Tag: MMR

Can Vaccines Cause Arthritis?

Many people think that vaccines can cause arthritis.

Vaccines and Arthritis

That’s not surprising, as there are many case reports associating vaccines and arthritis.

Arthritis is even listed as an adverse reaction in the package insert for the MMR vaccine.

While rubella vaccines can cause arthritis, so can a rubella infection.
While rubella vaccines can cause arthritis, so can a rubella infection.

And chronic arthritis is also listed as a table injury for vaccines containing the rubella virus.

Can Vaccines Cause Arthritis?

So that means that vaccines cause arthritis, right?

Actually, no, it doesn’t. At least not the type of arthritis that most people associate with the term arthritis.

Wait, what does that mean?

Vaccines do not cause juvenile arthritis or rheumatoid arthritis, for example.

“Rubella-containing vaccines (e.g. MMR) can cause mild, acute, transient arthralgia or arthritis, rarely in children but very commonly in certain adult women (between 10-25% of adult female vaccinees without preexisting rubella immunity), usually beginning 1-3 weeks after vaccination and then persisting up to 3 weeks. Other vaccines currently routinely recommended to the general population in the U.S. have not been shown to cause chronic arthralgia or arthritis.”

Do Vaccines Cause Arthralgia or Arthritis?

While rubella-containing vaccines can cause arthritis, it is a mild type of arthritis that is usually temporary, lasting about two days.

“Postpubertal females should be informed of the frequent occurrence of generally self-limited arthralgia and/or arthritis beginning 2 to 4 weeks after vaccination.”

MMR-II Package Insert

It is also rare in children.

And it also occurs after a natural rubella infection. In fact, up to 70% of adult women with rubella develop arthralgia or arthritis.

Of course, arthritis isn’t the rubella complication that we worry about…

During the rubella epidemic in the United States just before the rubella vaccine was developed, there were 2,000 cases of encephalitis, 11,250 therapeutic or spontaneous abortions, 2,100 neonatal deaths, and 20,000 babies born with congenital rubella syndrome.

Vaccines for Arthritis

Except for temporary arthritis after the rubella vaccine, not only do vaccines not cause arthritis, it is recommended that people with chronic arthritis get vaccinated.

“Keeping up with your vaccinations is always a smart move, but getting immunized is especially important when you have an autoimmune disease like rheumatoid arthritis (RA). Both RA and the medicines you take to treat it can increase your risk for infections.”

RA & Vaccinations

And one day, we might even have therapeutic vaccines for arthritis!

Rheumavax completed a phase I clinical trial in Australia a few years ago. That led to the development of a new drug, DEN-181, that is now in phase 1 trials.

What to Know About Vaccines Causing Arthritis

Rubella containing vaccines can cause mild, temporary arthritis, but mostly in postpubertal females and less commonly than after a natural rubella infection.

More on Vaccines and Arthritis

How Do You Know If You Have Measles Immunity?

With all of the measles cases, you might be wondering if you have immunity to measles?

Are you worried that you might get measles?

Should you get a booster dose of MMR?

Or a titer test?

How Do You Know If You Have Measles Immunity?

Fortunately, most of us can feel confident that we do have measles immunity and that we won’t get caught up in any of the ongoing outbreaks.

Why?

If you have had two doses of MMR, then you can be confident that you have measles immunity.
If you have had two doses of MMR, then you can be confident that you have measles immunity.

Because we are vaccinated and protected!

If you haven’t had two doses of MMR (or any measles containing vaccine since 1967), then understand that two doses is your best protection against measles.

Is There a Blood Test for Measles Immunity?

What about titer tests?

While there is a blood or titer test for measles immunity, it isn’t routinely used.

The one situation in which a measles titer test might be useful though, is for those born before 1957 to confirm that they really had measles.

For others considering a titer test in place of vaccination, it is typically better to just get another dose of MMR, but only if you haven’t already had two doses.

Why Was My Measles Titer Negative?

A positive measles titer does mean that you are immune, but what about a negative measles titer?

“For HCP who have 2 documented doses of MMR vaccine or other acceptable evidence of immunity to measles, serologic testing for immunity is not recommended. In the event that a HCP who has 2 documented doses of MMR vaccine is tested serologically and determined to have negative or equivocal measles titer results, it is not recommended that the person receive an additional dose of MMR vaccine. Such persons should be considered to have presumptive evidence of measles immunity. Documented age-appropriate vaccination supersedes the results of subsequent serologic testing.”

Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

If you have had two doses of MMR and have a negative measles titer, you don’t need another dose of MMR. You are likely immune, even with that negative titer.

“Most vaccinated persons who appear to lose antibody show an anamnestic immune response upon revaccination, indicating that they are probably still immune.”

Epidemiology and Prevention of Vaccine-Preventable Diseases

And since you would need a second dose if you had a negative titer after having just one shot, you might as well just get the second dose instead of checking your titer.

Do You Need a Measles Booster?

Have you had two doses of MMR?

If so, then you don’t need another dose.

The second dose isn’t technically a booster anyway. It is just for those who might not have responded to their first dose.

And two doses of MMR are about 97% effective at preventing measles.

