Southwark borough apparently has "outbreak" and is advising second MMR 4 weeks after the first

[FattipuffsandThinnifers]

I had a call from my GP surgery, saying my my ds (2 1/2) is due for his second MMR. Apparently the borough of Southwark has an "outbreak" and they are advising that the second MMR booster (normally given around 4 yo??) should in fact be given 4 weeks after the first jab . In cases like my ds who is older, they're advising to have the second jab as soon as possible.

I asked what disease the "outbreak" was and she said "MMR" - couldn't answer me when I asked her which of the three diseases it actually was, just repeated "MMR"

This seems really bizarre and extreme to me. Has anyone else heard about this? And any views on what to do? I procrastinated for long enough about the first MMR, and my instinct is to ignore it but would this be reckless?

My dc#2 is due in 5 days and I don't need any extra worry about illness in either ds or a newborn!

In wandsworth we have the first one at 12 months the second 3 - 6 months later. There are always signs around our doctors surgery outlining the number of measles cases in the borough

That is absolutely shameful re. the call from the Gp surgery. Are you assuming the outbreak is measles?

There was a lot of measles last year in Southwark. I don't think we have a very high percentage of children vaccinated here. A surprisingly large number of children at my dc primary school caught it last winter and quite a few ended up in hospital. It galvanised me into action and getting my ds's second jab done.

I am in favour of the MMR so would advise you to go ahead because if your new baby is going to catch measles from anyone it is more likely to be your son than anyone else.

Thanks, good to know it's not that unusual to have the jabs in relatively quick succession. Bibbity, yes I suppose I was assuming it was measles.

It's just such a big jab I'm slightly reluctant to give it again unless absolutely necessary. And if it's a measles outbreak, I'd rather just give the vax for that rather than all three if not necessary. Maybe I'll see if I can speak to a GP directly about it.

Thanks, good to know it's not that unusual to have the jabs in relatively quick succession. Bibbity, yes I suppose I was assuming it was measles.

It's just such a big jab I'm slightly reluctant to give it again unless absolutely necessary. And if it's a measles outbreak, I'd rather just give the vax for that rather than all three if not necessary. Maybe I'll see if I can speak to a GP directly about it.

From what I can see on the HPA data it's more likely to be mumps; however this is only up-to-date as far as the 2nd quarter of 2009 and not broken down by London region:

www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1195733790975

Where info is available by London region from the 9th Oct 09, I cannot see anything about recent notifications for either measles or mumps in Southwark here (p6):

www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1254510509257

It's possibly a very local outbreak being dealt with by the HPU, and that hasn't been reported yet.

Thanks Musukebba, that is really useful.

Yea and as stated earlier, it's probably also compounded by Southwark having one of the lowest MMR vaccination rates for children at 5 years of age (55%). See table 11a in this document (scroll to second page of table and it's the last column):

www.ic.nhs.uk/webfiles/publications/immunisationstats0809/NHS_Immunisation_Statis ticsEngland200809Bulletin.pdf

BTW it is OK to have the 2nd dose close to the first one, in an outbreak.

If the MMR is ineffective four weeks after being given it's hardly a vote of confidence.

If it was me, I wouldn't have it.

It's not a booster, it's the same injection. Exactly the same. It was introduced because of waning immunity from the first. So your child should have enough immunity from the jab already given.

If your child has not gained immunity from the first jab there is a reason for that, to do with your child's immune system. It's very possible that that reason would also mean he does not gain immunity from a second jab too.

Too many risks, too few benefits. If it was me, I wouldn't do it.

Musukebba why is it NOT ok if there is not an outbreak?

Fattipuff, if you had measles/mumps yourself and if you weren't vaccinated yourself you should pass a temporary immunity to your baby.

stuffit: you are taking my advice a bit too literally and then reversing the logic inappropriately. It doesn't mean it's not OK to have them close together in another situation.

Many vaccines are used differently in outbreaks, in order to get as many local people immunised as possible in the shortest time. The mumps component of MMR can be less immunogenic and so two doses are needed to be sure. You have to wait a certain length of time between doses; but there's no consistent evidence of harm, or that giving both doses closer together makes the overall immunisation less effective.

Your general statements about a vaccine failure being to do with the child's immune system are inaccurate and very misleading.

You say the risks of giving a second MMR in an outbreak situation outweigh the benefits. What are these 'risks' exactly and where is the objective evidence to support your advice?

I think saying it's OK in an outbreak implies it's not OK, or less OK, when not in an outbreak. It implies that because the risk is greater, it cancels out the/any perceived risk of the second jab. But it seems that's not what you meant. It wasn't clear.

Would you link the studies saying there is no consistent evidence of harm? Or any studies specifically on giving MMR a month apart wrt adverse effects? It's my understanding that the "safe four weeks apart" advice is given not wrt the adverse effects but wrt to the immunogenicity.

The risks? All the risks associated with the MMR up to and including death. However we both know that those are the risks with the vaccine generally, and not wrt them being given closely together. We also know that safety studies on the MMR were "inadequate". So it would be great to see a link to a study of children given the vaccine four weeks apart.

I asked first...

Surely the sensible thing to do is to offer the single vaccine for whichever MMR disease is doing the rounds to the people who could be at risk for it.

Ah but of course we can't do that because our government has made the insane decision to refuse to offer single vaccines under any circumstances.

Alternatively children could be tested for immunity to see if they actually need boosted. Perhaps the money saved on vaccines that wouldn't need to be given would go some way to canceling out the cost of testing for those who only see the bottom line.

Triple vaccines are well documented as being more reactive then singles. There is no excuse for pushing a triple vaccine when it is medically unnecessary. Unnecessary medical intervention breaks a code of ethics that is in place to protect the public. The government rides roughshod over this time and time again. Shame on them.

The whole concept of the blanket MMR booster in order to catch the supposedly tiny percentage who need it is indefensible.

With regards to vaccine failure, there is documentation examining female non takers of rubella vaccine for example.

Some people do not develop antibodies despite repeat vaccines. If I have time later I'll see if I can find the stuff I read on it.

I'm guessing that is the sort of thing Suffitllama is referring to. It seems logical that this type of non taker reaction is due to the individual's immune system and the way they react to vaccines/disease.