Having an autoimmune disorder in a measles outbreak

On my baby’s immunisation list in his Plunket book, the rotavirus vaccine remains unchecked. The measles vaccine will remain unchecked for some time too, until his immune system can cope with it. I can’t have live vaccines, and as a result, neither can he. With the latest figure at over 1000 cases of measles in New Zealand, there’s a lot of messages out there that people need to get vaccinated. Of course we do (if possible!) and I also believe it’s going to take more than that. As someone with an autoimmune disorder, and with a 3 month old who can’t be vaccinated, here’s my perspective.

Many people with compromised immune systems are incredibly anxious about this latest measles outbreak. So are parents whose kids, whether because of their age or immune status, can’t be vaccinated yet. Having an autoimmune disorder means I’m on a biological drug – it works by suppressing my overactive immune system, in a complicated chain of chemical reactions. The medication I take every 12 weeks, infliximab, is injected into my blood stream, and it has helped me in a lot of ways – but it’s times like these that the burden of having a chronic illness rears up at me, over and over. 

People on biologic drugs or immunosuppressants can’t be vaccinated against measles because it’s a live vaccine – our immune systems couldn’t cope with it. Even if we have been vaccinated in the past, the medication can eradicate the effect of the vaccines we’ve had before, so we may still be vulnerable to getting these illnesses. 

Like me, there will be women out there who were on biologic medications while pregnant. Now, the physical and mental burden is doubled because our babies are passed on the biologic. It generally stays in their immune system for about a year. 

The consequences of babies and the immuno-compromised getting sick from measles, or other illnesses, are a lot worse. It’s harder to fight off viruses, and we’re more prone to infections. 

Plunket are advising that in areas where there’s a measles outbreak, babies as young as 6 months old can be vaccinated. The other day on a visit to the medical centre, our nurse said that some 6 month olds can get the measles vaccine, and they’d still need to have the additional two measles vaccinations at 15 months and 4 years. All I could think about was not being able to vaccinate my baby until the medication is out of his immune system – and we have plans to travel to Auckland and Japan next month, when he’s 5 months old.

One of the hardest things to cope with is the uncertainty in these situations. Should you risk travelling somewhere with a measles outbreak? Should you suck it up and hope you won’t be affected by it? Should you put up with people thinking you’re a total hypochondriac, for asking everyone you know if they’ve had their second measles vaccine? (I have asked this so many times over the past few days, I’ve lost count).

It’s not just measles that’s a problem for people with compromised immune systems. I notice that people soldier on through colds and illnesses and come to work, go to public spaces or get on planes when they’re sick. It’s as if people can’t allow themselves the time to get well anymore, and we all think we’re too important and needed by the world, to spend a day at home in bed. For me, and others like me, colds could lead to pneumonia. Stomach bugs can lead to major flares of gastro illness. Measles could be lethal.

Getting vaccinated is one solution, and the public health messages are clear: everyone who can be, should be vaccinated against measles. But it’s not the only answer to stopping the spread of illness. We have to have a mental shift. It’s about being aware that not everyone is able to get over illnesses quickly. It’s not spreading around colds or bugs, and it’s about putting the choice back into the hands of the people who can’t fight off those bugs as well. Tell them that you’re sick, or that your kids are sick. Respect their decision not to see you and know they’re grateful that you told them. 

If we can all think of the needs of others, it would go a long way to alleviating some of the anxiety about measles, and help all of us stay well.