vaccination question

[Guest guest]

When some of the list members contacted their local veterinarians and other

Veterinarian schools we didn't find but one who had taken the vaccine.

This individual was a Vet who worked at the Army research

lab in VA (sometime in the past).

If anyone has any information to add, please do. I'm not sure if the

details are correct for the Army Veterinarian.

Gerry WA ANG

[Guest guest]

We have personally mailed a ton of them and so far all have responded that

they have not taken the vaccine. In the process of putting the info together

into a readable form for the list.

egs1018@... wrote:

> From: egs1018@...

>

> can anyone confirm the last time a US veterinarian was vaccinated against

anthrax? will help my argument during January drill... thanks. Eddie S.

[Guest guest]

Bare in mind the military has veterinarians. Both officers, and enlisted

personnel. They are primarily used as food inspectors in most areas. Thus

US veterinarians are vaccinated regularly, just probably not civilian types.

Dave

vaccination question

From: egs1018@...

can anyone confirm the last time a US veterinarian was vaccinated against

anthrax? will help my argument during January drill... thanks. Eddie S.

[Guest guest]

First thing we have to do is FIND a veterinarian that was vaccinated

against anthrax using the same schedule as the military is using, then

we can answer the question. Wish I could help but we are still looking

for one here in Oklahoma.

egs1018@... wrote:

>

> From: egs1018@...

>

> can anyone confirm the last time a US veterinarian was vaccinated against

anthrax? will help my argument during January drill... thanks. Eddie S.

[Guest guest]

I wrote IA St, Wis, OK ST, Cal , and K State and no one has had or

heard of anyone getting the vaccine. I also talked to a vet friend of my

neighbor whose dad was the head of the Minn vets assn and she does not know

of anyone who had the vaccine. She said you vaccininate your cow not your

self.

Jake

[Guest guest]

In a message dated 12/14/99 9:40:51 AM Eastern Standard Time,

jakec130@... writes:

<<

I wrote IA St, Wis, OK ST, Cal , and K State and no one has had or

heard of anyone getting the vaccine. I also talked to a vet friend of my

neighbor whose dad was the head of the Minn vets assn and she does not know

of anyone who had the vaccine. She said you vaccininate your cow not your

self. >>

Jake,

This is your chance to educate them to what is going on. Send them some

information and ask them to write their congressman/woman.

[Guest guest]

should i keep my son away from a child who was vaccinated yesterday for

measles being that my son is not vaccinated? can an unvaxed child catch a

disease from one who is recently vaxed? thanks, marla

[Guest guest]

In a message dated 1/29/02 3:52:14 PM GTB Standard Time, gadmrd@...

writes:

<<

should i keep my son away from a child who was vaccinated yesterday for

measles being that my son is not vaccinated? can an unvaxed child catch a

disease from one who is recently vaxed? thanks, marla

>>

I would not worry about it to much.My dd was sneezed/coughed in the face by

the neighbor girl(on purpose...little brat)who got her 4yo booster shot,and

my dd was fine.

Sara

[Guest guest]

At 08:49 AM 01/29/2002 EST, you wrote:

>should i keep my son away from a child who was vaccinated yesterday for

>measles being that my son is not vaccinated? can an unvaxed child catch a

>disease from one who is recently vaxed? thanks, marla

>

Yes, the potential is there with any live vaccine.

I don't know if you meant MMR - but its the same with separate, single

measles, mumps or rubella vaccines.

"

Excretion of small amounts of the live attenuated rubella virus from the

nose or throat has occurred in the majority of susceptible individuals 7-28

days after vaccination. There is no confirmed evidence to indicate that

such virus is transmitted to susceptible persons who are in contact with

the vaccinated individuals. Consequently, transmission through close

personal contact, while accepted as a theoretical possibility, is not

regarded as a significant risk.24 However, transmission of the rubella

vaccine virus to infants via breast milk has been documented (see Nursing

Mothers.)

There are no reports of transmission of live attenuated measles on mumps

viruses from vaccinees to susceptible contacts. "

DON'T agree with their statement of no reports of transmission from measles

or mumps.

See below

Mosby's GenRx®, 10th ed.

Copyright © 2000 Mosby, Inc.

------------------------------------------------------------------------

Measles, Mumps and Rubella Virus Vaccine Live (001704)

CATEGORIES:

Indications: Immunization, measles; Immunization, mumps; Immunization,

rubella

Pregnancy Category C

WHO Formulary

FDA Pre 1938 Drugs

FDA DRUG CLASS: Vaccines/Antisera

BRAND NAMES: Imovax-ROR (Greece); MMR II (Hong-Kong, Philippines, Taiwan,

South-Africa); M.M.R. II (Israel); M.M.R. Vaccine (Korea); M-M-R II (US);

M-M-R Vax (Germany, Austria); Morupar (Philippines); Mumeru Vax

(Philippines, Korea); Pluserix (Benin, Burkina-Faso, Ethiopia, Gambia,

Ghana, Guinea, Ivory-Coast, Kenya, Liberia, Malawi, Mali, Mauritania,

Mauritius, Morocco, Niger, Nigeria, Senegal, Seychelles, Sierra-Leone,

Sudan, Tanzania, Tunia, Uganda, Zambia, Zimbabwe, Germany, Belgium,

Greece); R.O.R. Vax (France); Trimovax (Bulgaria, Italy, Hong-Kong,

Thailand, Taiwan); Triviraten Berna (Hong-Kong, Malaysia, Philippines,

Thailand);

(International brand names outside U.S. in italics)

DESCRIPTION:

M-M-R II (Measles, Mumps, and Rubella Virus Vaccine Live) is a live virus

vaccine for immunization against measles (rubeola), mumps and rubella

(German measles).

M-M-R II is a sterile lyophilized preparation of (1) Attenuvax (Measles

Virus Vaccine Live), a more attenuated line of measles virus, derived from

Enders' attenuated Edmonston strain and grown in cell cultures of chick

embryo; (2) Mumpsvax (Mumps Virus Vaccine Live), the Jeryl Lynn (B level)

strain of mumps virus grown in cell cultures of chick embryo; and (3)

Meruvax II (Rubella Virus Vaccine Live), the Wistar RA 27/3 strain of live

attenuated rubella virus grown in human diploid cell (WI-38) culture.1,2The

vaccine viruses are the same as those used in the manufacture of Attenuvax

(Measles Virus Vaccine Live), Mumpsvax (Mumps Virus Vaccine Live) and

Meruvax II (Rubella Virus Vaccine Live). The three viruses are mixed before

being lyophilized. The product contains no preservative.

