DTaP - wait longer than 2 months between shots?

[lucy4]

We are following a selective schedule with my baby. At 2 mo he got DTaP only with no preservatives. At 3 months HIB and PCV7. I am thinking: why not wait 6 months before getting boosters for these? Btw, he is in day care, BM - fed. Did anybody waited?

[hollytheteacher]

2 months is pretty young to start vax's in my opinion (and my ds did get vax's at his 2 month check up because i was bullied into it by our first ped), but anyway to answer you question my son is 28 months and has only had 3 dtaps so far but they have each been like 6-8 months apart!! You can space them as far as you want and it does not matter (like you don't have to "start over" or anything like that). In fact, with some vax's if you put them off for a bit the child actually needs fewer vax's all together (I think you make your child's last dtap at 4 years they don't need to get the last dose)

[lucy4]

Originally Posted by hollytheteacher

In fact, with some vax's if you put them off for a bit the child actually needs fewer vax's all together (I think you make your child's last dtap at 4 years they don't need to get the last dose)

Really? Hmm.... Interesting.
Since we had our first shots, does it mean he is protected somewhat against those diseases? Or what does it mean? I will ask our pedi, but I know what she is going to say - "follow the recommended schedule, he is not protected until he gets what is on the schedule", or something like that. So, I am wondering: Isn't it that your body either immune to something or is not immune? You can't be a little bit immune to a disease, right? Our 4 mo apt is this week, and I've decided to wait before giving him a second round. Our pedi will not be happy...........

[hollytheteacher]

Originally Posted by lucy4

Really? Hmm.... Interesting.
Since we had our first shots, does it mean he is protected somewhat against those diseases? Or what does it mean? I will ask our pedi, but I know what she is going to say - "follow the recommended schedule, he is not protected until he gets what is on the schedule", or something like that. So, I am wondering: Isn't it that your body either immune to something or is not immune? You can't be a little bit immune to a disease, right? Our 4 mo apt is this week, and I've decided to wait before giving him a second round. Our pedi will not be happy...........

I think (and someone feel free to jump in if i'm wrong) that the point of each vax is to fully immunize the child to the specific disease BUT only a certain percentage of the population is immune after one dose...after each dose it is a higher percentage...so like with dtap it requires 5 shots. Some kids might be perfectly immune (assuming the vax's work the way they are supposed to) after only one shot...more kids are immune after two...etc. by the fifth does the 'research' shows that 98 to 100% of kids are immune...

someone may be able to answer a little clearer but that is sort of my vague understanding.

[claddaghmom]

Originally Posted by lucy4

We are following a selective schedule with my baby. At 2 mo he got DTaP only with no preservatives. At 3 months HIB and PCV7. I am thinking: why not wait 6 months before getting boosters for these? Btw, he is in day care, BM - fed. Did anybody waited?

Well I guess I'm curious as to your reasons for getting the DTAP? It sounds as if he won't be fully vaccinated before he hits 6 months, and 6 months is the big cutoff for when Pertussis is "deadly" or whatever they say.

But regardless of that....IMO I would wait longer than 2 months for reaction observation. Note that he got the DTAP at 2 months and then 4 weeks later 2 more vaccines. How will you know if he reacts, whether it was from the DTAP, the HIB or the PCV7?

[mamakay]

Originally Posted by hollytheteacher

I think (and someone feel free to jump in if i'm wrong) that the point of each vax is to fully immunize the child to the specific disease BUT only a certain percentage of the population is immune after one dose...after each dose it is a higher percentage...so like with dtap it requires 5 shots. Some kids might be perfectly immune (assuming the vax's work the way they are supposed to) after only one shot...more kids are immune after two...etc. by the fifth does the 'research' shows that 98 to 100% of kids are immune...

someone may be able to answer a little clearer but that is sort of my vague understanding.

What you're saying is true for measles, but for pertussis, it might be "sliding scale" of immunity. Pertussis is odd in that complete immunity is never reached via vaccination (and doesn't stick around all that long after natural infection.)
With pertussis, the vaccine (almost definitely) just makes the symptoms milder when you catch it.

[lucy4]

Originally Posted by claddaghmom

Well I guess I'm curious as to your reasons for getting the DTAP? It sounds as if he won't be fully vaccinated before he hits 6 months, and 6 months is the big cutoff for when Pertussis is "deadly" or whatever they say.

The reasons we got first DTaP was to get him to be immune to the diseases.
(The schedule sais - 2,4,6 mo.) So, are you saying that with the schedule, "P" is useless for all kids who do it?

Originally Posted by claddaghmom

But regardless of that....IMO I would wait longer than 2 months for reaction observation. Note that he got the DTAP at 2 months and then 4 weeks later 2 more vaccines. How will you know if he reacts, whether it was from the DTAP, the HIB or the PCV7?

Yes, I am thinking about waiting longer than 2 months to get his DTaP. So, for me, it's this:

2 mo - got DTaP alone.
3 mo got HIB and PCV7

Baby turns 4 months tomorrow.

No reaction to anything yet. If a reaction will show now (which would be weird-- so long after shots!), I would assume it was either HIB or PCV7 - I know which leg the shots where given.

I was considering waiting on doing the second round of shots till he is about 6 to make it easier on him. But if the "P" part is useless after 6 months anyway, then, I don't know...

Also, I am wondering if I could skip the third round of DTaP because of all the last dose reactions I am hearing about. And just give him the "T" booster every 10 years or TDaP wich is a weaker vax. In any case, I might go to the lab and ask if they could test his blood and see what his immunity is looking like to the diseases, and only then I would do a third round of DTaP if immunity is low.

