An infant in Belfast and Measles risk
February 4, 2015 5:10 PM

Early MMR for a 6 month old infant traveling to Belfast, Northern Ireland?

My daughter is taking her children to visit their grandmother in Belfast, Northern Ireland in March 2015, where there has been a small measles outbreak, as documented by BBC in December. Her son and daughter are currently 18 months (fully immunized) and 5 months old (also fully immunized). MMR is not scheduled until 1 year, so the littlest one has not yet received MMR, but there is a noted possibility of early MMR immunization on ACIP's immunization schedule. Both children are otherwise in good health and there are no known contraindications to immunization.

I understand that this would confer temporary immunity during the trip, and the baby would still need her 1 year and booster shots. Are there additional risks - scientifically based, please- that would make her hesitate to ask her pediatrician for an early vaccination?

She breast feeds her daughter 100%, and has been fully immunized herself, so there is a real possibility breastfeeding would make this moot, but we'd welcome informed Mefites weighing in.
posted by citygirl to Health & Fitness (6 answers total) 1 user marked this as a favorite
I think this is a question for a GP or pediatrician, but in the meantime this post from Pediatric Insider may offer some general information about how immunity works for young babies.
posted by jasperella at 6:57 PM on February 4, 2015


I'm searching on Belfast measles outbreak and the latest news I can find is from December 2012. was there a more recent one? If 2012 is the most recent outbreak then I don't think early immunization would be warranted any more than if staying home (after all, there's an outbreak of measles here in the USA now, assuming she's American). But indeed, it's a question for the pediatrician.
posted by treehorn+bunny at 7:48 PM on February 4, 2015


If it helps, infants are not immunized until 6 months because up till that point they are presumed to be protected by their mother's antibodies (even if not breastfeeding) and they have to get the vaccine later on because of the early vaccine can be inhibited by congenital antibodies.

The CDC does recommend a dose of MMR for infants age 6 months traveling out of the country, regardless of where they're going and whether there is measles there.
posted by treehorn+bunny at 8:06 PM on February 4, 2015


Measles is a notifiable disease in Ireland, and I looked up the cases in the past three years (available as an Excel file here); there were 14 cases in 2014, 51 in 2013, and 21 in 2012. It's possible there's an outbreak that hasn't made it to the published surveillance data, since the 2015 data aren't up on the website yet, but there's nothing on the Northern Ireland Public Health Agency Health Protection news page or the WHO Europe homepage about a measles outbreak. The Council for Foreign Relations Vaccine-Preventable Disease map doesn't show any measles outbreaks in Ireland in 2014 or 2015, and does show the outbreak treehorn+bunny mentions in Belfast in December 2012.
Since the baby isn't yet 6 months old, and the vaccine takes a little time to work, I think your daughter still needs to talk to the pediatrician to figure this one out in light of the CDC advice, but I don't think there's an outbreak of measles (or mumps or rubella) in Ireland right now.
posted by gingerest at 8:40 PM on February 4, 2015


As someone who was encouraged by our pediatrician to consider early MMR vaccination for my daughter if traveling internationally (to Italy), I would just put out there that the fear of exposure is not just the destination but the airports and flights themselves. Measles is airborne and very contagious and all it would take is one traveller on the plane to expose most passengers. One of my close friends just vaccinated her 6 month old in preparation for a short trip overseas, it seems to be the standard pediatric advice here in MA.

Breastfeeding is irrelevant. She should talk to her pedi. Better safe than sorry, in my opinion.
posted by lydhre at 10:43 PM on February 4, 2015


Oh, the airport and flights are a huge concern. I have no doubt that's why CDC recommends vaccination for everyone over 6 months who's travelling internationally.
posted by gingerest at 11:26 PM on February 4, 2015


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