The reconstituted vaccine is for subcutaneous administration. When

reconstituted as directed, the dose for injection is 0.5 ml and contains

not less than the equivalent of 1,000 TCID50 (tissue culture infectious

doses) of the U.S. Reference Measles Virus; 20,000 TCID50of the U.S.

Reference Mumps Virus; and 1,000 TCID50of the U.S. Reference Rubella Virus.

Each dose contains approximately 25 mcg of neomycin. The product contains

no preservative. Sorbitol and hydrolyzed gelatin are added as stabilizers.

CLINICAL PHARMACOLOGY:

Clinical studies of 279 triple seronegative children, 11 months to 7 years

of age, demonstrated that M-M-R II is highly immunogenic and generally well

tolerated. In these studies, a single injection of the vaccine induced

measles hemagglutination-inhibition (HI) antibodies in 95 percent, mumps

neutralizing antibodies in 96 percent, and rubella HI antibodies in 99

percent of susceptible persons.

The RA 27/3 rubella strain in M-M-R II elicits higher immediate

postvaccination HI, complement-fixing and neutralizing antibody levels than

other strains of rubella vaccine3-9 and has been shown to induce a broader

profile of circulating antibodies including anti-theta and anti-iota

precipitating antibodies.10,11 The RA 27/3 rubella strain immunologically

simulates natural infection more closely than other rubella vaccine

viruses.11-13 The increased levels and broader profile of antibodies

produced by RA 27/3 strain rubella virus vaccine appear to correlate with

greater resistance to subclinical reinfection with the wild virus,11,13-15

and provide greater confidence for lasting immunity.

Vaccine induced antibody levels following administration of M-M-R II have

been shown to persist up to 11 years without substantial decline.16,43

Continued surveillance will be necessary to determine further duration of

antibody persistence.

INDICATIONS AND USAGE:

M-M-R II is indicated for simultaneous immunization against measles, mumps,

and rubella in persons 15 months of age or older. A second dose of M-M-R II

or monovalent measles vaccine is recommended (see Revaccination.)17,18,19

Infants who are less than 15 months of age may fail to respond to the

measles component of the vaccine due to presence in the circulation of

residual measles antibody of maternal origin, the younger the infant, the

lower the likelihood of seroconversion. In geographically isolated or other

relatively inaccessible populations for whom immunization programs are

logistically difficult, and in population groups in which natural measles

infection may occur in a significant proportion of infants before 15 months

of age, it may be desirable to give the vaccine to infants at an earlier

age. Infants vaccinated under these conditions at less than 12 months of

age should be revaccinated after reaching 15 months of age. There is some

evidence to suggest that infants immunized at less than one year of age may

not develop sustained antibody levels when later reimmunized. The advantage

of early protection must be weighed against the chance for failure to

respond adequately on reimmunization.20

Previously unimmunized children of susceptible pregnant women should

receive live attenuated rubella vaccine, because an immunized child will be

less likely to acquire natural rubella and introduce the virus into the

household.

Individuals planning travel outside the United States, if not immune, can

acquire measles, mumps or rubella and import these diseases to the United

States. Therefore, prior to International travel, individuals known to be

susceptible to one or more of these diseases can receive either a single

antigen vaccine (measles, mumps or rubella), or a combined antigen vaccine

as appropriate. However, M-M-R II is preferred for persons likely to be

susceptible to mumps and rubella; and if single-antigen measles vaccine is

not readily available, travelers should receive M-M-R II regardless of

their immune status to mumps or rubella.21,22,23

Non-Pregnant Adolescent and Adult Females: Immunization of susceptible

non-pregnant adolescent and adult females of childbearing age with live

attenuated rubella virus vaccine is indicated if certain precautions are

observed (see below and PRECAUTIONS). Vaccinating susceptible postpubertal

females confers individual protection against subsequently acquiring

rubella infection during pregnancy, which in turn prevents infection of the

fetus and consequent congenital rubella injury.24

Women of childbearing age should be advised not to become pregnant for

three months after vaccination and should be informed of the reasons for

this precaution.*

It is recommended that rubella susceptibility be determined by serologic

testing prior to immunization.** If immune, as evidenced by a specific

rubella antibody titer of 1:8 or greater (hemagglutination-inhibition

test), vaccination is unnecessary. Congenital malformations do occur in up

to seven percent of all live births.25 Their chance appearance after

vaccination could lead to misinterpretation of the cause, particularly if

the prior rubella-immune status of vaccinees is unknown.

Postpubertal females should be informed of the frequent occurrence of

generally self-limited arthralgia and/or arthritis beginning 2 to 4 weeks

after vaccination (see ADVERSE REACTIONS.)

Postpartum Women: It has been found convenient in many instances to

vaccinate rubella susceptible women in the immediate postpartum period.

(See Nursing Mothers.)

Revaccination: Children first vaccinated when younger than 12 months of age

should be revaccinated at 15 months of age.

The American Academy of Pediatrics (AAP), the Immunization Practices

Advisory Committee (ACIP), and some state and local health agencies have

recommended guidelines for routine measles revaccination and to help

control measles outbreaks.26.27***

*NOTE: The Immunization Practices Advisory Committee (ACIP) has recommended

" In view of the importance of protecting this age group against rubella,

reasonable precautions in a rubella immunization program include asking

females if they are pregnant, excluding those who say they are, and

explaining the theoretical risk to the others. " 24

**NOTE: The Immunization Practices Advisory Committee (ACIP)) has stated

" When practical, and when reliable laboratory services are available,

potential vaccinees of childbearing age can have serologic tests to

determine susceptibility to rubella.... However, routinely performing

serologic tests for all females of childbearing age to determine

susceptibility so that vaccine is given only to proven susceptibles is

expensive and has been ineffective in some areas. Accordingly, the ACIP

believes that rubella vaccination of a woman who is not known to be

pregnant and has no history of vaccination is justifiable without serologic

testing. " 24

***NOTE: A primary difference among these recommendations is the timing of

revaccination: the ACIP recommends routine revaccination at entry into

kindergarten or first grade, whereas the AAP recommends routine

revaccination at entrance to middle school or junior high school. In

addition, some public health jurisdictions mandate the age for

revaccination. The complete text of applicable guidelines should be

consulted.26,27

Vaccines available for revaccination include monovalent measles vaccine

(Attenuvax (Measles Virus Vaccine Live)) and polyvalent vaccines containing

measles (e.g., M-M-R II, M-R-VAX II (Measles and Rubella Virus Vaccine

Live)). If the prevention of sporadic measles outbreaks is the sole

objective, revaccination with a monovalent measles vaccine should be

considered (see appropriate product circular). If concern also exists about

immune status regarding mumps or rubella, revaccination with appropriate

monovalent or polyvalent vaccine should be considered after consulting the

appropriate product circulars. Unnecessary doses of a vaccine are best

avoided by ensuring that written documentation of vaccination is preserved

and a copy given to each vaccinee's parent or guardian.

