Tag: attenuated vaccines

Can I Get Rotavirus from My Recently Vaccinated Baby?

Your two month old recently got her vaccines, including the rotavirus vaccine.

Shedding Season is not a real thing.
Shedding Season is not a real thing.

Now you have diarrhea.

Was it from shedding from your child’s rotavirus vaccine?

Does the Rotavirus Vaccine Shed?

Like some other live virus vaccines, it is well known that the rotavirus vaccine can shed.

And like with most other vaccines, this shedding isn’t usually a cause for concern and definitely isn’t a reason to think about skipping or delaying your child’s vaccines.

Why not?

“All members of the household should wash their hands after changing the diaper of an infant. This minimizes rotavirus transmission, for an undetermined number of weeks after vaccination, from an infant who received rotavirus vaccine.”

General Recommendations on Immunization Recommendations of the Advisory Committee on Immunization Practices (ACIP)

If you wash your hands when you change your child’s diapers after they have been vaccinated, just like you hopefully do anyway, you can avoid any possible contact with any rotavirus vaccine virus that might be shed in your child’s stool.

Can I Get Rotavirus from My Recently Vaccinated Baby?

But what would be the risk of your getting sick if you did come into contact with shedding rotavirus vaccine virus in your child’s diaper?

Would you be at risk to get sick?

Did your baby get sick after getting the actual vaccine?

That’s the thing about shedding that many people don’t understand. These live vaccines are made with attenuated or weakened strains of viruses, so they don’t typically get you sick when you are vaccinated. And they don’t typically get you sick when you are exposed through shedding. In fact, this shedding can sometimes help build herd immunity, as more people get exposed to the weakened strain of vaccine virus.

But can they get you sick?

Yes, if you have a problem with your immune system, which is why there are warnings about giving live vaccines to folks who are immunocompromised. And there used to be warnings about giving the oral polio vaccine to kids if they were around anyone with an immune system problem.

Vaccine viruses could also get you sick if they mutated from their attenuated state and became more virulent. Fortunately, that rarely happens with most vaccines.

“The theoretical risk of HRV and PRV shedding, transmission to, and infection of immunocompromised contacts is much lower than the real risk of wildtype rotavirus infection transmitted from unvaccinated children.”

Anderson on Rotavirus vaccines: viral shedding and risk of transmission

And most importantly, since kids are much more likely to shed virus after natural infections, it is much safer for everyone to get vaccinated and protected with these vaccines.

Surprisingly, even children with asymptomatic natural rotavirus infections can shed virus for several weeks, which is likely why these infections used to spread so easily or without known contacts.

Something that will likely surprise some folks even more is the news that just because someone gets diarrhea after being exposed to the rotavirus vaccine, either because they were vaccinated or through shedding, it doesn’t mean that the vaccine was the cause of the diarrhea!

“Of note, among all six AGE cases which possessed Rotarix-derived strains, four (sample No.1, 5, 6 and 7) were suspected to be caused by other pathogens. Most likely, the infants were infected with other pathogens during the shedding period of Rotarix strain.”

Kaneko et al on Identification of vaccine-derived rotavirus strains in children with acute gastroenteritis in Japan, 2012-2015

When vaccine strain rotavirus have been detected in kids with gastroenteritis, they often have other reasons to have diarrhea.

What does this all mean?

Don’t believe all of the hype anti-vaccine folks push about shedding from vaccines.

More on Shedding and Rotavirus Vaccines

Who is Joseph Meister

Most people know the big names in the history of vaccines.

They know that Edward Jenner developed the first smallpox vaccine (1798) and that both Jonas Salk (1955) and Albert Sabin (1960s) developed polio vaccines.

Many other important names are forgotten though.

Ever heard of James Phipps? He was the 8-year-old boy who was the first to become inoculated with cowpox by Jenner to see if it would protect him from smallpox.

Who is Joseph Meister

Edward Jenner didn’t go out of his way to experiment on Joseph Meister, but he has a similar story.

A plaque honors Joseph Meister and Louis Pasteur in the Alsace region of France.
A plaque honors Joseph Meister and Louis Pasteur in the Alsace region of France.

