We are moving to France next spring and would like to enroll our children in school there. Apparently, France loves to vaccinate. But the only truly mandated ones are diptheria, tetanus, and polio (not pertussus). They recommend a ton more, but those are the only required ones.
I have outlined our daughter's adverse reaction to her 4 month shots in the letter below I wrote to an American doctor in Paris who was recommended in the French tribal area as helpful for obtaining a certificat de contre-indication -- the only kind of waiver they have. You will see he proved to be not so helpful (perhaps he was only helpful in writing waivers when TB was required?).
Our son was fully vaccinated up to 18 months. We did not give him the "boosters" suggested in Canada between 4-6 (and MMR and DTaP). Right now, we are considering "catching up" on some vaxxes before puberty if they haven't gotten some of the diseases -- but we are also constantly researching. For now, we and our doctor are happy to say we are delaying until before puberty.
Anyway... in the short term -- we want to go to France! Does anyone know if the 4 DTaPs my son received are "enough" for the French? And has anyone had any luck actually getting a doctor to write this certificate de contre indication? Woulldn't you think that an "adverse reaction" like this would merit a letter of contraindication? Our doctor here is bilingual, so he could write a letter in French explaining the case.
Does anyone have any advice? I have pasted in all of the emails so you can read what I have asked so far (and what a load of patooie he has replied with).
Thanks for your help.
***********************
Dear Dr. French-American,
We are U.S. citizens living in Canada and we will be moving to France in Jan-June 2010 during my husband's sabbatical leave. I found your name doing research on vaccination requirements in France.
Can you please advise me how to obtain a certificat de contre-indication for vaccine requirements for French schools? We have a son who will be 7.5 and identical twin daughters who will be 4.5 when we arrive in France. One of our daughters had an adverse reaction to her 4 month shots (DTaP, HiB, polio, Pneumococcal conjugate vaccine - 7-valent). She had a long, horrible scream for 15-20 minutes, arched her body repeatedly, and then went grey and limp on the way to the hospital. She was unresponsive when the triage nurse saw us at emergency and sent us back immediately. As the doctor came in, she regained her color and regular breathing and after being evaluated for a half hour or so, she seemed fine. Our GP, the doctor in emergency, and the director of the local health unit believe she likely reacted to the pertussis portion of her shots. I had given her Tylenol about 20 minutes before she started screaming and they said perhaps the "adverse event" stopped when the Tylenol kicked in. They advised delaying vaccinations for a year.
We have been hesitant to continue vaccinating our children since this happened, however. With our doctor's knowledge, we would like to delay any more vaccines until pre-puberty. Because our daughters are monozygotic twins, we worry that if one was at risk for a vaccine reaction, the other could be as well.
I see that in France, the DTP (polio) vaccines are mandatory for school. Our son received four DTaP-IPV vaccines. Will that be enough for him? And if our doctor writes a letter outlining our daughter's adverse reaction, will that be enough for both girls to be exempt from the DTP requirements? They received two DTaP-IPV vaccines. Can our doctor here write a certificat de contre-indication? If not, would we be able to schedule an appointment with you in Paris shortly after our arrival?
Thank you for any advice you have. I appreciate you taking the time to read this email and help us prepare for our trip.
With thanks and best wishes,
LoisLane
********
Dear LoisLane,
I am uncertain if the French system will accept a letter of contra-indication or not, as I've not been asked this question since I arrived in France. A girl recently died of Measles here, and two children died in the US last month of Hib, and all were unvaccinated, so I suspect they will be strict.
You can certainly have your MD write this and try it!
The pertussis vaccine a generation back did indeed provoke high fevers and seizures, however, the acellular was designed specifically to avoid this. This event she has was just after the injection, or hours after? It sounds like she had a febrile seizure by your description, especially since she perked up so quickly (febrile seizures can be terrifying, even if they are benign!)
If so, an idea you might ask your MD about is to give vaccines as separately as possible, which we otherwise do °not° recommend for various reasons. The Hib is available in France separately, as is the Polio and of course Prevenar. The big problem is that, in Canada and the US, if a child has an adverse reaction to pertussis vaccine (which it seems unclear if that was actually the case), then we give the Td shot, a tetanus and modified diphtheria shot. However, it doesn't exist here. I would definitely recommend the tetanus shot, as it is quite deadly unless one gets prompt help, and even then it's a big problem. So...we could do individual shots here, if you and your MD agree, and then when you go back to Canada you could get the Td shots periodically.
I'm quite willing to work with you on this...but I have worked enough to see children die of measles, Hib, etc, and even paralyzed by polio, and I can assure you that you would prefer a scary febrile seizure over that!
Let me know the results of your discussion with your MD.
All the best,
Dr. French-American
******
My reply this morning:
Dear Dr. French-American,
I can't thank you enough for taking time for such a thorough and detailed answer. I imagine you are quite busy and have plenty of other things to do than help strangers an ocean away. Thank you so much.
We have not been able to find a way to give vaccines separately in Canada. I will talk with our MD and the health unit director again to press them on it, however. Even the CDC website recommends NOT giving DTaP again to a child after an serious adverse reaction (which is how they classified this), and all three doctors we spoke with after the reaction for some reason felt it was likely the "aP" part that caused it. They don't give TD in Canada until children are seven. Perhaps if our MD (who is fluent in French) writes a letter noting we will "catch them up" at seven... maybe that will be acceptable to a French doctor?
I won't expect another answer... but if you have time, do you know how many shots they will expect, both for my son, who will be 7.5 and probably in Grade 1 in France, and my girls, who will be 4.5 and in maternelle?