Use with other Vaccines

Routine administration of DTP (diphtheria, tetanus, pertussis) and/or OPV

(oral poliovirus vaccine) concomitantly with measles, mumps, and rubella

vaccines is not recommended because there are limited data28relating to the

simultaneous administration of these antigens. M-M-R II should be given one

month before or after administration of other vaccines.

However, other schedules have been used. For example, the American Academy

of Pediatrics has noted that when the patient may not return, some

practitioners prefer to administer DTP, OPV, and M-M-R II on a single day.

If done, separate sites and syringes should be used for DTP and M-M-R

II.29The Immunization Practices Advisory Committee (ACIP) recommends

routine simultaneous administration of M-M-R II, DTP and OPV or inactivated

polio vaccine (IPV) to all children [image] 15 months who are eligible to

receive these vaccines on the basis that there are equivalent antibody

responses and no clinically significant increases in the frequency of

adverse events when DTP, M-M-R II and OPV (or IPV are administered either

simultaneously at different sites or separately.* Administration of M-M-R

II at 15 months followed by DTP and OPV (or IPV) at 18 months remains an

acceptable alternative, especially for children with caregivers known to be

generally compliant with other health-care recommendations.

*NOTE: The Immunization Practices Advisory Committee (ACIP) recommends

administering M-M-R II concomitantly with the fourth dose of DTP and the

third dose of OPV to children 15 months of age or older providing that 6

months have elapsed since DTP-3; or, if fewer than three DTPs have been

received, at least 6 weeks have elapsed since the last dose of DTP and OPV.

CONTRAINDICATIONS:

Do not give M-M-R II to pregnant females; the possible effects of the

vaccine on fetal development are unknown at this time. If vaccination of

postpubertal females is undertaken, pregnancy should be avoided for three

months following vaccination. See PRECAUTIONS, Pregnancy.

Anaphylactic or anaphylactoid reactions to neomycin (each dose of

reconstituted vaccine contains approximately 25 mcg of neomycin).

History of anaphylactic or anaphylactoid reactions to eggs (see WARNINGS,

Hypersensitivity To Eggs.)

Any febrile respiratory illness or other active febrile infection.

Active untreated tuberculosis.

Patients receiving immunosuppressive therapy. This contraindication does

not apply to patients who are receiving corticosteroids as replacement

therapy, e.g., for 's disease.

Individuals with blood dyscrasias, leukemia, lymphomas of any type, or

other malignant neoplasms affecting the bone marrow or lymphatic systems.

Primary and acquired immunodeficiency states, including patients who are

immunosuppressed in association with AIDS or other clinical manifestations

of infection with human immunodeficiency viruses;30,31cellular immune

deficiencies; and hypogammaglobulinemic and dysgammaglobulinemic states.

Individuals with a family history of congenital or hereditary

immunodeficiency, until the immune competence of the potential vaccine

recipient is demonstrated.32

WARNINGS:

Hypersensitivity To Eggs

Live measles vaccine and live mumps vaccine are produced in chick embryo

cell culture. Persons with a history of anaphylactic, anaphylactoid, or

other immediate reactions (e.g., hives, swelling of the mouth and throat,

difficulty breathing, hypotension, or shock) subsequent to egg ingestion

should not be vaccinated. Evidence indicates that persons are not at

increased risk if they have egg allergies that are not anaphylactic or

anaphylactoid in nature. Such persons may be vaccinated in the usual

manner. There is no evidence to indicate that persons with allergies to

chickens or feathers are at increased risk of reaction to the vaccine.20

PRECAUTIONS:

General

Adequate treatment provisions including epinephrine, should be available

for immediate use should an anaphylactic or anaphylactoid reaction occur.

Due caution should be employed in administration of M-M-R II to persons

with a history of cerebral injury, individual or family histories of

convulsions, or any other condition in which stress due to fever should be

avoided. The physician should be alert to the temperature elevation which

may occur following vaccination. (See ADVERSE REACTIONS.)

Children and young adults who are known to be infected with human

immunodeficiency viruses but without overt clinical manifestations of

immunosuppression may be vaccinated; however, the vaccinees should be

monitored closely for vaccine-preventable diseases because immunization may

be less effective than for uninfected persons.30,31

Vaccination should be deferred for at least 3 months following blood or

plasma transfusions, or administration of human immune serum globulin.

Excretion of small amounts of the live attenuated rubella virus from the

nose or throat has occurred in the majority of susceptible individuals 7-28

days after vaccination. There is no confirmed evidence to indicate that

such virus is transmitted to susceptible persons who are in contact with

the vaccinated individuals. Consequently, transmission through close

personal contact, while accepted as a theoretical possibility, is not

regarded as a significant risk.24 However, transmission of the rubella

vaccine virus to infants via breast milk has been documented (see Nursing

Mothers.)

There are no reports of transmission of live attenuated measles on mumps

viruses from vaccinees to susceptible contacts.

It has been reported that live attenuated measles, mumps and rubella virus

vaccines given individually may result in a temporary depression of

tuberculin skin sensitivity. Therefore, if a tuberculin test is to be done

it should be administered either before or simultaneously with M-M-R II.

Children under treatment for tuberculosis have not experienced exacerbation

of the disease when immunized with live measles virus vaccine;33 no studies

have been reported to date of the effect of measles virus vaccines on

untreated tuberculous children.

As for any vaccine, vaccination with M-M-R II may not result in

seroconversion in 100% of susceptible persons given the vaccine.

Pregnancy Category C

Animal reproduction studies have not been conducted with M-M-R II. It is

also not known whether M-M-R II can cause fetal harm when administered to a

pregnant woman or can affect reproduction capacity. Therefore, the vaccine

should not be administered to pregnant females; furthermore, pregnancy

should be avoided for three months following vaccination (see

CONTRAINDICATIONS.)

