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Former Member
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Help with Yellow Fever vaccination

I dont know if this is the forum to ask this but I am a bit desparate. My wife found out yesterday (15 November 2007) that she is 7 weeks pregnant. We went to Brazil and we had to get Yellow Fever injections as stated by the South African Authorities. We got the injection on 5 November 2007. My problem is that we dont know if this injection will affect our unborn baby and if there will be any side affects of it. We need to make a decision if we need to terminate the pregnancy or not, but we can not find any information if the injection would be bad for the baby or not. Is there anyone that can help me get some information to help us make a desicion? Any previous similar cases. We did not visit a yellow fever area but had to have the injection. The name of the injection is STAMARIL. THANK YOU
[Nov 16, 2007 12:03:22 PM]   Link   Report threatening or abusive post: please login first  Go to top 
Sekerob
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Re: Help with Yellow Fever vaccination

That's indeed a serious concern. Found at the CDC website some information, point B. discussing your wive's particular situation.

http://www.cdc.gov/mmwr/preview/mmwrhtml/00001620.htm

Of course, you should immediately consult the health-centre that performed the inoculation for a professional opinion.

Hope it works out well.
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[Edit 1 times, last edit by Sekerob at Nov 16, 2007 12:31:17 PM]
[Nov 16, 2007 12:29:08 PM]   Link   Report threatening or abusive post: please login first  Go to top 
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Re: Help with Yellow Fever vaccination

Hello mullersh,
Read the CDC bulletin carefully, then think. It references 2 known cases of encephalitis in 34 million cases of vaccination. Admittedly, 'known' is the important word. Next, because infants have weak immune systems, it suggests:
However, in no instance should infants less than 4 months of age receive yellow fever vaccine because of the risk of encephalitis

For pregnancy it says:
Pregnancy. Although specific information is not available concerning adverse effects of yellow fever vaccine on the developing fetus, pregnant women theoretically should not be vaccinated, and travel to areas where yellow fever is present should be postponed until after delivery. If international travel requirements constitute the only reason to vaccinate a pregnant woman, rather than an increased risk of infection, efforts should be made to obtain a waiver letter from the traveler's physician (see section D. Hypersensitivity). Pregnant women who must travel to areas where the risk of yellow fever is high should be vaccinated. Under these circumstances, for both mother and fetus, the small theoretical risk from vaccination is far outweighed by the risk of yellow fever infection.

They are obviously not minimizing the importance of 2 cases of encephalitis in 34 million vaccinations. It is reassuring to remember that many infants of HIV-infected mothers are born HIV-free. The placenta is a great biological invention that has protected many babies from their mother's diseases. It is not perfect protection, but it often works. This explains why the CDC uses the phrase:
the small theoretical risk from vaccination


As Sekerob says, you should ask the doctors who gave you the vaccination for complete information. It will be a big relief.

Lawrence
[Nov 16, 2007 8:53:08 PM]   Link   Report threatening or abusive post: please login first  Go to top 
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Re: Help with Yellow Fever vaccination

One web site says it can be given to pregnant women but only when absolutly necessary:

4.6 Pregnancy and lactation

Pregnancy

No animal reproduction studies have been conducted with STAMARIL® and the potential risk for humans is unknown. Data on a limited number of exposed pregnancies indicate no adverse effects of STAMARIL® on pregnancy or the health of the fetus/newborn child. Nevertheless, STAMARIL® should be given to pregnant women only when clearly needed and only after careful consideration of the potential risks and benefits.

Lactation

It is not known if the live attenuated yellow fever virus is excreted in animal or human breast milk. Although there have been no reports of transmission of vaccine viruses from breastfeeding mothers to infants STAMARIL® should not be given to nursing mothers unless this cannot be avoided.

