To ask if YOU having MMR?

(259 Posts)
foreverondiet Wed 24-Apr-13 23:30:37

Ok. I have vaccinated my dc according to schedule. I got an email at work today from occupational health people (not healthcare or similar) saying that if you a) born after 1972 b) didn't have 2 doses MMR and c) didn't have confirmed case measles then should have MMR now! I asked my Dad (retired gp) and he said I had one measles jab as child, didn't have mmr (although my younger brother did) - he said v v likely I was immune. However he thought slight risk of not being immune.

I am sure a lot of you fall into the category above (most people born between 1972 and 1980) - so who is having.

I don't work with children or in healthcare - I work in an office.

MyDarlingClementine Fri 26-Apr-13 18:40:00

Had my MMR today, I only had one measles jab, doc said I could have another one.
DH has no vaccination records and has had one MMR today also, another one soon.

noblegiraffe Fri 26-Apr-13 19:39:52

Are you in an outbreak area, Clementine, or are they offering in non-outbreak areas too?

There's been two confirmed cases in my London borough and a few in the neighbouring boroughs, so I've emailed my doctors to ask if I need to have the MMR.

I was born in 1980. I remember vividly having my pre-school boosters. (but not sure what they were) I had rubella in my last year of primary school. TB and a measles jab (due to outbreak) in secondary school. But would like to know if I am immune.

I work with small children and pregnant mums, and are thinking about TTC.

MyDarlingYoni Fri 26-Apr-13 20:35:58

no, but have baby and am going away, am concerned about airport etc.

shufflehopstep Fri 26-Apr-13 23:18:25

I had mine today. Nurse actually said that in our particular area, uptake of vaccines is about 91% so there shouldn't be a problem, however, my mum and dad live not too far from an outbreak area so just thought we'd be on safe side. My little girl is due for her first MMR injection next month but as husband and I are not immune and she won't be fully covered until after her second one, we thought it better to be safe than sorry.

The nurse did say I only needed one as I have already had mumps (the illness) and my rubella jab. She did run through side effects and I can look forward to mild mumps and measles symptoms over the next week or so. Lovely.

MyDarlingYoni Sat 27-Apr-13 00:22:38

Hoefully you wont get side affects though.

OrlaKiely Sat 27-Apr-13 08:35:36

Does anyone know if having had the illness makes you more immune than having the vaccination? iyswim?

WhyParkThere Sat 27-Apr-13 11:16:51

I'm in the outbreak area and having mine at school on Wednesday. We have all been told we will need second jab after 4 weeks.

lisson Sat 27-Apr-13 13:26:50

surely if you are immune then you are immune? (like if you are pregnant then you can't be a little bit pregnant) Not being pedantic... I just don't understand.

GoombayDanceBand Sat 27-Apr-13 15:07:27

Lisson I think these has been some suggestion that the protection from the vaccine isn't lifelong iyswim. Whereas having the illness might protect someone for longer - I don't know?

There are two issues, vaccine efficacy and waning immunity.

After 2 doses of MMR protection conferred is estimated at nearly 100% for measles, measured by antibody titres (95% for one dose). That means that 5% of people vaccinated will not display levels of antibodies though to indicate immunity after only 1 shot. Hence the second shot ref. There will be a very small proportion still not displaying high antibody titres after the second shot as 100% efficacy is not guaranteed.

It is thought if you have the measles virus naturally then you have life long protection. The vaccine offers long term protection, but it may wane over time ref as an example.

The mumps component has been estimated to be between 91 to 94.6% effective even after the second shot and only with the Jeryl Lynn strain (the Urabe and Rubini strains were less effective, in early MMR and there were outbreaks in the UK in vaccinated individuals ref). Therefore even after 2 MMR shots 9 to 5.4% may not be adequately protected.

There are cases of reinfection from mumps in both vaccinated individuals (see ref above) and those who have natural immunity (1-2% suggested here though not sure where they get that figure from). There is also waning immunity shown in this study in vaccinated children.

Rubella as part of MMR is 95% effective after one dose. Both vaccine and natural immunity can wane over time, naturally immune people tend to have higher antibody titres ref. It is possible to get reinfected with rubella.

GoombayDanceBand Sat 27-Apr-13 16:38:38

thankyou for explaining.

CoteDAzur Sat 27-Apr-13 17:29:52

I don't know about waning natural immunity and getting childhood diseases multiple times. Before vaccinations came along, we all had these diseases. If you get one as a baby before immune system matures, you can get it again later on (the way I had measles twice). However, once immune to a childhood disease that you have had, you stay immune. If there are exceptions, there are surely very very rare and are due to a dysfunction of the immune system.