In counseling women who are inadvertently vaccinated when pregnant or who

become pregnant within 3 months of vaccination, the physician should be

aware of the following: (1) In a 10 year survey involving over 700 pregnant

women who received rubella vaccine within 3 months before or after

conception (of whom 189 received the Wistar RA 27/3 strain), none of the

newborns had abnormalities compatible with congenital rubella syndrome;34

(2) Although mumps virus is capable of infecting the placenta and fetus,

there is no good evidence that it causes congenital malformations in

humans. Mumps vaccine virus also has been shown to infect the placenta, but

the virus has not been isolated from the fetal tissues from susceptible

women who were vaccinated and underwent elective abortions;35 and (3)

Reports have indicated that contracting of natural measles during pregnancy

enhances fetal risk. Increased rates of spontaneous abortion, stillbirth,

congenital defects and prematurity have been observed subsequent to natural

measles during pregnancy. There are no adequate studies of the attenuated

(vaccine) strain of measles virus in pregnancy. However, it would be

prudent to assume that the vaccine strain of virus is also capable of

inducing adverse fetal effects.

Nursing Mothers

It is not known whether measles or mumps vaccine virus is secreted in human

milk. Recent studies have shown that lactating postpartum women immunized

with live attenuated rubella vaccine may secrete the virus in breast milk

and transmit it to breast-fed infants.36In the infants with serological

evidence of rubella infection, none exhibited severe disease; however, one

exhibited mild clinical illness typical of acquired rubella.37,38 Caution

should be exercised when M-M-R II is administered to a nursing woman.

ADVERSE REACTIONS:

Burning and/or stinging of short duration at the injection site have been

reported.

The adverse clinical reactions associated with the use of M-M-R II are

those expected to follow administration of the monovalent vaccines given

separately. These may include malaise, sore throat, cough, rhinitis,

headache, dizziness, fever, rash, nausea, vomiting or diarrhea; mild local

reactions such as erythema, induration, tenderness and regional

lymphadenopathy; parotitis, orchitis, nerve deafness, thrombocytopenia and

purpura; allergic reactions such as wheal and flare at the injection site

or urticaria; polyneuritis; and arthralgia and/or arthritis (usually

transient and rarely chronic).

Anaphylaxis and anaphylactoid reactions have been reported.

Vasculitis has been reported rarely.

Otitis media and conjunctivitis have been reported.

Moderate fever (101-102.9°F (38.3-39.4°C)) occurs occasionally, and high

fever (above 103°F (39.4°C)) occurs less commonly. On rare occasions,

children developing fever may exhibit febrile convulsions. Afebrile

convulsions or seizures have occurred rarely following vaccination with

live attenuated measles vaccine. Syncope, particularly at the time of mass

vaccination, has been reported. Rash occurs infrequently and is usually

minimal, but rarely may be generalized. Erythema multiforme has also been

reported rarely.

Forms of optic neuritis, including retrobulbar neuritis, papillitis, and

retinitis may infrequently follow viral infections, and have been reported

to occur 1 to 3 weeks following inoculation with some live virus vaccines.

Clinical experience with live attenuated measles, mumps and rubella virus

vaccines given individually indicates that encephalitis and other nervous

system reactions have occurred very rarely. These might occur also with

M-M-R II.

Experience from more than 80 million doses of all live measles vaccines

given in the U.S. through 1975 indicates that significant central nervous

system reactions such as encephalitis and encephalopathy, occurring within

30 days after vaccination, have been temporally associated with measles

vaccine very rarely.39 In no case has it been shown that reactions were

actually caused by vaccine. The Center for Disease Control has pointed out

that " a certain number of cases of encephalitis may be expected to occur in

a large childhood population in a defined period of time even when no

vaccines are administered " . However, the data suggest the possibility that

some of these cases may have been caused by measles vaccines. The risk of

such serious neurological disorders following live measles virus vaccine

administration remains far less than that for encephalitis and

encephalopathy with natural measles (one per two thousand reported cases).

There have been rare reports of ocular palsies, Guillain-Barre syndrome, or

ataxia occurring after immunization with vaccines containing live

attenuated measles virus. The ocular palsies have occurred approximately

3-24 days following vaccination. No definite causal relationship has been

established between these events and vaccination. Isolated reports of

polyneuropathy including Guillain-Barre syndrome have also been reported

after immunization with rubella-containing vaccines.

There have been reports of subacute sclerosing panencephalitis (SSPE) in

children who did not have a history of natural measles but did receive

measles vaccine. Some of these cases may have resulted from unrecognized

measles in the first year of life or possibly from the measles vaccination.

Based on estimated nationwide measles vaccine distribution, the association

of SSPE cases to measles vaccination is about one case per million vaccine

doses distributed. This is far less than the association with natural

measles, 6-22 cases of SSPE per million cases of measles. The results of a

retrospective case-controlled study conducted by the Center for Disease

Control suggest that the overall effect of measles vaccine has been to

protect against SSPE by preventing measles with its inherent higher risk of

SSPE.40

Local reactions characterized by marked swelling, redness and vesiculation

at the injection site of attenuated live measles virus vaccines, and

systemic reactions including atypical measles, have occurred in persons who

received killed measles vaccine previously. M-M-R II was not given under

this condition in clinical trials. Rarely, more severe reactions that

require hospitalization, including prolonged high fevers and extensive

local reactions, have been reported.41Panniculitis has been reported rarely

following administration of measles vaccine.42

Arthralgia and/or arthritis (usually transient and rarely chronic), and

polyneuritis are features of natural rubella and vary in frequency and

severity with age and sex, being greatest in adult females and least in

prepubertal children. This type of involvement as well as myalgia and

paresthesia, have also been reported following administration of Meruvax II

(Rubella Virus Vaccine Live).

Chronic arthritis has been associated with natural rubella infection and

has been related to persistent virus and/or viral antigen isolated from

body tissues. Only rarely have vaccine recipients developed chronic joint

symptoms.

Following vaccination in children, reactions in joints are uncommon and

generally of brief duration. In women, incidence rates for arthritis and

arthralgia are generally higher than those seen in children (children:

0-3%; women: 12-20%),43 and the reactions tend to be more marked and of

longer duration. Symptoms may persist for a matter of months or on rare

occasions for years. In adolescent girls, the reactions appear to be

intermediate in incidence between those seen in children and in adult

women. Even in older women (35-45 years), these reactions are generally

well tolerated and rarely interfere with normal activities.

DOSAGE AND ADMINISTRATION:

FOR SUBCUTANEOUS ADMINISTRATION

Do not inject intravenously

The dosage of vaccine is the same for all persons. Inject the total volume

of the single dose vial (about 0.5 ml) or 0.5 ml of the 10 dose vial of

reconstituted vaccine subcutaneously, preferably into the outer aspect of

upper arm. Do not give immune globulin (IG) concurrently with M-M-R II.