In 1885, Louis Pasteur had been working on an attenuated (weakened) rabies vaccine in his lab in Paris, but had still not tested it on any human patients yet.

One hot July morning in 1885, feverish little Joseph Meister was dragged by his frantic mother through the streets of Paris in search of an unknown scientist who, according to rumors, could prevent rabies. For nine-year-old Joseph had been bitten in 14 places by a huge, mad dog and in a desperate attempt to cheat death, his mother had fled from their home town in Alsace to Paris. Early in the afternoon Mme Meister met a young physician in a hospital. “You mean Pasteur,” he said. “I’ll take you there.”

Time magazine 1939

Supervised by two doctors, Dr. Alfred Vulpian and Dr. Jacques-Joseph Grancher, Joseph Meister received the first of 14 doses of Pasteur’s rabies vaccine on July 6, 1885, two days after he was bitten.

Joseph Meister survived and became the first person to be successfully vaccinated against rabies.

“As the death of this child appeared inevitable, I decided, not without deep and severe unease, as one can well imagine, to try on Joseph Meister the procedure which had consistently worked in dogs.”

Louis Pasteur

So at about the same time as anti-vaccine folks were marching in Leicester, Joseph Meister’s mother traveled over 400km to see a doctor she didn’t know, to get her son an experimental vaccine that had never even been used on a person before.

News of the Newark kids going to Paris to get Pasteur's rabies vaccine made the front page of the New York Times.
News of the Newark kids going to Paris to get Pasteur’s rabies vaccine made it into the New York Times.

Her son was lucky that she did.

It saved his life.

A few months later, a teenager named Jean-Baptiste Jupille was bitten by a rabid dog as he saved six other children that were being attacked. He became the second person to receive Pasteur’s rabies vaccine and he too lived.

Soon, Pasteur was a hero and many people were seeking his rabies vaccine from all over the world.

In December 1885, six boys from Newark, New Jersey were bitten by a rabid dog and there were calls to send them to Paris to be treated by Pasteur. Donations were collected and four of the boys ended up going on the steamship Canada to Paris.

While that trip to Paris generated some controversy, as some later doubted that the dog had rabies, there is no doubt that Pasteur’s rabies vaccine saved a lot of lives.

Few people survived having rabies in the pre-vaccine era.
Few people survived having rabies in the pre-vaccine era.

Why were folks in Newark, and apparently everywhere else, so afraid of rabies?

It had only been a few months earlier, about the time that Joseph Meister was being successfully vaccinated in Paris, that newspapers were reporting about “the terrible death” of a 5-year-old in Newark “after suffering the most intense agony.”

He had rabies.

Even if news of that case wasn’t fresh on their minds, it is easy to see that rabies wasn’t something you survived.

It should come as no surprise that there were soon rabies treatment clinics in major cities all over the world using Pasteur’s vaccine.

What to Know About Joseph Meister

At about the same time as anti-vaccine folks were marching in Leicester, Joseph Meister’s mother traveled over 400km to see a doctor she didn’t know, to get her son an experimental vaccine that had never been used on a person before – to save him from rabies.

More About Joseph Meister

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Attenuated Vaccines

An attenuated vaccine is one that has been weakened, so that it can’t make you sick, but will still trigger the creation of antibodies and an immune reaction.

Attenuated Vaccines

Examples of attenuated vaccines include the:

  • chicken pox vaccine
  • nasal spray flu vaccine
  • MMR vaccine
  • oral polio vaccine
  • oral typhoid vaccine
  • rotavirus vaccines
  • shingles vaccine
  • smallpox vaccine
  • yellow fever vaccine

These are all live vaccines and are often described as being “the closest thing to a natural infection.”

The main downside of live, attenuated vaccines, in addition to the fact that they can’t usually be given to people with immune system problems, is that there is always the “remote possibility exists that an attenuated microbe in the vaccine could revert to a virulent form and cause disease.”

That became a concern with the oral polio vaccine and the very small risk of vaccine-associated paralytic poliomyelitis (VAPP). It has not been an issue with other live, attenuated vaccines, such as measles or flu.

More on Attenuated Vaccines