MMR - when to give

[susanmt]

I am NOT looking for a fight!
I am pro MMR and my dd had it with no problems. But I have come accross some things on Mumsnet recently suggesting that it should be given later rather than earlier in order to maximise immune response. We had dd immunised at 14 months as we were going to a large church conference in the south of England and I was worried about her being exposed to non-immunised children. At that point I'd not heard anything about late immunisation. But ds's appointment came in today and he was only 13 months on Monday, and the appointment is for Wed. I would rather wait a few months if it is likely that his immune response to the jab (which he will have, no doubt abou that) will be better.
Does anyone have any really solid evidence to back up the idea that jabs given later have a better response? Thanks

I left DS2 until he was 18 months old, partly as I couldn't decide whether to go MMR or single and partly so he was older/stronger/better able to cope with it. I went with MMR as he was starting nursery at 2 and I wanted him vaccinated prior to that. I spent a couple of months giving him "immune boosting" fruit smoothies first!

I don't think your doctor will have any problems with you phoning and saying that you'd rather wait until your DS is older. They were perfectly happy for me to delay DS1s as he'd just had the (then new) Men C jab.

Both DS1 and DS2 had it without any problems, side affects or even whinginess.

My ds had the jab at 15 months as at the time I'd heard that was the "optimal" time to have the jab. Not sure what the current theory is though, sorry

susanmt- well you know my views on mmr No but seriously- I have read a lot and it appears that it is more likely to work if given later. This is because antibodies from the mother may interfere with the vaccine if given earlier. Am I right in thinking you bfed for an extended period? If so I would tend to hold off until at least 15 months and probably 18 months (to be on the safe side). I haven't got any references to hand but I read that sort of thing in a few places.

I'm still breastfeeding. Does this mean I should hold off until I stop - I hoped youwould reply Jimjams, you have done all the reading on vaccination!

Not sure susanmt. I'm still bfeeding my 13 month old - mainly in the hope that it will be passing across antibodies, against various things as he's not being vaccinated at all. However I'm not entirely sure how effective it is- I've always found the evidence somewhat conflicting. Some things I've read suggest that with the exception of colostrum breastmilk provides next to no antibodies although personally I think that is unlikely. Of course the other extreme is it provides full protection which is also probably untrue.

Basically becuase of the way the vaccine works if you are actively passing across antibodies then it will have the potential to interfere with the MMR and it would probably be worth waiting 6 months after stopping bfeeding. If however bfeeding doesn't pass that many antibodies then I would say get it done at 18 months when apparently it "should" be effective. I'm sure you know lots more about bfeeding that me- so you may be able to get your answer from that.

I would be very interested to hear if you do find the answer. This is the sort of thing I wish doctors could give me an answer to!!!

Why aren't these decisions easy????

I can't say for the MMR because I wasn't breastfeeding when ds had it. But for the other vaccines when he was younger I was really grateful he was breastfeeding as it was a really quick way to calm him down afterwards. Also, having good blood sugar levels "reduces" pain apparently so a quick feed before and after a jab is beneficial.

In the usa they will not accept a mmr jab that has been done before 12 mo. and make you do it again. I seem to remember my paediatrician saying that it is more effective later. I think it is probably a balance between effectiveness and the chance of exposure to the diseases. Is your ds in a nursery or with a childminders where he is exposed to other children who may not be vaccinated?

SofiaAmes is right; I got barred from signing up for classes at University in California (?1989) because I hadn't given proof of vax against measles, then when I did drudge up a grotty certificate, they said my original jab didn't count because I was too young.

Jimjams; where have you read that the antibodies in breastmilk are so insignificant after colostrum? It sounds contrary to everything else I thought I knew. I thought that the antibody level in breastmilk goes up after child is one year old, for instance, which suggests that antibodies must be more important than ever.

ps: DD had her MMR this week, 17 months, late for all the reasons people give.

Zebra what would hapeen if you actually had had measles (as I did). Do they accept that? Just interested.

I agree the bfeeding stuff does sound mad. It's not an area I've really looked into just noted when reading around (usually when reading something else). It's all contradictory though. Good to hear though- do you have any references? I'll carry on bfeeding ds2 for a while longer then (actually if I have excess milk I express into a cup and give it to ds1 in the hope it will be doing his immune system some good (he needsit) so that's reassuring).

When ds2 was 4 and a half months he had a fairly major exposure to whooping cough- I was pretty worried as obviously that's a really bad age to get it. Lots of things I read said that whooping cough antibodies aren't passed to baby from mother so I was really worried (although I thought that was somewhat strange). He didn't get it though so I'm sure he must have had protection from me.

jimjams, I think they do, but you have to have a test to show that you have the antibodies. I was married the first time around in California and you had to either show immunity to rubella by being tested or get vaccinated for it in order to get married.

America is a strange place..... Does that include boys?