During shipment, to insure that there is no loss of potency, the vaccine

must be maintained at a temperature of 10°C (50°F) or less.

Before reconstitution, store M-M-R II at 2-8°C (36-46°F).Protect from light

..

CAUTION: A sterile syringe free of preservatives, antiseptics, and

detergents should be used for each injection and/or reconstitution of the

vaccine because these substances may inactivate the live virus vaccine. A

25 gauge, 5/8 " needle is recommended.

To reconstitute, use only the diluent supplied, since it is free of

preservatives or other antiviral substances which might inactivate the

vaccine.

Single Dose Vial --First withdraw the entire volume of diluent into the

syringe to be used for reconstitution. Inject all the diluent in the

syringe into the vial of lyophilized vaccine, and agitate to mix

thoroughly. Withdraw the entire contents into a syringe and inject the

total volume of restored vaccine subcutaneously.

It is important to use a separate sterile syringe and needle for each

individual patient to prevent transmission of hepatitis B and other

infectious agents from one person to another.

10 Dose Vial (available only to government agencies/institutions) Withdraw

the entire contents (7 ml) of the diluent vial into the sterile syringe to

be used for reconstitution, and introduce into the 10 dose vial of

lyophilized vaccine. Agitate to ensure thorough mixing. The outer labeling

suggests " For Jet Injector or Syringe Use " . Use with separate sterile

syringes is permitted for containers of 10 doses or less. The vaccine and

diluent do not contain preservatives; therefore, the user must recognize

the potential contamination hazards and exercise special precautions to

protect the sterility and potency of the product. The use of aseptic

techniques and proper storage prior to and after restoration of the vaccine

and subsequent withdrawal of the individual doses is essential. Use 0.5 ml

of the reconstituted vaccine for subcutaneous injection.

It is important to use a separate sterile syringe and needle for each

individual patient to prevent transmission of hepatitis B and other

infectious agents from one person to another.

Each dose contains not less than the equivalent of 1,000 TCID50of the U.S.

Reference Measles Virus, 20,000 TCID50 of the U.S. Reference Mumps Virus

and 1,000 TCID50 of the U.S. Reference Rubella Virus.

Parenteral drug products should be inspected visually for particulate

matter and discoloration prior to administration. M-M-R II, when

reconstituted, is clear yellow.

Storage

It is recommended that the vaccine be used as soon as possible after

reconstitution. Protect vaccine from light at all times, since such

exposure may inactivate the virus. Store reconstituted vaccine in the

vaccine vial in a dark place at 2 - 8°C (36 - 46°F) and discard if not used

within 8 hours.

REFERENCES:

1) Plotkin, S. A.; Cornfeld, D.; Ingalls, T. H.: Studies of immunization

with living rubella virus: Trials in children with a strain cultured from

an aborted fetus, Am. J. Dis. Child. 110: 381-389, 1965. 2) Plotkin, S. A.;

Farquhar, J.; Katz, M.; Ingalls, T. H.: A new attenuated rubella virus

grown in human fibroblasts: Evidence for reduced nasopharyngeal excretion,

Am. J. Epidemiol. 86: 468-477,1967. 3) Fogel, A.; Moshkowitz, A.; Rannon,

L.; Gerichter, Ch. B.: Comparative trials of RA 27/3 and Cendehill rubella

vaccines in adult and adolescent females, Am. J. Epidemiol. 93: 392-393,

1971. 4) Andzhaparidze, O. G.; Desyatskova, R. G.; Chervonski, G. I.;

Pryanichnikova, L. V.: Immunogenicity and reactogenicity of live attenuated

rubella virus vaccines, Am. J. Epidemiol. 91: 527-530, 1970. 5) Freestone,

D. S.; Reynolds, G. M.; McKinnon, J. A.; Prydie, J.: Vaccination of

schoolgirls against rubella. Assessment of serological status and a

comparative trial of Wistar RA 27/3 and Cendehill strain live attenuated

rubella vaccines in 13-year-old schoolgirls in Dudley, Br. J. Prev. Soc.

Med. 29: 258-261, 1975. 6) Grillner. L.; Hedstrom, C. E.; Bergstrom, H.;

Forssman, L.; Rigner, A.; Lycke, E.: Vaccination against rubella of newly

delivered women,Scand. J. Infect. Dis. 5: 237-241, 1973. 7) Grillner, L.:

Neutralizing antibodies after rubella vaccination of newly delivered women:

a comparison between three vaccines, Scand. J. Infect. Dis. 7: 169-172,

1975. 8) Wallace, R. B.; Isacson, P.: Comparative trial of HPV-77, DE-5 and

RA 27/3 live-attenuated rubella vaccines, Am. J. Dis. Child. 124: 536-538,

1972. 9) Lalla, M.; Vesikari, T.; Virolainen, M.: Lymphoblast proliferation

and humoral antibody response after rubella vaccination, Clin. Exp.Immunol.

15: 193-202, 1973. 10) LeBouvier, G. L.; Plotkin, S. A.: Precipitin

responses to rubella vaccine RA 27/3, J. Infect. Dis. 123: 220-223, 1971.

11) Horstmann, D. M.: Rubella: The challenge of its control, J. Infect.

Dis. 123: 640-654, 1971. 12) Ogra, P. L.; Kerr-Grant, D.; Umana, G.;

Dzierba, J.; Weintraub, D.: Antibody response in serum and nasopharynx

after naturally acquired and vaccine-induced infection with rubella virus,

N. Engl. J. Med.285: 1333-1339, 1971. 13) Plotkin, S. A.; Farquhar, J. D.;

Ogra, P. L.: Immunologic properties of RA 27/3 rubella virus vaccine, J.

Am. Med. Assoc. 225: 585-590, 1973. 14) Liebhaber, H.; Ingalls, T. H.;

LeBouvier, G. L.; Horstmann, D.M.: Vaccination with RA 27/3 rubella

vaccine. Persistence of immunity and resistance to challenge after two

years, Am. J. Dis. Child. 123: 133-136, 1972. 15) Farquhar, J. D.:

Follow-up on rubella vaccinations and experience with subclinical

reinfection, J. Pediatr. 81: 460-465, 1972. 16) Weibel, R. E.; Carlson, A.

J.; Villarejos, V. M.; Buynak, E. B.; McLean, A. A.; Hilleman, M. R.:

Clinical and Laboratory Studies of Combined Live Measles, Mumps, and

Rubella Vaccines Using the RA 27/3 Rubella Virus, Proc. Soc. Exp. Biol.

