The Happy virus has kept me from keeping up with the comments re: varivax.
Teresa and Rob's comments intrigued me as they were different from what the
resources our public health office contained and my strong belief in
informed consent drives me to make sure what I am telling clients truly
reflects the known information.  So, our local Merck rep was in town and our
state immunization coordinator email Dr. Atkinson at CDC:  the Merck rep did
tell me the same thing both of you had said and is sending me the research
to support this.  At the same time Dr. Atkinson responded as the pink book,
VIS and IAC state: post immunization vesicular rash needs to be treated as
wild disease.  His reason is that there is the possibility that it is wild
disease that is lessened because of the vaccine (prophylactic use of the
vaccine can lessen the disease if used shortly...can't recall the exact time
frame...after exposure)and not rash resulting from the vaccine.  He did not
directly respond to the question of post vaccination mode of transmission.
The likely hood of this is very small I understand.  I never did consider
Varivax contraindicated for a breastfeeding mom, but I still think she needs
to understand the potential risk.  Could she wait until the baby is a year
old and could be vaccinated at the same time?
Just one more comment: today I was cutting a Grandma's toenails (another one
of my public health duties.) Her daughter is 3 mos. pregnant with her second
child, she has never had chicken pox, had her first child vaccinated about a
year ago and he now has chicken pox.  It is what would be expected: mild
case with few leasions that appear to be drying quickly but mom is upset
because she believed he would not get chicken pox.  Informed consent?
Teresa, about what I would tell a mom with Herpes: first I have not had this
question for a long time so would need to review the current
recommendations.  A quick review of the Redbook: primary mode of
transmission for Herpes Simplex I is contact with lesions and oral
secretions and with varicella it is aerobic...but that takes us back to wild
disease vs vaccine related.
Once again Lactnet discussion has prompted me to dig in and learn...thanks!

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