MMR Vaccine only partially administered to infant - what next?

August 11, 2016 5:59 PM

My pediatrician's office accidentally gave my one year old a partial MMR vaccine and now wants to give her a repeat dose.

My pediatrician, who I generally really like, made a mistake and gave my baby only a partial MMR dose. (The tech put the syringe in the fridge or freezer because our visit was running really long and she didn't want it to get too warm, it froze up, they gave her the shot, could only get part of the dose into her, tried again, tried again, gave up. It was awful. Then we had to go draw blood for something else. Happy first birthday baby.) The pediatrician says there's no way of knowing how much of the MMR she got, so we need to give her the vaccine all over again. It has been about 6 weeks since then. The pediatrician warned us that 3-12 days after the vaccine, she might have a fever. She did - at ten days after the vaccine she had a low fever for three days.

We are very pro vaccine and give them on the CDC schedule for our kids but I am nervous. I wanted to do a titer to see if she received enough of the vaccine to be protected but my doctor says they can't do titers for babies. I want a second opinion before we go ahead and give her another dose of the vaccine but I don't quite know how to set that up. I can't see another pediatrician seeing us just to answer that question. My doctor said we should try to give her the repeat dose before she turns 15 months so I've got a few weeks to make a decision. Any insight?

posted by Amizu to Health & Fitness (18 answers total)

Best answer: I mean, good luck getting a straight answer because I've never gotten one about these issues.

If I were you, I'd put it off until you could check titers. Your baby had a fever right on schedule and the MMR is a live vaccine, so the viruses grow after injection. If you feel like a second dose can't hurt, than get a second medical doctor opinion on when that should happen.

If you want a fact-to-face opinion, my experience is you can go to any covered physicians office once you make an appointment. They don't care if you are only there for a second opinion. If your insurance won't cover extra appointments, you can call the nurse helpline at your insurance company.

You can also call a children's clinic or medical college and see if anyone is willing to parse this for you.

I'm so sorry that happened. It sounds awful and now it's confusing, too. I think you should make phone calls instead of appointments, to see what you can find out.

WAIT!!!!

Can you call the manufacturer? See if you can ask them! I mean, if anyone knows, the manufacturer does!!! And yes, your doctor's office should have this info so you know who to call. You'll make the right choice, just put in some time collecting data.
posted by jbenben at 6:13 PM on August 11, 2016 [1 favorite]

The second dose of MMR can be given any time after four weeks after the first dose. So, best case scenario you're getting her second dose out of the way early. Worst case you're getting her first dose a few months late.
posted by mskyle at 6:18 PM on August 11, 2016 [11 favorites]

I'd trust the doctor on the risks of repeat immunization being way smaller than the risks of possible inadequate dosage here. It's standard practice to repeat the dose if there's any concern that it wasn't valid. (See this kind of disturbing slidedeck about common vaccination errors!)
posted by cogitron at 6:19 PM on August 11, 2016 [9 favorites]

What is it that you are worried about happening? What did the pediatrician say when you expressed this worry? Fevers after vaccine do not mean a whole lot for future outcomes.
posted by smoke at 6:19 PM on August 11, 2016 [6 favorites]

Seconding "why not," since either way, baby's getting poked again. Mine had a medium-bad reaction to the first MMR and everything I've read says that reactions to the second dose tend to be lesser.
posted by teremala at 6:33 PM on August 11, 2016

(By "risks of repeat immunization" I only mean dealing with the same small risks again. To my knowledge there's no risk specific to getting the shot again if you've developed immunity already. In fact, this is the recommendation for people with unknown status. CDC--see "Unknown or Uncertain Vaccination Status," immunize.org.)
posted by cogitron at 6:44 PM on August 11, 2016

An extra dose of the vaccine won't hurt your baby. I don't think any reputable pediatrician will advise you otherwise. I understand that it is scary to see a reaction of any kind - but think how much worse actual measles will be. My son is at heightened risk of seizures and I was scared to do his MMR but did it anyway because I knew the fear was irrational given that an infectious disease would be worse than a seizure! He got a fever and that wasn't fun, but I just focused on how awesome it is that modern medicine means the worse bugs I have to worry about now are colds.
posted by yarly at 7:28 PM on August 11, 2016 [6 favorites]

I'd give the second dose. Chances of a big problem due to thenvaccine are really close to zero. With more and more kids not getting vaccines, chances of your kid being exposed to the real thing are climbing. I'd ask for triple in my hippie town, but apparently the pediateicians have alrwady figured out what will almost always protect my kid. Plus I'd seem crazy.
posted by Kalmya at 7:48 PM on August 11, 2016

In your shoes I would have the second dose. That said, I am confused about the titer comment. My child had MMR titers measured around 18 months after her first dose at 15 months. But there were compelling reasons to do so involving evidence of immunocompromise in her combined with an active measles outbreak in our area.

