bit like breastfeeding as a contraception - effective if you look at whole population statistics, but would you be happy to rely on it as your sole method?)

The whooping cough jab is given in pregnancy as that definitely exposes the mother to the vaccine (acellular) virus, she produces the antibodies and they cross the placenta.

Of course not as a sole method but in the first few weeks before an infant can be immunised better than nothing and if a newborn has been exposed to an infectious disease, the chances are the mother has too.

That's all - certainly not a substitute for vaccination.

Oh mother nature