This blog is a way of sharing the information and resources that have helped me to recover my son Roo from an Autism Spectrum Disorder. What I have learned is to view our symptoms as the results of underlying biological cause, which can be identified and healed. I say "our symptoms" because I also have a neuro-immune disorder called Myalgic Encephalomyelitis.

And, of course, I am not a doctor (although I have been known to impersonate one while doing imaginative play with my son)- this is just our story and information that has been helpful or interesting to us. I hope it is helpful and interesting to you!

Sunday, September 21, 2014

Shedding From Live Virus Vaccines

This is a mainstream article from NBS news addressing vaccine shedding and the risk to immunocompromised people.

Vaccine-derived poliomyelitis 12 years after infection in Minnesota
N Engl J Med. 2011 June 16;364(24):2316-23This is the case of a 44 year old woman who had an immune deficiency and died from polio, which it is argued that she was carrying since her child was vaccinated.  "Type 2 vaccine-derived poliovirus was isolated from stool. The viral capsid protein VP1 region had diverged from the vaccine strain at 12.3% of nucleotide positions, and the two attenuating substitutions had reverted to the wild-type sequence. Infection probably occurred 11.9 years earlier (95% confidence interval [CI], 10.9 to 13.2), when her child received the oral poliovirus vaccine."

PEDIATRICS Vol. 22 No. 2 August 1, 1958 pp. 259 -267
"Nine cases of eczema vaccinatum are presented, including two fatalities. Seven were caused by contact of a child with eczema with a recently vaccinated sibling... The following steps are recommended for prophylaxis: 1) No child with atopic eczema or other skin disorder should be vaccinated. 2) No child should be vaccinated if any member of his family has eczema or other skin disorder. 3) Parents of children with eczema should be notified at the onset of the disease of the danger from vaccination contact. 4) If a sibling of a child with atopic eczema is vaccinated, he must be completely separated from that child for at least 21 days. 5) Forms used by state and local health departments for parents' consent to vaccination should include an appropriate warning of the contraindications. 6) Eczema vaccinatum should be a reportable disease. 7) Patients recently vaccinated must be excluded from pediatric wards containing patients with atopic eczema, other diseases of the skin, burns or healing surgical incisions. 8) Vaccination may be recommended at 2 months of age, especially for babies from strongly allergic families."

"The FluMist influenza vaccine strains replicate in the nasopharynx and can be recovered and 
cultured from respiratory secretions of vaccinated individuals (shed). The pattern and duration 
of shedding is important to understand because with prolonged shedding at high titer there is a 
theoretical risk of loss of attenuated phenotype, reassortment with wild-type influenza virus 
during influenza season, and transmission of vaccine virus to unvaccinated people, some of 
whom may be immunocompromised and/or at risk for complications of live viral infections. "
(this is from paperwork regarding updating the package insert of the FluMist vaccine to include additional information about viral shedding)

Risks: Smallpox Vaccine and Sexual Contact
"It is one of five known cases in the past 12 months of women from four states who got vaccinia through sexual contact with a member of the military, the July 2 Morbidity and Mortality Weekly Report said."
Detection of measles virus RNA in urine specimens from vaccine recipients
J Clin Microbiol. 1995 Sep; 33(9): 2485–2488."Analysis of urine specimens by using reverse transcriptase-PCR was evaluated as a rapid assay to identify individuals infected with measles virus. For the study, daily urine samples were obtained from either 15-month-old children or young adults following measles immunization. Overall, measles virus RNA was detected in 10 of 12 children during the 2-week sampling period. In some cases, measles virus RNA was detected as early as 1 day or as late as 14 days after vaccination. Measles virus RNA was also detected in the urine samples from all four of the young adults between 1 and 13 days after vaccination. This assay will enable continued studies of the shedding and transmission of measles virus and, it is hoped, will provide a rapid means to identify measles infection, especially in mild or asymptomatic cases."

Detection of measles vaccine in the throat of a vaccinated child.
Vaccine. 2002 Feb 22;20(11-12):1541-3."Measles vaccine is widely used, most often in association with mumps and rubella vaccines. We report here the case of a child presenting with fever 8 days after vaccination with a measles-mumps-rubella vaccine. Measles virus was isolated in a throat swab taken 4 days after fever onset. This virus was then further genetically characterised as a vaccine-type virus. Fever occurring subsequent to measles vaccination is related to the replication of the live attenuated vaccine virus. In the case presented here, the vaccine virus was isolated in the throat, showing that subcutaneous injection of an attenuated measles strain can result in respiratory excretion of this virus."

