Why you SHOULD vaccinate your children....
- Thread starter Lissa
- Start date
I don't take offense; people should be able to discuss a subject without the assuming or taking quick offense.Kaytee said:
What I was try to point out is that the ped and the family will have to devise some sort of schedule. Just saying "this should be a child to child situation" doesn't add any information as it doesn't give any details or even guiding principles.
I have no real problem with Dr. Sears' schedule either. But the point is that there are over 70 million kids in the US and every child who will be vaxed needs some sort of schedule which needs to be figured out shortly after birth. The recommended schedule has the weight of the Advisory Committee on Immunization Practices and other science-based input. Dr. Sears mainly has the weight of his individual experiences, the experiences of his ped kids and RN wife, and the experience of raising a lot of kids. This is better than nothing or sheer guessing.
In kids with no history of reactions, what would you base the schedule on? What do you consider higher or lesser risks? My nephew has Asbergers and ADHD and is fully vaxed. My cousin has classic autism and was never vaxed. I didn't consider my kids to be at higher or lesser risk for vaxes.
not a personal schedule based on possibility of reaction. Of course some kids are more proned to vaccine reaction, but that would be children with siblings that had reactions in the past. I am referring to situational in terms of lifestyle. Nothing to do with reaction. Most children will not show side affects, I'm sorry if thats what you thought I meant. I am just referring to not every disease is going to be as risky for every child. Of course their are always risks so I never said that either.Ari2 said:
Here is an example. Rotavirus: a child in daycare is more likly to get this then say a child is EBF'ed and not in a daycare setting.
The idea of tailoring a schedule for individual kids sounds good, but without any data and with so much apparent variability peds and parents would be left without guidance.Kaytee said:
Ok, so a formula-fed kid in daycare is more likely to get rota. What about the kids who are fed partially with formula and partially with breastmilk? What about breastfed kids not in daycare but with older siblings who are? What if the older siblings shared a bed with the younger kid? What if a parent works in a setting with higher rota exposure?
I'm not bringing all this up to be a PITA, but when you say the vax schedule should be determined by each child's lifestyle, you are just opening up an unending amount of perceived or possible variation. Where are the data that parents could rely on to tell them what to do in their exact, particular situation? In the past you have supported the idea of making informed decisions. How could parents make these decisions under a lifestyle-tailored process? Where are the data?
No schedule at all? You just show up randomly, a vax is picked by you and your doc at random, and you move forward that way? You said you are "pretty much following" Dr. Sears' schedule previously. If not that, how does it work?Kaytee said:
The efficacy of most of these vaxes varies by the timing of the doses. It doesn't have to be down to the day or usually even the month, but it makes no sense to give one dose of, for example, rota at 6 months and never again or two doses of Hib at 8 months and two more doses at age 5.
you are right there are many variation and it all depends on the answers to those questions you asked. No breastfed kids are not less likely to get rotavirus but it is almost impossible for them to get it severe. Of course some may still, but the chances are slimAri2 said:
The Journal of Family Practice
talks all about how they are less likely to get it severe. So I would say a child who is breastfed and has no older siblings is at a much less risk of getting rotavirus and thus less severe then a child who has siblings that our older or a formula fed infant in daycare.
and no she has no schedule. I don't use Dr. Sears Schedule either, I said I would follow something simialr with the next one. Nichole had her 2 month vaxes, then had a polio vax at 4 months..... none after that till she went to a allergist at 12 months. They gave her DT. That was the last time she had a vax. She has been to all of her well babies up till this point though. Her doc and I discussed the MMR at her 18 month check up, I then told her what we would be doing after that. So we go next week for her measles vaccine. Not the MMR. She most likely will not get another one till she is 3. At that point we will discuss what we think is best for her.