That’s why most of the people in measles outbreaks are unvaccianted.

Neither primary nor secondary (waning immunity) vaccine failure are common with the measles vaccine.

What’s the biggest issue with the MMR? Folks who are still too scared to get their kids vaccinated and protected!

More on Measles Immunity

Who’s Getting Measles?

We will soon pass the last record high number of measles cases – 963 cases – set in 1994.

We will soon pass the last record high number of measles cases - 963 cases - set in 1994.

With 839 cases as of mid-April, it’s hard to believe that only 55 cases were reported during all of 2012!

Who’s Getting Measles?

So what do we know about the people who are getting measles?

More importantly, the thing that most parents want to know – are their families at risk?

We know that of the 839 cases right now:

  • 442 are in Brooklyn among the Orthodox Jewish community, where only 4% of cases have been fully vaccinated
  • 125 are in Rockland County, New York, among the Orthodox Jewish community, where only 3% of cases have been fully vaccinated
  • 78 were in the Pacific Northwest Outbreak (Washington and Oregon), where none were fully immunized – (ended)
  • 43 are in Michigan, mostly among Oakland County’s Orthodox Jewish community, triggered by a man who had recently traveled from New York

So just over 80% of cases are associated with four outbreaks, one of which has been declared over, and mostly among children and adults who were intentionally not vaccinated.

The rest of the 200 cases?

Among 45 cases in California, are 30 cases in these four outbreaks.
Among 45 cases in California, are 30 cases in these four outbreaks.

They are spread out in smaller outbreaks in other states, including Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, Oklahoma, Pennsylvania, Tennessee, and Texas.

Does that mean that you don’t have to worry about measles?

It means that you don’t have to panic about measles.

Get your kids vaccinated and protected, which might include an early dose of MMR, learn the signs and symptoms of measles, and keep up on news of outbreaks in your area.

That should help decrease the risk that they get caught up in an outbreak.

And double check your own vaccine records! Have you had an MMR vaccine? Have you had two doses?

Unfortunately, not everyone can get vaccinated and protected, which is causing some folks to panic. This includes those who are too young to be vaccinated, or fully vaccinated, and those with immune system problems.

That’s not fair.

Let’s stop the outbreaks so we don’t get to the point that measles truly is everywhere and even more high-risk people are put at risk.

More on Who’s Getting Measles

What’s Your Chance of Getting Measles Right Now?

It shouldn’t be a surprise that a lot of folks are thinking about their risk of getting measles right now.

But with record levels of measles cases this year, some of us are thinking about our level of risk much differently than others.

rIf you are unvaccinated and exposed to someone with measles, you risk is actually 1,000,000 times higher…

While most of us simply want to make sure we are vaccinated and protected, anti-vaccine folks are taking every opportunity to downplay their risks.

What’s Your Chance of Getting Measles Right Now?

So what’s your chance of getting measles?

“Measles is one of the world’s most contagious diseases. It is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions. The virus remains active and contagious in the air or on infected surfaces for up to 2 hours. It can be transmitted by an infected person from 4 days prior to the onset of the rash to 4 days after the rash erupts.”

WHO on Measles

That’s actually not that simple to figure out, but depends on:

Those who have had two doses, with no plans to travel, and who live in an area with no reported cases, are at extremely low risk to get measles – the risk won’t be zero until measles is eradicated.

In this kind of low risk situation, kids don’t need early doses of MMR vaccines and most adults can probably get away with just having one dose of MMR.

“Measles is highly contagious and spreads through the air when an infected person coughs or sneezes. It is so contagious that if one person has it, 9 out of 10 people of all ages around him or her will also become infected if they are not protected.”

CDC on Measles is Highly Contagious

On the other hand, if you are unvaccinated and were at the AMC Theater on Lemon Street in Fullerton, between 11 p.m. and 4 a.m. on April 25, then your chance of getting measles is about 90%!

Wait! That’s a little more than the 0.000092% chance that anti-vaccine folks are throwing around…

The odds of being hit by lightning are low because we practice storm safety and don’t run around outside when we see lightning!

To think of it another way, if you knew that your chances of getting hit by lightning were a little over 1 in a million, would that make you think it is okay to go outside and play golf during a severe thunderstorm?

Would you think the risk is so low that you could let your kids play outside if you heard thunder and saw lightning flashes nearby, or would you all rush inside?

That’s right! The risk of getting hit by lightning is low because most of us don’t take chances when we hear thunder or see lightning.

It’s the same with measles and other vaccine-preventable diseases.

The overall risk is low because most people are vaccinated and protected!

If you aren’t vaccinated and protected, as we see more and more cases, your risk of getting sick, and getting others sick, is going to continue to get higher and will always be much higher than someone who is fully vaccinated, no matter how much you want to believe in shedding, mild measles, or whatever myths help you justify keeping your kids unvaccinated and unprotected during an outbreak.

Remember, you can’t hide in the herd if you are scaring away too much the herd…

Vaccines are safe, with few risks, and are obviously necessary.

You can avoid getting measles.
You can greatly reduce your family’s risk of getting measles.

Make sure your family is protected so they don’t get caught up in a measles outbreak

More on Your Chance of Getting Measles