[hollytheteacher]

Originally Posted by lucy4

The reasons we got first DTaP was to get him to be immune to the diseases.
(The schedule sais - 2,4,6 mo.) So, are you saying that with the schedule, "P" is useless for all kids who do it?


Yes, I am thinking about waiting longer than 2 months to get his DTaP. So, for me, it's this:

2 mo - got DTaP alone.
3 mo got HIB and PCV7

Baby turns 4 months tomorrow.

No reaction to anything yet. If a reaction will show now (which would be weird-- so long after shots!), I would assume it was either HIB or PCV7 - I know which leg the shots where given.

I was considering waiting on doing the second round of shots till he is about 6 to make it easier on him. But if the "P" part is useless after 6 months anyway, then, I don't know...

Also, I am wondering if I could skip the third round of DTaP because of all the last dose reactions I am hearing about. And just give him the "T" booster every 10 years or TDaP wich is a weaker vax. In any case, I might go to the lab and ask if they could test his blood and see what his immunity is looking like to the diseases, and only then I would do a third round of DTaP if immunity is low.

I am pretty sure there are actually FIVE dtap shots on the recommendation schedule... but the child only needs FOUR if you give the last one at age four.

[claddaghmom]

Originally Posted by lucy4

The reasons we got first DTaP was to get him to be immune to the diseases.
(The schedule sais - 2,4,6 mo.) So, are you saying that with the schedule, "P" is useless for all kids who do it?


Yes, I am thinking about waiting longer than 2 months to get his DTaP. So, for me, it's this:

2 mo - got DTaP alone.
3 mo got HIB and PCV7

Baby turns 4 months tomorrow.

No reaction to anything yet. If a reaction will show now (which would be weird-- so long after shots!), I would assume it was either HIB or PCV7 - I know which leg the shots where given.

I was considering waiting on doing the second round of shots till he is about 6 to make it easier on him. But if the "P" part is useless after 6 months anyway, then, I don't know...

Also, I am wondering if I could skip the third round of DTaP because of all the last dose reactions I am hearing about. And just give him the "T" booster every 10 years or TDaP wich is a weaker vax. In any case, I might go to the lab and ask if they could test his blood and see what his immunity is looking like to the diseases, and only then I would do a third round of DTaP if immunity is low.

Well the DTAP is one that doesn't make a lot of sense when you break it down.

Diptheria has always been very rare regardless of the vaccine.
Tetanus is due to poor wound care/diabetes in the elderly. If your child did have growth of Tetani and present with the symptoms, he could receive the Tetanus Immunoglobulin shot immediately as opposed to getting a vaccine or booster.

http://www.cdc.gov/mmwr/preview/mmwr...053713.htm#top

“(13%) of the 122 non-neonatal patients with supplemental data were reported to have received at least a primary series (i.e., three or more doses) of TT before onset of illness (Table_1), including two (40%) of the five non-neonatal patients aged less than 20 years. Three (60%) of the non-neonatal patients aged less than 20 years were unvaccinated because of their parents' religious objections. The fourth case occurred in a boy aged 14 years who was bitten by a dog and who had received his last dose 2 years previously. “

The CDC is telling us that of the FIVE kids who were reported to have Tetanus, two of them were vaccinated and three were vaccine free. ZERO died. Interestingly, supplemental data does not include any information about wound care.

Pertussis is in its own disease cycle regardless of the vaccine. The vaccine largely reduces symptoms but not transmission. And although it is more a matter of opinion, I do not find Pertussis in a developmentally typical child to be scary.

Food for thought:

http://www.cdc.gov/ncidod/eid/vol6no5/pdf/srugo.pdf

“The effects of whole-cell pertussis vaccine wane after 5 to 10 years, and infection in a vaccinated person causes nonspecific symptoms (3-7). Vaccinated adolescents and adults may serve as reservoirs for silent infection and become potential transmitters to unprotected infants (3-11). The whole-cell vaccine for pertussis is protective only against clinical disease, not against infection (15-17). Therefore, even young, recently vaccinated children may serve as reservoirs and potential transmitters of infection.”

http://pediatrics.aappublications.or...ull/104/6/1381
“Case definition has been particularly problematic in all of the recent DTaP vaccine efficacy trials. For uniform comparative purposes a case definition was suggested by a WHO expert committee.39 This definition required 21 days of paroxysmal cough plus laboratory confirmation of pertussis in the subject or household contact. There are 2 problems with this definition. The first is that a substantial number of B pertussis infections in unvaccinated children are mild and would not meet the case definition. The second is that all pertussis vaccines tend to modify duration and severity of disease rather than completely preventing illness”

[JBaxter]

We do only one vaccine per visit starting at 12 months. Hib was our first then 3 months between the next hib. We will do the DTaP at 18 months. I will not do LESS than 3 months between shots. Giving a child a shot of something every month does not ( in my opinion) give their immune system a chance to rebound.

[OHmidwife]

Originally Posted by lucy4

At 2 mo he got DTaP only with no preservatives.

Slightly OT, but what brand of DPaT has NO preservatives? I wasn't aware that there was one, and if there is, I want it!

[OHmidwife]

Originally Posted by claddaghmom

http://www.cdc.gov/ncidod/eid/vol6no5/pdf/srugo.pdf

“The effects of whole-cell pertussis vaccine wane after 5 to 10 years, and infection in a vaccinated person causes nonspecific symptoms (3-7). Vaccinated adolescents and adults may serve as reservoirs for silent infection and become potential transmitters to unprotected infants (3-11). The whole-cell vaccine for pertussis is protective only against clinical disease, not against infection (15-17). Therefore, even young, recently vaccinated children may serve as reservoirs and potential transmitters of infection.”

The "a" in DTaP stands for "acellular." This study used whole cell pertussis vaccine (DTP, not DTaP), so it does not really apply here.