The strongest argument for Hepatitis B vaccination is the potential for chronic disease and its possible consequences. In addition to a short-term illness, Hep B can cause chronic hepatitis. This can progress to cirrhosis and liver failure, requiring a transplant. It also significantly raises the risk of liver cancer. Unfortunately, if you get Hep B as a young kid you are at greater risk to get the chronic disease than if you got it as an adult. While people like to scoff at the idea of young kids getting Hep B ("I don't think my baby has multiple sex partners or shares IV drug needles" etc), prior to the vax being offered nearly 20% of the US cases of chronic Hep B were from childhood infection.Lissa said:
In comparison, the Hep B vax is safe and usually provides decades-long immunity. While none of us like to think this way, we can't entirely predict whether our kids will have multiple sex partners, engage in safe sex, use IV drugs, or do other risky stuff when they are older. So for most the benefit of the vax outweighs the possible risks of the disease.
For Hep A, the situation is different. Unlike Hep B (or Hep C), Hep A has no chronic state. It is spread by ingesting the the virus, usually on food that has been handled by someone who didn't wash up properly after using the bathroom. (In contrast, Hep B is blood-borne.) If you get Hep A naturally, you are immune for life. In developed countries, Hep A is most frequent in kids ages 5-17, and the majority of infected kids either have no symptoms at all or very mild symptoms.
Here's the main rationale for the vax as I see it: Hep A can be a nasty disease, especially after childhood. Case reports (so a little iffy) before the vax put the death rate in the US at 0.01-2%. Short of death, people can develop what is called "fulminant Hep A", which means big-time liver problems that can lead to problems clotting (so you bleed like stink) and encephalopathy. In 30-60% of cases, people with fulminant Hep A recover spontaneously (so they don't need a transplant or other big intervention) and have no long-term problems. The remaining 70-40% (the fact that there is a huge range here should raise some concerns about 1) the quality of the data and 2) the variability of the people involved) generally recover completely but require a lot of care. The ones who don't are the 0.01-2% who die and the unknown-but-likely-also-very-small percent who had long-term problems.
In contrast, the Hep A vax is also seen as being safe. The long-term efficacy, however, is unknown. So no one can say how long the immunity of the vax or any boosters will last. It is known that the body mounts 10-100 times less of an immune response to the vax than to the natural viral infection.
HTH.
The most recent CDC stats are from 2006. These show a steady decline in Hep B in the US since the mid-to-late 80s. For 2006 the overall rate was 1.6 cases per 100,000 people with a total of less than 5,000 cases reported in the US.Kaytee said:
The CDC also puts the prevalence of chronic Hep B as low (less than 2%) throughout North America, including Mexico. You can see it on this map (I can't get it to display):
But I don't know more recent figures.
For Hep A you probably get infected as a kid, didn't realize it because you had no symptoms, and are now immune for life. The CDC and others have also noted that US adults seem to have strong herd-immunity: More people are immune and this is decreasing the risk of transmission to the non-immune. To be careful, you can take all the sensible precautions: washing your food, eating a clean-appearing restaurants. For adults, the vax isn't recommended except for a few exceptions: men who have sex with men, people who travel to risky places, people with possible occupational exposures, drug users (especially IV drugs), and folks with chronic liver disease or who rely on infusions of clotting factors because of some sort of clotting problem.Lissa said:
For Hep B, the vax recommendation for adults is similar: No vax unless you are in a high-risk group (e.g., HIV+, end-stage kidney disease, chronic kidney disease, occupational exposure, the same sex and lifestyle stuff as with Hep A, people with household members with Hep B, etc.). But with Hep B it is not uncommon to get a blood test to show whether you are immune if there is a concern or if you need proof of immunity for work in a hospital, clinic, or other higher-risk place. This usually isn't done for Hep A.
So you have the measles vax scheduled for next week, you have titers scheduled for June/July to determine immunity, and you have decided against the MMR and will defer further scheduling until age 3. This is a schedule, even if it is abbreviated, delayed, and not established all at once (I understand your caution after Nicole's reaction).Kaytee said:
To have no schedule at all would mean random vaxes at random intervals. This wouldn't work for anyone, the ped, the clinic, or the parent. And if a parent decides the kid will be vaxed early in life, this needs to be established early.
I'm not saying that every kid needs to follow the recommended schedule. While I think it can cause problems on a larger scale, I believe parents should have a say in the vaxes their child receives. But to do this requires some sort of schedule, be it the CDC's, Dr. Sears', or something like you have put together with your doc.
It seems like we probably aren't in that big of disagreement about this and just misunderstood each other a bit.