Med. 165: 323-326, 1980. 17) Bottiger, M.; Christenson, B.; Romanus, V.;

Taranger, J.; Strandell, A.: Swedish experience of two dose vaccination

programme aiming at eliminating measles, mumps, and rubella, Brit. Med. J.

295 (14): 1264-1267, November, 1987. 18) Markowitz, L. E.; Preblud, S. R.;

Orenstein, W. A.; et al: Patterns of transmission in measles outbreaks in

the United States, 1985-1986, N. Engl. J. Med. 320 (2): 75-81, January 12,

1989. 19) Peltola, H.; Heinonen, O. P.; Valle, M.; et al: Five-year

experience in elimination of indigenous measles, mumps, and rubella in

Finland, Abstracts of the 29th ICAAC, Houston, Texas, Abstract #179, 130,

September, 1989. 20) American Academy of Pediatrics: Report of the

Committee on Infectious Disease, ton, III., AAP, p. 136-137, 1982. 21)

Recommendations of the Immunization Practices Advisory Committee (ACIP),

Measles Prevention, MMWR 36 (26): 409-425, July 10, 1987. 22) Jong, E. C.,

The Travel and Tropical Medicine Manual, W. B. Saunders Company, p. 12-16,

1987. 23) Committee on Immunization Council of Medical Societies, American

College of Physicians, Phila., PA, Guide for Adult Immunization, First

Edition, 1985. 24) Recommendation of the Immunization Practices Advisory

Committee (ACIP), Morbidity and Mortality Weekly Report 33 (22): 301-310,

315-318, June 8, 1984. 25) McIntosh, R,; Merritt, K. K.; s, M. R.;

s, M. H.; Bellows, M. T.: The incidence of congenital malformations:

A study of 5,964 pregnancies, Pediatr. 14: 505-521, 1954. 26) American

Academy of Pediatrics, Committee on Infectious Diseases, Measles:

Reassessment of the Current Immunization Policy, Pediatrics 84 (6):

1110-1113, December, 1989. 27) Measles Prevention: Recommendations of the

Immunization Practices Advisory Committee (ACIP), Morbidity and Mortality

Weekly Report38 (S-9): 5-22, December 29, 1989. 28) Recommendations of the

Immunization Practices Advisory Committee (ACIP), General Recommendations

on Immunization, MMWR 38 (13) 205-228, April 7, 1989. 29) American Academy

of Pediatrics: Report of the Committee on Infectious Disease, ton,

III., 1982, p. 17. 30) Center for Disease Control: Immunization of Children

Infected with Human T-Lymphotropic Virus Type

III/Lymphadenopathy-Associated Virus, ls of Internal Medicine,106:

75-78, 1987. 31) Krasinski, K.; Borkowsky, W.; Krugman, S.: Antibody

following measles immunization in children infected with human T-cell

lymphotropic virus type III/lymphadenopathy associated virus (HTLV-III/LAV)

(Abstract). In: Program and abstracts of the International Conference on

Acquired Immunodeficiency Syndrome, Paris, France, June 23-25, 1986. 32)

Recommendation of the Immunization Practices Advisory Committee (ACIP),

General Recommendations on Immunization, Morbidity and Mortality Weekly

Report 32 (1): 13, January 14, 1983. 33) Starr, S.; Berkovich, S.: The

effect of measles, gamma globulin modified measles, and attenuated measles

vaccine on the course of treated tuberculosis in children, Pediatrics 35:

97-102, January, 1965. 34) Rubella vaccination during pregnancy--United

States, 1971-1981. Morbidity and Mortality Weekly Report 31 (35): 477-481,

September 10, 1982. 35) Recommendation of the Immunization Practices

Advisory Committee (ACIP), Mumps Vaccine, Morbidity and Mortality Weekly

Report31 (46): 617-620, 625, November 26, 1982. 36) Losonsky, G. A.;

Fishaut, J. M.; Strussenber, J.; Ogra, P. L.: Effect or immunization

against rubella on lactation products. II. Maternal-neonatal interactions,

J. Infect. Dis. 145: 661-666, 1982. 37) Landes, R. D.; Bass, J. W.;

Millunchick, E. W.; Oetgen, W. J.: Neonatal rubella following postpartum

maternal immunization, J. Pediatr. 97: 465-467, 1980. 38) Lerman, S. J.:

Neonatal rubella following postpartum maternal immunization, J. Pediatr.

98: 668, 1981. (Letter) 39) CDC. Important Information about Measles,

Mumps, and Rubella, and Measles, Mumps, and Rubella Vaccines. 1980. 1983.

40) CDC, Measles Surveillance, Report No. 11, p. 14, September, 1982. 41)

Recommendation of the Immunization Practices Advisory Committee (ACIP),

Measles Prevention, Morbidity and Mortality Weekly Report 31 (17): 217-224,

229-231, May 7, 1982. 42) Buck, B. E.; Yang, L. C.; Caleb, M. H.; Green, J.

M.; South, M. A.: Measles virus panniculitis subsequent to vaccine

administration, J. Pediatrics 101 (3): 366-373, 1982. 43) Unpublished data

from the files of Merck Sharp and Dohme Research Laboratories.

--------------------------------------------------------

Sheri Nakken, R.N., MA

Vaccination Information & Choice Network, Nevada City CA & Wales UK

$$ Donations to help in the work - accepted by Paypal account

vaccineinfo@...

(go to http://www.paypal.com) or by mail

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http://www.nccn.net/~wwithin/vaccine.htm

ANY INFO OBTAINED HERE NOT TO BE CONSTRUED AS MEDICAL OR LEGAL ADVICE. THE

DECISION TO VACCINATE IS YOURS AND YOURS ALONE.

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[Guest guest]

I think this depends a whole lot on the individual bio-medical profile of

your child (in addition to the vaccines themselves and what is in them).

I've read lots of examples of children regressing after an MMR booster.

---Does your child have autism or any related condition (including sensory

integration issues)?

---Does your child have allergies?

---Do you know whether your son's selenium and glutathione levels are ok

(these help the body process toxins)?

---It turns out some populations carry a higher genetic risk of damage from

vaccines due to a slight mutation of the MTHFR gene b/c they are a little

less capable than everyone else of basic detoxification. This mutation is

prevalent in people of European origins. For example, up to 70% of the

Irish carry it.

--Does your child have any amalgam dental fillings?

--Did your child react to any other vaccines to your knowledge (fever,

" knot " at site of injection, etc etc)

Have you taken a look at Dr. Cave's What Your Doctor May Not Tell

You About Childhood Vaccines? (A Great book)? It may help you make your

decision.