Chickenpox Attributable to a Vaccine Virus Contracted From a Vaccinee With Zoster
PEDIATRICS Vol. 106 No. 2 August 1, 2000 pp. e28
"Five months after 2 siblings were immunized with varicella vaccine, 1 developed zoster. Two weeks later the second sibling got a mild case of chicken pox. Virus isolated from the latter was found to be vaccine type. Thus, the vaccine strain was transmitted from the vaccinee with zoster to his sibling. Vaccinees who later develop zoster must be considered contagious."

(information about shedding, including Table 3, is on the 3rd page)
"Shedding of vaccine viruses within 28 days of vaccination with FluMist was evaluated in (1) multi-center study MI-CP129 which enrolled healthy individuals 6 through 59 months of age (N = 200); and (2) multi-center study FM026 which enrolled healthy individuals 5 through 49 years of age (N = 344). In each study, nasal secretions were obtained daily for the first 7 days and every other day through either Day 25 and on Day 28 or through Day 28. In study MI-CP129, individuals with a positive shedding sample at Day 25 or Day 28 were to have additional shedding samples collected every 7 days until culture negative on 2 consecutive samples. Results of these studies are presented in Table 3."

Identification of strains of RotaTeq rotavirus vaccine in infants with gastroenteritis following routine vaccination
J Infect Dis. 2012 Aug 1;206(3):377-83"Thirteen of the 61 samples collected from infants developing gastroenteritis after RotaTeq vaccination contained vaccine-derived (vd) rotavirus strains. Of these, 4 contained a vdG1P[8] strain derived by reassortment between the G1P[5] and G6P[8] parental vaccine strains. Northern hybridization analysis of 460 surveillance samples identified 3 samples that contained RotaTeq vaccine-derived strains, including 2 vdG1P[8] reassortant vaccine strains."

Detection of fecal shedding of rotavirus vaccine in infants following their first dose of pentavalent rotavirus vaccine
Vaccine. 2011 May 31;29(24):4151-5"Vaccine-type rotavirus was detected in all 50 antigen-positive specimens and 8 of 8 antigen-negative specimens. Nine (75%) of 12 EIA-positive and 1 EIA-negative samples tested culture-positive for vaccine-type rotavirus. Fecal shedding of rotavirus vaccine virus after the first dose of RV5 occurred over a wide range of post-vaccination days not previously studied. These findings will help better define the potential for horizontal transmission of vaccine virus among immunocompromised household contacts of vaccinated infants for future studies."

Transmission of varicella vaccine virus to a non-family member in China
Vaccine. 2011 Mar 3;29(11):2015-7"A 23-year-old teacher presented to hospital with a mild case of varicella. VZV vaccine strain vOka that resembles Varilrix but not Varivax or Biken strains was isolated from the skin lesion of the patient and was identified by single nucleotide polymorphism (SNP) analysis. The teacher denied having varicella vaccine before. Retrospective analysis suggests the transmission came from a pupil who developed zoster 13 months after varicella vaccine Varilrix. This is the first report in China in which an adult with varicella was attributable to vaccine virus and the 6th report of transmission of vaccine virus to a susceptible adult around the world."

Neonatal vaccine-strain varicella-zoster virus infection 22 days after maternal postpartum vaccination
Pediatr Infect Dis J.  2012 Sep; 31(9):977-9
"A 25-day-old infant developed varicella 22 days after her mother received varicella vaccine postpartum. Infection with vaccine-strain varicella-zoster virus was confirmed by genetic analysis. The mother had no postvaccination rash nor did other contacts have rash or recent vaccination. The potential means of transmission to the infant are explored."

Varicella Zoster Virus DNA at Inoculation Sites and in Saliva After Zostavax Immunization
J. Infect Dis. Jun 1, 2011; 203(11):1542-1545
"Analysis of 36 individuals over age 60 years who were immunized with Zostavax revealed varicella zoster virus (VZV) DNA in swabs of skin inoculation sites obtained immediately after immunization in 18 (50%) of 36 subjects (copy number per nanogram of total DNA, 28 to 2.1 × 106) and in saliva collected over 28 days in 21 (58%) of 36 subjects (copy number, 20 to 248). Genotypic analysis of DNA extracted from 9 random saliva samples identified vaccine virus in all instances. In some immunized individuals over age 60, vaccine virus DNA is shed in saliva up to 4 weeks."