Vaccines, on the other hand, do not provide the same level of immune response. They are great, and have obviously saved generations from the devastation of diseases like small pox and polio, but the immunity they confer is not as dependable as natural immunity to a disease our immune system has actually fought.

Wannabestepfordwife Sat 27-Apr-13 18:07:10

I had the mmr jab in dec and jan my mum didn't want me to have it as a child. After having it I have been diagnosed as having hyperthyrodism and the mmr has been put down as a possible cause but tbh I think it was coincidence

That is true Cote, natural immunity is longer lasting than vaccine induced immunity. There are rare cases though of people having had mumps and rubella from the wild-type virus more than once. Viruses will mutate over time, so maybe that is part of it.

The immune system is still not fully understood, there are many factors which contribute to immunity, genetics, nutrition and stress, for example. Plus purely having high levels of antibodies does not necessarily mean immunity to a virus ref. The cell mediated response may be equally if not more important than the humoral in some cases.

CoteDAzur Sat 27-Apr-13 19:24:23

If viruses causing childhood diseases were to mutate, everyone would be reinfected.

I'm not sure what you are talking about, tbh.

CoteDAzur Sat 27-Apr-13 19:30:20

As I said before, when you have a disease as a baby, immunity doesn't necessary form. I had measles twice.. DS will probably have rubella twice (he had it once, but he was only 4 months old, so I don't think he is now immune).

This doesn't mean that natural immunity waned like vaccine immunity does.

There are women who have had rubella who do not test positive for antibodies when tested in pregnancy. If antibody titres are to be taken as a measure of immunity as they are in the case of vaccines then that would imply waning immunity.

There are rare cases when people are reinfected for whatever reason.

There are multiple strains of rubella viruses differing by up to 10% in their nucleotide sequence second pdf link here. We get multiple colds and influenza viral infections in our lifetimes because the viruses mutate. It is entirely possible that we could if exposed to a strain very different to the one we were originally infected by that we could exhibit symptoms of infection. We may not commonly come in contact with them (the Mongolian strain for example) therefore not everyone would be reinfected.

CoteDAzur Sat 27-Apr-13 20:36:23

You know they have had rubella because...?

I'm asking because rubella is so mild and transient that most times it goes unnoticed. Parents usually don't realise their babies/children have had it, and even it they notice a rash and take them to the doctor for a diagnosis, they get told that it looks like a mild viral infection and will be fine. Given that it lasts about a day and can only be diagnosed by a blood test, it is quite difficult to be sure that one has had rubella, rather than some other viral infection that would present with a very similar rash.

In fact, the only way to make sure that you have had rubella is to test immune to it. Natural immunity just doesn't wane in the way that vaccine immunity does.

And slight changes in the genotype don't mean that we will be reinfected with all of them if we come into contact, as I'm sure you well know. And we don't.

You cannot be sure without testing for rubella, but you can take anecdotal evidence. The hpa only has lab confirmed cases post 1996 on their website, you would have to take their word for it that all notifications pre 1996 were actually rubella too.

Ref talking about decreasing antibody titres for natural rubella antibodies here. Also mentions larger decreases for vaccinated individuals.

I have not said that natural immunity wanes in the same way vaccine induced immunity does. Before vaccinations individuals would have been more commonly exposed to childhood illnesses within the population post infection, thus naturally boosting their antibody levels. We see less wild type cases now so less chance to boost antibody levels and therefore natural immunity.

No just coming into contact with a new strain of a virus does not mean we would all be reinfected, individual immune response would play a part, some may be exposed and exhibit no symptoms at all.

foreverondiet Sat 27-Apr-13 21:48:53

iwish I also have autoimmune thyroiditis - why would that make a difference? I know I am immune to rubella and I had mumps so only measles I am worried about - although did have single vax as baby....

infamouspoo Sun 28-Apr-13 12:08:12

dd3 was diagnosed with rubella by a GP but he didnt order blood tests. He just examined the rash, her and declared it was rubella and he hadnt seen a case for a while (he was an older GP).

1985 here

Don't believe I have been vaccinated

Both DDs have been vaccinated

I would if offered - no questions

Got an email back from Doctors that says:

"Patient has only has one dose MR in 1994 - patient needs to have 2 doses MMR a month apart and not be pregnant or intend to get pregnant for 3/12 (^3 months?^) after being vaccinated."

Off to book an appointment...

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