But it seems like it would be more traumatic to draw blood for titers than just to get a second dose of vaccine and be covered. Risk wise, the risks seem low. It totally sucks though and I get why you're unhappy about the situation.
posted by telepanda at 8:11 PM on August 11, 2016 [1 favorite]

IANYD, but as a mom, I'd get the second dose as soon as you can.
And side note, I love you all.
posted by treehorn+bunny at 8:33 PM on August 11, 2016 [12 favorites]

In terms of awfulness for your baby, it seems like another shot is much preferable to a blood draw that might lead to another shot anyway.

Good luck!
posted by bluedaisy at 1:45 AM on August 12, 2016 [7 favorites]

It should be fine! Nothing bad will happen by giving the same vaccine twice (especially since she reacted normally the first time), and it will make sure she definitely gets the correct dose. IANAD, but trying to remember my biochemistry textbooks, and I think that if she already created enough antibodies the first time, it will be a breeze for her body to deal with this dose, and if she didn't, well, that's what this shot is for. So, fine either way.
posted by easternblot at 2:18 AM on August 12, 2016

There's no real medical concern to repeating many vaccines, even multiple times. When I lived in India, there were programs that would gives mothers food/clothes/electronics/toys for getting their kids immunized. Some families would hit the program every time it came to town and the general consensus from the medical community was that it's better if this population is vaccinated 4x over than not at all. There were no concerns a second dose of the same vaccine would harm the child. More that they were wasting goodies that could go to another unvaccinated family.

Also, more anecdata--when I worked in immigration, the protocol if you lost or had no immunization record was to get every single shot again, even if you swore up and down you had had it. Slightly different than you situation, but my husband's pediatrician lost all their records so he got to get many of his childhood immunizations again at age 30 as part of a medical clearance process.
posted by whitewall at 3:19 AM on August 12, 2016 [1 favorite]

The thing about the fever is that it doesn't mean the vaccine wholly "took". The measles part often gives a fever a week or so later, but her getting that fever doesn't mean she has good cover for rubella or mumps, kwim?

If i were you i'd get the vaccine again. Blood draws are miserable, if it's a choice between the two it's a no-brainer.
posted by intergalacticvelvet at 4:03 AM on August 12, 2016

I see no reason at all not to redose. You don't say what your concern is. If you are worried that this office can't get the very simplest of medical treatments right, I'd change doctors and get the repeat dose there instead, or request a different nurse or tech.
posted by tchemgrrl at 7:10 AM on August 12, 2016

When my daughter was 18 months old she got her flu shot with her other scheduled vaccines and the nurse forgot to note it in her chart. So, while we were all pretty damn certain she'd already had it, the pediatrician strongly suggested we give it to her again a month later just to be 100% sure. So we did.

And that's the flu vaccine. I would absolutely 100% no questions asked give my kid a second dose of MMR in your situation because the risk of not being protected is just not worth it.
posted by lydhre at 12:19 PM on August 12, 2016

My daughter had her first dose of MMR twice. The pediatrician wanted her to get it an early dose because we were travelling internationally, but when giving it that early there is only an 85% chance of getting strong immunity vs. something like 95% when giving it at the normal time, so they also did a second dose at the normal time. It sounded like this was a pretty normal thing to do.

Even if it is possible to test for antibodies to see if your daughter is already immune from the partial dose, if she is anything like my kids that will be way more traumatic for her than just having the shot again.
posted by insoluble uncertainty at 2:42 PM on August 12, 2016

You need to report it to the manufacturer, regardless. (I work in pharmaceuticals. They need to be informed of any errors in the use of the product.)
posted by Green Eyed Monster at 8:28 AM on August 13, 2016