See http://emc.medicines.org.uk/emc/assets/c/html/DisplayDoc.asp?DocumentID=9846
[Nov 17, 2007 2:25:23 AM]   Link   Report threatening or abusive post: please login first  Go to top 
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Re: Help with Yellow Fever vaccination

More information:

Vaccines

Pregnant travellers should avoid the use of live vaccines. These include measles, mumps and rubella (Priorix), chickenpox vaccine (Varilrix, Varivax) the live influenza vaccine (FluMist - not available in Australia), oral polio (Sabin - not available in Australia), the live cholera vaccine (Orochol), the live typhoid vaccine (Typh-Vax), BCG and the yellow fever vaccine (Stamaril, Arilvax). If these vaccines are considered essential, the risks must be weighed against the benefits. Alternatives may be available.

Yellow fever vaccine should be used in pregnancy only if travel to an infected area cannot be avoided. Ideally, vaccination should be deferred for nine months after delivery.

A recent study in Brazil showed the vaccine used (in that country) to be effective and very safe during pregnancy. A similar study using Stamaril has not been carried out. Most killed vaccines are considered safe during pregnancy, but should be avoided during the first trimester. The benefits and risks of vaccination should be discussed with the attending doctor. In some instances, little information is available.

See http://www.mmc.org.au/travel/index.php?id_number=000020
[Nov 17, 2007 2:32:26 AM]   Link   Report threatening or abusive post: please login first  Go to top 
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Re: Help with Yellow Fever vaccination

Data Sheet

STAMARIL®

[YELLOW FEVER VACCINE (LIVE), STABILISED]

Use in Pregnancy:

As with all live vaccines, pregnancy constitutes a contraindication (a situation where it should not be used), particularly during the first trimester. However a vaccination carried out during an unsuspected pregnancy does not justify termination of pregnancy. In the case of outbreaks, the vaccine may be administered in pregnant women after assessment of the risk related to the epidemiological context.

Use in Lactation

No data exists on the use of STAMARIL® during lactation. There is a theoretical risk of transmission of the live attenuated Yellow Fever virus in STAMARIL® from vaccinated breastfeeding mothers to the newborn. This applies particularly when the newborn is below 4 months of age.

See: http://www.msd-newzealand.com/content/downloads/Data%20Sheet%20-%20Stamaril.pdf

The vaccine is manufactured by Sanofi Pasteur MSD (a joint venture between Sanofi Pasteur and Merck and Co. Inc.) and is based in the United Kingdom.

My voormalige vriendin was Suid Afrikaner. Van haar ek geleer om te praat Afrikaans. Alle voorspoed met die swangerskap.
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[Edit 2 times, last edit by Former Member at Nov 17, 2007 3:01:28 AM]
[Nov 17, 2007 2:38:26 AM]   Link   Report threatening or abusive post: please login first  Go to top 
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Re: Help with Yellow Fever vaccination

Dear All

Thank you for all the valuebale information you gave us. It surely helped us with making our decision. It is a very sad day for me as we decided to terminate the pregnancy. There was so many factors to consider at the end. We decided on the fact that there is no medical proof of a positive or negative outcome, that we would not endanger my wifes life as well as the baby's life. We do not want to sit the next 8 months wondering if all is ok or not and then subject the baby to numerous exsaustive tests after he/she is born. This was one of our most important decisions we had to make and I do hope that I will be forgiven for what we have done.

I now hope and pray that some medical facility would do tests and research on this, for I do not want any other person to go through what we went through the last couple of days.

Regards
Stephan

PS. Larry, jou vriendin het jou baie goed geleer. Dankie vir jou insette en navorsing. Dit word opreg waardeer!!
[Nov 19, 2007 9:29:05 AM]   Link   Report threatening or abusive post: please login first  Go to top 
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Re: Help with Yellow Fever vaccination

Baie dankie. From the vaccine's data sheet provided by the manufacturer, termination of pregnancy is not recommended. I suggest you contact the manufacturer first before termination occurs to see if any new information is available. In the balance, from the available information, it seems that no harm is the likely outcome.
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[Edit 1 times, last edit by Former Member at Nov 19, 2007 2:10:30 PM]
[Nov 19, 2007 12:22:40 PM]   Link   Report threatening or abusive post: please login first  Go to top 
crooks_uk
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Re: Help with Yellow Fever vaccination

Whatever the outcome; I hope all goes well.
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[Nov 19, 2007 2:28:54 PM]   Link   Report threatening or abusive post: please login first  Go to top 
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