Again, thank you so very much for your help as we prepare for our trip.
LoisLane
I have outlined our daughter's adverse reaction to her 4 month shots in the letter below I wrote to an American doctor in Paris who was recommended in the French tribal area as helpful for obtaining a certificat de contre-indication -- the only kind of waiver they have. You will see he proved to be not so helpful (perhaps he was only helpful in writing waivers when TB was required?).
Our son was fully vaccinated up to 18 months. We did not give him the "boosters" suggested in Canada between 4-6 (and MMR and DTaP). Right now, we are considering "catching up" on some vaxxes before puberty if they haven't gotten some of the diseases -- but we are also constantly researching. For now, we and our doctor are happy to say we are delaying until before puberty.
Anyway... in the short term -- we want to go to France! Does anyone know if the 4 DTaPs my son received are "enough" for the French? And has anyone had any luck actually getting a doctor to write this certificate de contre indication? Woulldn't you think that an "adverse reaction" like this would merit a letter of contraindication? Our doctor here is bilingual, so he could write a letter in French explaining the case.
Does anyone have any advice? I have pasted in all of the emails so you can read what I have asked so far (and what a load of patooie he has replied with).
Thanks for your help.
***********************
Dear Dr. French-American,
We are U.S. citizens living in Canada and we will be moving to France in Jan-June 2010 during my husband's sabbatical leave. I found your name doing research on vaccination requirements in France.
Can you please advise me how to obtain a certificat de contre-indication for vaccine requirements for French schools? We have a son who will be 7.5 and identical twin daughters who will be 4.5 when we arrive in France. One of our daughters had an adverse reaction to her 4 month shots (DTaP, HiB, polio, Pneumococcal conjugate vaccine - 7-valent). She had a long, horrible scream for 15-20 minutes, arched her body repeatedly, and then went grey and limp on the way to the hospital. She was unresponsive when the triage nurse saw us at emergency and sent us back immediately. As the doctor came in, she regained her color and regular breathing and after being evaluated for a half hour or so, she seemed fine. Our GP, the doctor in emergency, and the director of the local health unit believe she likely reacted to the pertussis portion of her shots. I had given her Tylenol about 20 minutes before she started screaming and they said perhaps the "adverse event" stopped when the Tylenol kicked in. They advised delaying vaccinations for a year.
We have been hesitant to continue vaccinating our children since this happened, however. With our doctor's knowledge, we would like to delay any more vaccines until pre-puberty. Because our daughters are monozygotic twins, we worry that if one was at risk for a vaccine reaction, the other could be as well.
I see that in France, the DTP (polio) vaccines are mandatory for school. Our son received four DTaP-IPV vaccines. Will that be enough for him? And if our doctor writes a letter outlining our daughter's adverse reaction, will that be enough for both girls to be exempt from the DTP requirements? They received two DTaP-IPV vaccines. Can our doctor here write a certificat de contre-indication? If not, would we be able to schedule an appointment with you in Paris shortly after our arrival?
Thank you for any advice you have. I appreciate you taking the time to read this email and help us prepare for our trip.
With thanks and best wishes,
LoisLane
********
Dear LoisLane,
I am uncertain if the French system will accept a letter of contra-indication or not, as I've not been asked this question since I arrived in France. A girl recently died of Measles here, and two children died in the US last month of Hib, and all were unvaccinated, so I suspect they will be strict.
You can certainly have your MD write this and try it!
The pertussis vaccine a generation back did indeed provoke high fevers and seizures, however, the acellular was designed specifically to avoid this. This event she has was just after the injection, or hours after? It sounds like she had a febrile seizure by your description, especially since she perked up so quickly (febrile seizures can be terrifying, even if they are benign!)
If so, an idea you might ask your MD about is to give vaccines as separately as possible, which we otherwise do °not° recommend for various reasons. The Hib is available in France separately, as is the Polio and of course Prevenar. The big problem is that, in Canada and the US, if a child has an adverse reaction to pertussis vaccine (which it seems unclear if that was actually the case), then we give the Td shot, a tetanus and modified diphtheria shot. However, it doesn't exist here. I would definitely recommend the tetanus shot, as it is quite deadly unless one gets prompt help, and even then it's a big problem. So...we could do individual shots here, if you and your MD agree, and then when you go back to Canada you could get the Td shots periodically.
I'm quite willing to work with you on this...but I have worked enough to see children die of measles, Hib, etc, and even paralyzed by polio, and I can assure you that you would prefer a scary febrile seizure over that!
Let me know the results of your discussion with your MD.
All the best,
Dr. French-American
******
My reply this morning:
Dear Dr. French-American,
I can't thank you enough for taking time for such a thorough and detailed answer. I imagine you are quite busy and have plenty of other things to do than help strangers an ocean away. Thank you so much.
We have not been able to find a way to give vaccines separately in Canada. I will talk with our MD and the health unit director again to press them on it, however. Even the CDC website recommends NOT giving DTaP again to a child after an serious adverse reaction (which is how they classified this), and all three doctors we spoke with after the reaction for some reason felt it was likely the "aP" part that caused it. They don't give TD in Canada until children are seven. Perhaps if our MD (who is fluent in French) writes a letter noting we will "catch them up" at seven... maybe that will be acceptable to a French doctor?
I won't expect another answer... but if you have time, do you know how many shots they will expect, both for my son, who will be 7.5 and probably in Grade 1 in France, and my girls, who will be 4.5 and in maternelle?
Again, thank you so very much for your help as we prepare for our trip.
LoisLane
