We've been talking a lot in class about the pros and cons of live vs. inactivated vaccines. A few days ago, promed released a report involving a case of Yellow Fever that was probably caused by the live vaccine. Interestingly, the vaccine did not infect the woman who received the vaccine, but rather her 5-week-old son. The suspected mode of transmission was breastfeeding, as the infant was not exposed to any other sources of infection, such as insects or other sick people.
The article sheds light on our ongoing class discussion about live vaccines and the risks and the benefits that they pose. Current guidelines recommend that breastfeeding mothers should not get vaccinated with the yellow fever vaccine because of the rare, but possible chance that the live vaccine will infect breastfeeding infants. In this case, it seems that the woman should have ideally avoided visiting a Yellow Fever area since her son was too young to get vaccinated and because of the danger of breastfeeding after receiving the vaccine. However, if she had no choice but to take the trip, she would have had to weigh the costs and benefits between 1) going without the vaccine and hoping that she did not get Yellow Fever (since the area she visited was not high risk) or 2) getting the vaccine and hoping that breastfeeding would not result in infection (which is what she did). It goes back to what Dr. Bob says about the context of vaccination and how, particularly with live vaccines, the risks involved really depend on the situation at hand.