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Celeste NP
Celeste NP, Nurse Practitioner
Category: Health
Satisfied Customers: 1002
Experience:  Family Practice with emphasis in Women's Health, Forensics, Urgent Care, for 14 years.
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his first MMR shot at the age of 2 1/2 years and am due for the second

Customer Question

I have a 5 year old and a 5 1/2 month old. I alternated my older childs vaccine schedule so that he only got a few vaccines at a time. I got his first MMR shot at the age of 2 1/2 years and am due for the second anytime now. He has now started kindergarten and is due for the MMR and now the flu shot which is supposed to be available this week on base (we live in Japan on the Navy base). My question is, should I get him the flu shot first and then wait 4 weeks and then the MMR? I am not very comfortable getting the MMR and Flu shot at the same time...that is just too much for anyone to handle. Also, should I try in get my older child the shot or nasal mist? I am just concerned about any contagiousness to my 5 1/2 month old. If my 5 1/2 month got his Pc vaccine almost 2 weeks ago and is scheduled for his 6 months shots next month, then when should I start him on his Flu shot schedule without overloading his immune system with vaccines all at once. i am definitely pro vaccines but just not all at the same time. Also, being a breastfeeding mom, should I get the vaccine or nasal mist? If the vaccine is not mercury free, should I get the nasal mist? What if I get the shot and then my baby gets the shot, is that too much for him? How much actually passes through my breastmilk to him or is it more just antibodies?    Also, should I be looking into getting my MMR booster and how long should I wait between my Flu shot and MMR booster and how will vaccines I get interact with my baby getting vaccinated? I apologize for all the questions, but most of the time I get very short and vague answers from my docs here. I have read the Vaccine Book and pretty much live by it, but just would like a second opinion. Also, my 5 year old just got his first varicella vaccine in June, so based on the American Academy of Pediatrics schedule, he shouldn't be due for another varicella for 2 this correct?    Thank you, XXXXX XXXXX Buskirk
Submitted: 6 years ago.
Category: Health
Expert:  Celeste NP replied 6 years ago.



I have been working on your answer! You did ask questions and a lot of good questions as well!


1. For your 5 yo: I would get the MMR now and then get the flu vaccines when all of you can get them. Since your 5 1/2 month old has to wait until 6 months anyway then all of you can get them at the same time. Hopefully that makes sense. ANd you are correct it has to be at least 4 weeks AFTER the MMR.


2. Get the injections instead of the nasal mists. There is a very weak but LIVE virus in the flu mist and it is VERY RARE that there is a transmission to another person but there has been cases of it so I would just eliminate that possibility and do the injections.


3. There is no good studies about nursing moms getting the vaccine and excretion in milk. It is advised just to use caution. However, that is why if you wait until he is over 6 months than you will be ok. There just is not a lot of information about that. Sorry.


4. As far as thimerosol free, it is difficult to get. Here is a site from the CDC that you can check out and see if the base will order for you. It is called FluZone.


This link is from the CDCs report on Prevention and Control of Influenza. The whole report is at:
Here's the part about vaccine without thimerosal:
Aventis Pasteur produces FluZone®, which is FDA-approved for persons aged >6 months. FluZone containing thimerosal as a preservative is available in multidose vials. Preservative-free FluZone packaged as 0.25-mL unit dose syringes is available for use among persons aged 6--35 months.

You can also find information at this site:
Questions & Answers: Thimerosal-Containing Influenza Vaccine



I hope that this helps you to make your decisions. I know that it is very confusing and a difficult choice. You are doing a great job and Thanks for serving our Country. My son is a Marine!

Celeste NP and 4 other Health Specialists are ready to help you
Customer: replied 6 years ago.
Thank you for your advice, but being in Japan the Navy only offers the vaccine this week. So, if I do not get it this week then I am not sure it will be available to us in a month. It is a huge dilemma and very frustrating as a parent b/c we are not left with any options in how to vaccinate our children. If I could, I would get all of us the mercury free vaccine, that is what I did while in Hawaii, however, the only vaccine they have for children is the Flumist and I believe they only have that one for adults as well. I just don't know what in the world to do. Also, found out that they may not even get the vaccine for infants to have....
Expert:  Celeste NP replied 6 years ago.

I don't know if Japan has a health department that you can contact and ask them first if they have the flu vaccine, also you could ask them about the incidence of flu in that country. I will try to see if I can get that for you from the CDC.


Another option is to discuss with the base clinic to see if they will "hold" back your doses. The FluMist is only for 2 and up so unfortunately all of you could not have that one anyway. What do they do about the 2nd dose that is needed for children if this is their first time getting the flu vaccine?


Are you coming home (USA) for Christmas? You might consider waiting until then to get your flu vaccines.

I will try to check with the CDC about the peak season there. Give me some time!

Expert:  Celeste NP replied 6 years ago.

What I found out so far is that the Flu Vaccine is not on the recommended travelers list. You could draw a conclusion from that that the incidence is low...


I spoke with the CDC and they are going to get me more specific information within 48 hours. I will pass that on to you when I get it.


The incidence reports that you get online about Japan are extrapolated meaning they are not actual statistics so they are not useful.


You did ask about a MMR booster for you. I would first get a titer done and see if you even need one. It is not recommended currently for adults to get boosters without a titer first.


ANother option would be to Increase your Vitamen D which studies have shown to boost the immune system and prevent flu.

Edited by Celeste NP on 10/12/2010 at 2:01 PM EST
Customer: replied 6 years ago.
Hi Celeste,

Thank you so much for all of your help and working with me...your information and knowledge is priceless. You have no idea how many times I have tried to talk with a doctor about my concerns and looked at like I have 3 heads, anyways...I truly appreciate you answering me in such a timely manner. :) I just don't want to leave my 5 year old exposed at the DODD school here esp. since most parents are getting the flumist for their children who will then be around my child and possibly shed the virus from their vaccine. I know that I will go ahead and get the vaccine if they have the shot form for my age but hate leaving my children without the protection. My husband is currently deployed and I have no one to really bounce ideas around with, so that is one reason I am needing to talk about this matter. Thank you again.
Expert:  Celeste NP replied 6 years ago.
You are very welcome. I am happy to help! I will get you the incidence rate as soon as I get it. WE are just programmed in the States to do it in Oct because that is our FLU season but I believe it is different there. OF course they are good for a year!