Also, please go to www.nvic.org <http://www.nvic.org/> and read up on the

individual vaccines your child is due to receive.

If you do decide to go ahead with the vaccines, insist on writing the lot

and batch number and manufacturer of the vaccines down for your own records

and - most importantly - insist on reading the insert and insuring there is

no thimerosol contained within.

Also, be aware that the absence of thimersol on the insert doesn't entirely

guarantee that the vaccine is thimerosol free. A recent independent test of

thimerosol-free vaccines showed many that still contained it in spite of

manufacturers claims. See article I've attached at the bottom.

Also, you can have your child's titers checked to see if maybe s/he already

has immunity and doesn't 'need' the boosters. Your doctor's office should

be able to help you with this and if they won't, that might mean it is time

to find a new doctor!!

Personally, I would say - no, it's not safe at all.

If you do end up feeling it is the best decision for you, there are things

you can do to minimize the impact on your child's body such as high levels

of vitamin C. Dana has a great link to stuff like this on www.danasview.net

<http://www.danasview.net/> (don't have the exact link but it is on this

site)

From the New AUTISM RESEARCH REVIEW INTERNATIONAL VOL 18, No 2, 2004

HAPI " MERCURY FREE VACCINES STILL CONTAIN MERCURY

Vaccines marketed as mercury free still contain the toxic metal, according

to an investigation by Health Advocacy in the Public Interest (HAPI)

Earlier this year, HAP arranged to have four vials of vaccine tested by

Doctors Data, an independent laboratory specializing in heavy metal testing.

The manufacturers of two of the vials claimed that they contained only

traces of mercury, while the other two vials were claimed to be completely

free of mercury-free.

All four vaccine vials tested contained mercury, HAPI reports. They add,

All four vials also contained aluminum, one nine times more than the other

three, which tremendously enhances the toxicity of mercury, causing neuronal

death in the brain.

Noting that many manufacturers voluntarily agreed to begin producing mercury

free vaccines in 1999, HAPI officials have called on the FOOD AND DRUG

ADMINISTRATION (*my comment, the who cares agency) to take action against

" blatant mislabeling and misrepresentation of ingredients in FDA licensed

vaccines.

HAPI officials say their investigation revealed that thimerosal, a

preservative that is approximately 50 percent mercury, is still being used

to produce most vaccines, and is simply filtered out afterward. The group

cites BOYD HALEY, a vaccine expert, who notes that mercury binds to the

antigenic protein in vaccines and cannot be completely removed.

Clearly, more testing is needed, HAPI officials say. The FDA has the

ability and authority (like they are going to use it, my comment), to take

on the necessary testing: however, at present, this task sadly appears to be

up to the public.

Vaccination question

My son will be 5yrs old in a couple of months. I think there is 3 shots

required at this age. If I split them up and not inject all 3 at the same

time -is

it safe????

Diane

[Guest guest]

Before making any decisions, I would strongly recommend reading

Cave's book " What Your Doctor May Not Tell You About Children's

Vaccinations " .The book does not necessarily rally againt vaccinating per se,

but helps the reader make an informed choice and has many pointers about

how to more safely vaccinate if you choose to do so.

With regard to your son's booster shots, you may want to request a blood-

draw to test his immunity (titers) to the boosters being recommended. If he has

immunity, the boosters may not be necessary. You'll want to check the PAVE

website (People Advocating Vaccine Education), to learn more about your

particular state's vaccine laws regarding school entry. Some state's word the

law so that you only have to show proof of " immunity " (e.g., a positive titer)

as

opposed to proving that your child was " immunized " . Read carefully.

Good Luck! :-)

Abby

- In , Cramwash@a... wrote:

> My son will be 5yrs old in a couple of months. I think there is 3 shots

> required at this age. If I split them up and not inject all 3 at the same time

-is

> it safe????

> Diane

>

>

>

[Guest guest]

Cave has a great book on vaccine safety.

Vaccination question

>

> My son will be 5yrs old in a couple of months. I think there is 3 shots

> required at this age. If I split them up and not inject all 3 at the same

> time -is

> it safe????

> Diane

>

>

>

[Guest guest]

> My son will be 5yrs old in a couple of months. I think there is 3 shots

> required at this age. If I split them up and not inject all 3 at the

same time -is

> it safe????

Depends on which shots and what biomedical you have done with your child.

Here is my general info page

http://www.danasview.net/myvaxopn.htm

Splitting them up can work, however certain shots are nasty, even if

split up.

If you decide to waive shots, find your state here

http://home.san.rr.com/via/STATES/allstates.htm

Good luck.

Dana

[Guest guest]

My daughter isn't vaccinated! She is 16 with CVID

lorri

_____

From: [mailto: ] On Behalf Of

Holly

Sent: Thursday, November 16, 2006 8:14 PM

Subject: Vaccination Question

Does anyone on the list have a child with an immune deficiency that is not

vaccinated? If so, please e-mail me offlist. Thanks!

[Guest guest]

Hi, My son is 4 and we went in for his 4yr check-up and vaccinitions

my Ped called my sons Immunologist and he said no vaccinations while

on IVIG. Prior to diagnosis he had all of his vaccinations.

Misty

mom to Jake age 4 selective antibody def been of IVIG 3yrs

>

> Does anyone on the list have a child with an immune deficiency that

is not vaccinated? If so, please e-mail me offlist. Thanks!

>

>

[Guest guest]

From what I understand there's no point in vaxing while on IVIG because they

get the antibodies though the IVIG. We don't vax and even if we did it would

be pointless because my dd doesn't produce an immune response to them. (she

did get her 2 mo shots, had a severe rxn and we stopped, did end up with 2

pneumonia shots though)

Re: Vaccination Question

>

> Hi, My son is 4 and we went in for his 4yr check-up and vaccinitions

> my Ped called my sons Immunologist and he said no vaccinations while

> on IVIG. Prior to diagnosis he had all of his vaccinations.

> Misty

> mom to Jake age 4 selective antibody def been of IVIG 3yrs

>

>

>>

>> Does anyone on the list have a child with an immune deficiency that

> is not vaccinated? If so, please e-mail me offlist. Thanks!

>>

>>

[Guest guest]

Just a question? Why the DTaP? My son Lucas did not do well on it at all. He had

a major left shift and a very high fever . We ended back in the hospital 12

hours later with vomiting. They started him on IV antx. he had been fine before

the appt. without any problems and then

WAM. Actually I had held off vaccines with him because of this problem earlier

and kind of felt like I was pushed into vaccinating him that day at Childrens

hospital in Seattle. Granted he was already 2 but they had told me that he

would not react to the aP because it was attenuated. Wrong. I am still leary

with vaccines with him. I understand in some cases it is the right thing to do

but I always want to know why and what is the purpose before I let them

vaccinate him.

