Getting the MMR booster after an adverse reaction

My post MMR and joint pain in toddlers got a ton of traffic.  It is still one of my most visited posts.  Only the breastfeeding husbands get more traffic.  (You pervs.)

I was inspired to write my original MMR post when I was starting to consider whether Lane should get her MMR booster at her 4-year checkup, after the reaction she had from the vaccine when she was 15 months old (knee pain with an unwillingness to walk for a week).  To say I was worried was an understatement.  Well, as a rule I’m not a worrier.  My one foray into wanting antidepressant medication after my mom died was a bit challenging – most antidepressants (at least nearly a decade ago) were also indicated as anti-anxiety, but since even being down and out I wasn’t all that anxious, my doctor was pretty concerned one of the standards — Prozac or Zoloft — would make me abandon all reasonable caution.  I ended up on Wellbutrin, which has a side effect of weight loss.  Oh, and seizures.  Luckily under its spell I had some of the former and none of the latter, and just generally a better ability to get out of bed in the morning.

Anyway, enough of that tangent!!  I was as worried about Lane getting her MMR booster as I’m generally capable of being.  I did a lot of reading, and talked to her pediatrician ad nauseum about it.  He was dubious of the vaccine causing the reaction, but at least was not obnoxious enough to be dismissive of my concerns.  He was supportive of checking her titers instead of doing the vaccine, he was just worried the school district would give us grief over her not getting the booster.

I cannot find where I initially read it, but here’s the gist of the knowledge I put together about the reaction Lane suffered.  Joint pain from MMR is caused by the rubella component of the vaccine.  People who have the joint pain reaction tend to have the reaction because they are, at the point they are vaccinated, susceptible to actual German measles infection, and thus their bodies react more strongly when the vaccine is introduced to their system, as joint pain is a symptom of actual German measles infection.

The alternative of checking her titers to see if she was properly protected by her first shot was alluring in avoiding a shot, but Lane is not a child who gets over shots or blood draws easily.  The little tiny bit of blood they had to draw to test her iron levels when she was three-and-a-half left her heaving and sobbing for like 20 minutes.  She definitely takes after her daddy in this respect.  So the idea of having her titers checked, and the full-on mega blood draw it meant certain trauma and freakout.  And if her titers didn’t check out right, she’d have to get the shot anyway, at which point the same reaction could have happened because she wasn’t properly protected against rubella.  If I went ahead and just got her booster, while chances are she didn’t actually need it, it’s because she didn’t need it that she would be protected from adverse side effects.  And if she did have another side effect, then that probably meant she needed the shot.

So, we went ahead with the shot.  This booster was administered in her arm, rather than her leg as it was last time.  And she came through it with flying colors.  A few tears at the initial administration, but the next day after the Band-Aid was gone, she couldn’t even tell me which arm she got her shot in.  I asked her nearly every day for the next couple weeks if she had any boo-boos on her arm and she always said no… and she would totally let me know if her arm hurt.

That about does it.  I just wanted to share for anyone looking for a follow-up.

MMR vaccine and joint pain in a toddler

The news is currently quite heavy with stories of lawsuits and settlements and the link (or lack thereof) between vaccines, especially the MMR vaccine, and autism. I’ve been watching, but not closely. When Lane was little, the idea of this link made me nervous and I did a lot of reading, and it became clear pretty quickly that any “link” between vaccines and autism was pretty much based on shoddy science and anecdotal evidence.

It is well-documented that the MMR vaccine can cause joint pain, especially in adolescent and adult women. Up to 25% of women will experience joint pain, from the rubella component of the vaccine. Joint pain is rare – but not unheard of – in adult males and children.

We got to experience this first-hand. 12 days after receiving her MMR vaccine at 15 months old, Lane stopped walking. (She’d been walking for 2 months at this point.) We figured out pretty quickly, even though she couldn’t tell us, that her right knee hurt. We didn’t know what it could be. We didn’t remember her injuring herself at all, but then again she was at day care 5 days a week at that point and perhaps she got hurt there. After speaking with her teacher, they could not recollect an injury either but in retrospect did notice a hesitancy to walk. Then I remembered that she’d gotten a couple different vaccinations at her appointment a couple weeks earlier, and as I do, I started Googling. I discovered how common arthritic-like joint pain was for women who receive the rubella vaccine, and that it can take up to 2 weeks before it sets in. To me, it didn’t seem like much of a stretch that if 25% of women could experience joint pain, that the occasional toddler might too.

However, my otherwise healthy daughter wasn’t walking, and experiencing pain in her knee. It was enough that I wanted her to see a doctor. And, as it often goes with pediatricians, my suspicions were dismissed. The pediatrician had never seen such a reaction in a child to the vaccine, so naturally such a reaction could not be occurring. Just to be on the safe side, I went along with his desire to do an x-ray and some blood tests to rule out an injury or something else like rheumatoid arthritis. The x-ray was clear, and I guess the blood test did show some slightly elevated something that could indicate rheumatoid arthritis. But in my mind, as I’d done more reading over the next day or so, I became more convinced that this was a reaction to the vaccine. The whole pathology of her symptoms was so in line with the typical joint pain in the older women — it was the knee on the leg where the vaccine was administered, it started within two weeks of getting the vaccine, it was local to that one joint, and then it went away a week after it started, and hasn’t happened since. I spoke to the pediatrician again after the fact, and he still dismissed the idea that the pain could be related to the vaccine. I guess he made up his mind pretty quickly, or had another idea, and my hypothesis didn’t fit with his, and since he was the ‘expert’ his ideas trumped mine.

The whole thing has come up again in my consciousness because Lane just had a well-child doctor’s appointment. She wasn’t due for a visit, but we’d just moved and she needed a doctor’s sign-off to sign up for pre-K in the fall. The doctor asked me about any medical history (asthma, injuries, etc.), and it was the only thing that I could really think of, so I mentioned it. This new pedi, too, was dubious.

And I understand the dubiousness. It’s not a documented side effect of the vaccine for children. I’ll also bet, for little kids getting the vaccine and experience the reaction, it goes unreported. Plus, how many other cases are like ours — the reaction happens, but is never officially reported as a reaction because the pediatrician and/or the parents don’t link the reaction to the vaccine?

So, Lane will be due to get her second dose of MMR at her 4-year appointment, which will happen this summer. Above all, I don’t want my child to experience pain, but a small part of me really wants to see the reaction happen again, so that I can be confirmed in my suspicions, but also perhaps then we can get the pediatrician to officially report the reaction to the powers-that-be. In the meantime, I filled out the VAERS online form to self-report her initial reaction. Maybe if more reports happen, more pediatricians will become aware of this possible reaction, and more parents won’t have their suspicions dismissed.

All that said, I have no intention of skipping or delaying that next MMR vaccine administration. The benefits of being vaccinated against those diseases far outweighs some temporary joint pain.

I’m also hoping by writing this that parents whose child has also had this reaction will stumble across my post. If you suspect your child has had a similar reaction to the MMR vaccine, I’d love to hear from you in a comment.

***********************************

UPDATE:  I’ve recently posted an update to our MMR saga.  You can click here to read more of our story.