Susanmt- a couple of other thoughts occurred to me. As with any vaccination best not to vaccinate during an eczema outbreak and the big one for MMR- avoid chickenpox like crazy when vaccinating with MMR. Apparently quite a few of the cases seen at the Autism Research Unit had MMR and then were unfortunate enough to catch chickenpox shortly afterwards. There is a statistically significant link between catching wild chickenpox and mumps in the same year and going on to develop autism (I think it was that one which was significant- other combinations showed increased risk but not statistically significant). If that was a worry it could be worth emailing Paul Shattock at the ARu to ask advice. I would imagine he would advise waiting 6 months after chickenpox before MMR - maybe not - just a guess from a past conversation I've had with him.

Jim Jams, I am worried now, my ds is 10 months, he is in the midst of both the chicken pox and a bad excema flare up, our local surgery does the MMR round about the child first birthday, Don't suppose you could pass on the email address you have mentioned, would be very grateful.

Um, aren't they proposing including a chickenpox jab in with the MMR in the very near future?! Sounds worrying if there is a connection, JimJams.

Yes sensible isn't it Georgina I've laways said the no-one at the D of H actually reads scientific papers! There's mor eon this in the last MMR thread if you dare go there.....lol

Girly The ARU can be found here It might lead you to the chickenpox research but not sure - I found it on a google search before. If not, you could always email the unit for some advice- they're very helpful- and they'll point you in the direction of the research. What they won;t do (quite rightly) is advise on whether or not to have the MMR.

I would postpone MMR until 15 -18 months as it's more likely to work- a google search should give you loads of hits on that (it's fairly well established). The eczema stuff came form a paper I read by Dr Natasha Campbell McBride in "The Autism File". I have a feeling she has a web page concerning her clinic in Cambridge- again you could try a google search. (vaccinating during an eczema flare up isn't sensible for other reasons to do with infection as well as autism).

BTW- the bit on the Gulf War vets is worth reading on the ARU site at the link given below (my son has a high IAG level)

especially the hooper articles- kind of relevant!!

The MMR jab is given at 13 months where I live - didn't realise you could request to postpone it though. DD is 11 months now so we have 2 months to completely make our minds up, but at the moment we are thinking of going ahead as planned. We live in one of the cities where the private clinic offering single jabs has just been shut down after there were problems with the single ones, etc.

I got married in California in 2001 and didn't have to produce proof of rubella or anything, maybe that rule has changed...

Could be zebra. I got married the first time in 1986. I think the idea was that they were actually still pretending to themselves that people didn't have children before getting married and therefore rubella antibodies wouldn't be important to a woman before getting married. And also, it was before every child got the mmr.

DS goes to a childminder but I know that there are no unvaccinated children in our area (dh is the local GP!).
He has had chickenpox recently, but I do want him vaxed before we go on hols in August, which will be about 5 months after CP, so I think I will ask for the jab in July or so. Even with all the info here I am still very happy to go ahead with MMR (some may think I am mad but hey!) but want ds to get the maximum protection available. I still think it is significant somehow that the only child in my family of 6 who DIDN'T get the measles vaccine and went on to get measles is the one who is autustic with bowel problems.

susanmt- when I last spoke to Paul Shattock concerning ds1's suspected chickenpox (acutally it was eczmea herpeticum) and his measles jab I told him there was 5 months between the two and he said "that should have been OK" - not that ds1's test results were those of a vaccine damaged child anyway. Just trying to reassure that that timescale sounds a sensible compromise.

Had a look in my 1981 (rearranged in 1988) book of family health by some consultant and it says During second year of life - measles vaccine - not less than three weeks following another live vaccine (which kind of flies in the face of mmr) so if you assume the same advice for any virus as well then July sounds like a good bet.

Research has shown that breastfed babies respond more efficiently to vaccination - can't find the paper at the moment. For that reason I chose to give one MMR vaccination only to my youngest 2 children. Initially when MMR came out it was a single vaccine. The second one was introduced to try and mop up those who had not given it first time round as well as to further establish immunity. Perhaps if it hadn't been given too early in the first place it might not have needed repeated. Just a thought.

susanmt, nearly took dd at 15 mths but cock-up and laziness prevented this and thank goodness cos she got chickenpox! (which we obviously thought was fleabites from our cats at first) in the end she was just over 18 mths and never even noticed the needle going in - nurse rather cleverly gave her a freebie toothbrush/toothpaste in health promotion exercise which held her attention. good luck.

Mears - I've always been determined to breastfeed ds2 (16 months) at least up until he has his MMR - thinking that will help his immune system cope, so I was a bit concerned about what was said earlier in this thread. Are you saying the vaccine is more likely to work in bf babies? That's reassuring.

I've already had a letter chasing me up for ds2's MMR. His original appointment was for when he was 13months and 3 days! Conveniently he had a chest infection - honest, he did - although there was no way he was having it that young. Ds1 didn't have his MMR til he was 17 months - he had a series of colds and I used that as an excuse to keep putting it off.

My hv has said she wouldn't be worried if I put it off until he was 18 months. She also told me that what she had read had not convinced her of the need for the booster, and hinted that her youngest hadn't had it. Consequently neither has ds1.