BARBIE

Vaccination question

Hi- as we approach our CCHMC visit, I am wondering how many of your kids

have severe reactions to vaccinations? Our did.... 105/106 fevers and

being sikc....when he was an infant cried (at the top of his lungs while

shaking) for 5 plus hours, had to bring him to ped for this, etc.

has been off of IgG for 3 months and we are going to retest his immune

system with DTaP to see ow he responds. Those of you with kids on IgG--

have your kids immune systems matured? i.e. did they start having responses

to vaccinations? I am worried that we'll be driving back home to NC with a

sick having a high fever.

Of course, now that we know more about is immune system....I wonder if I

should go ahead and let him havde the vaccination at all. sigh.

ANyone been through this? I am going to request that all vaccines be

thimerosal free.

Thanks everyone!

><>Pattie

[Guest guest]

My boys have had similar reactions and developmental regressions following

vax's. Both have autism dx's and we initially held off vax'ing our younger son,

but did a few after the autism was obviously already there. Our immuno looked

at the boys' reaction to the pneumovax, and both would initially make

antibodies, only to lose them over a couple of months. We let him revax our

older son once, but the same thing happened again.

We were able to get IVIG covered by insurance based on 3-4 years of labs and

prophylactic antibiotics not working. The immuno really wanted to revax both

boys again, but we just coulnd't let him and our regular pediatrician agreed it

was too risky. They started IVIG this Spring, and we're supposed to reassess

things this Fall. At this point, their infections are less frequent and much

less severe, but they're still getting sick. As of the last IV, there are no

plans to take them off IVIG. I'm not sure what we'll do when they want to trial

them off.

Good luck!

Vaccination question

Hi- as we approach our CCHMC visit, I am wondering how many of your kids

have severe reactions to vaccinations? Our did.... 105/106 fevers and

being sikc....when he was an infant cried (at the top of his lungs while

shaking) for 5 plus hours, had to bring him to ped for this, etc.

has been off of IgG for 3 months and we are going to retest his immune

system with DTaP to see ow he responds. Those of you with kids on IgG--

have your kids immune systems matured? i.e. did they start having responses

to vaccinations? I am worried that we'll be driving back home to NC with a

sick having a high fever.

Of course, now that we know more about is immune system....I wonder if I

should go ahead and let him havde the vaccination at all. sigh.

ANyone been through this? I am going to request that all vaccines be

thimerosal free.

Thanks everyone!

><>Pattie

[Guest guest]

They may be free of thimerosol as a preservative, but it is still used in the

processing of the vaccine & they all still contain aluminum as far as I know --

something to look into.

Most of the knowledgable doctors I know will never recommend re-vaccinating a

child who reacted poorly -- except one (Dr. Goldberg in Southern CA

http://www.nids.net/). He seems to be able to properly access the immune system

to detect when the body will respond favorably. If I were going to vaccinate a

child with a dysfunctional immune system, he would be the only doctor I would

trust as he does not take it lightly.

HTH,

Pattie Curran <catholicmomof3@...> wrote:

Hi- as we approach our CCHMC visit, I am wondering how many of your

kids

have severe reactions to vaccinations? Our did.... 105/106 fevers and

being sikc....when he was an infant cried (at the top of his lungs while

shaking) for 5 plus hours, had to bring him to ped for this, etc.

has been off of IgG for 3 months and we are going to retest his immune

system with DTaP to see ow he responds. Those of you with kids on IgG--

have your kids immune systems matured? i.e. did they start having responses

to vaccinations? I am worried that we'll be driving back home to NC with a

sick having a high fever.

Of course, now that we know more about is immune system....I wonder if I

should go ahead and let him havde the vaccination at all. sigh.

ANyone been through this? I am going to request that all vaccines be

thimerosal free.

Thanks everyone!

><>Pattie

[Guest guest]

Thanks, !

~Peace be with you~

Pattie

Imitation is the sincerest of flattery. ~ Caleb Colton (1780-1832)

[Guest guest]

Sheila,

I agree 100 % on this. As I was at a Session where the Dr spoke to parents and said a child with JA should not get any Live virus vaccines. If the child has JA no live Virus Vaccines. Non live Vaccine's go with Caution.

RobbinGet a sneak peek of the all-new AOL.com.

[Guest guest]

When I took Miranda to the ped for her school physical, the ped gave me

a list of (new?) vaccinations she should get, but then called her

rheumatologist to check if she was allowed to have them. Miranda is on

Methotrexate, so no live vaccines are allowed, and to be on the safe

side, the ped said she is exempt from any vaccinations while she is on

the MTX because it is an immunosuppressant.

I would urge everyone going through the back to school/off to college

physicals to have the doc consult with your child's rheumy before any

vaccinations are given.

Sheila

Miranda, 12, JIA/MMD

[Guest guest]

Wow

Thanks for sharing this, I called the dentist after I

ready this and it turns out Jen should be on antibotic

before her cleaning

Thanks

and 13

--- Sheila <mannas_mom@...> wrote:

> When I took Miranda to the ped for her school

> physical, the ped gave me

> a list of (new?) vaccinations she should get, but

> then called her

> rheumatologist to check if she was allowed to have

> them. Miranda is on

> Methotrexate, so no live vaccines are allowed, and

> to be on the safe

> side, the ped said she is exempt from any

> vaccinations while she is on

> the MTX because it is an immunosuppressant.

>

> I would urge everyone going through the back to

> school/off to college

> physicals to have the doc consult with your child's

> rheumy before any

> vaccinations are given.

>

> Sheila

> Miranda, 12, JIA/MMD

>

>

________________________________________________________________________________\

____

Got a little couch potato?

Check out fun summer activities for kids.

http://search./search?fr=oni_on_mail & p=summer+activities+for+kids & cs=bz

[Guest guest]

The first thing the doc told us with Devin is he will have to have antibiotics before any dental work.

[Guest guest]

There is not just one alternate. Dr. Cave wrote a book on it.

Generally you test titers to see what they are immune from, split the

shots up and get fresh vaccines. You also researcjh to see if any are

unnecessary, conflict with beliefs, alerhies or immune disease the jkid

has. No one size fits all answer.

>

> What is the " alternate " vaccination schedule that people talk about --

> is it simply splitting up certain shots like the MMR into three

> different vaccinations or is it eliminating some shots? Thank you.

>