Starting to Consider Selective Vax

[shelley4]

hi everyone.  my kids are 9, 7 and 3 years old.  my 9 year old son has Type 1 diabetes, he got diagnosed at 6.5 yrs old.. almost 3 years ago now.  seeing how hard it is to get him through common colds and stuff with diabetes.. blood sugars going sky high, having ketones, all that bad stuff on top of being sick... i'm starting to consider whether i should selectively, slowly vax him.  i'm mostly concerned about things like Pertussis, i can't even imagine him going through that without hospitalization.

anyways, i'm wondering if there are any former non-vaxxers who decided to selectively vax.. and if so, which vax did you start with, and how long did you wait between vaxes, etc.

i'm really not decided whether to go through with this or not, but i could really use some support and advice.

[carriebft]

I stopped vaccinated my first for a while while I researched, then I did some with her and more with my second and now we do a lot more and are much less selective and delayed. My research just took me in this direction.

If you are looking at a 3 year old and you want to avoid respiratory diseases, DTaP and PCV might be good choices. You could do one quick dose of hib and get full protection, but, by 3 its not as dangerous, though there are still deaths in that age range its a rare disease due to vaccination and usually hits younger when it does hit. PCV has a wider age range that it hits with severity. The 9 year old could get the other meningitis vaccine that covers a lot of those strains...I am not sure if PCV is recommended that old.

Do you feel he would be able to cope well with a chicken pox infection? If not, I might do that one but alone...like pair DtaP and PCV or other meningitis for older kids (you only need one PCV dose) and then varicella alone and then the next visit DTaP 2, etc.

Due to the risks associated with diabetes and influenza, you might want to consider that as well.

[shelley4]

thanks so much for your reply!

fortunately, he got chicken pox when he was 4.. before the diabetes.  so it's doubtful that he would get it again (though possible).  i would get his titers checked before vax'ing him for CP.

his diabetes doctor (ped) is very pro-vax, so i'm thinking i would go through our family doctor instead, who has been very patient and understanding of our decision not to vax so far.  i think i'd like to talk to him about all of this, and get his take on what kind of schedule he thinks would be good, and then think about it some more.  we're certainly not in a hurry at this point, lol.   if everything went okay with him, i would consider vax'ing the girls, but i'm much more confident of them weathering an illness.

i'm still really scared of potential reactions... one of the big reasons why we haven't vax'ed so far.

[EVC]

We're former non-vaxer's SLOWLY on our way to becoming selective/delayed vaxxers. 

So far dd has had two DTaP/Polio combo shots. She will need one more to be considered up to date (since we started after the age of 5). Our ped, who is pro-vax but willing to work with us, has strongly suggested we next do MMR/Varicella combo, but I'm not sold on that at this point (might be something I'll reconsider when she gets a bit older, if she doesn't come down with any of those diseases first). He has also suggested prioritizing Hep A (because of the places we tend to travel), but I'm not certain of that yet, either.

I was a non-vaxxer for 5 years, during which time I read everything I could about vaccines and "VPDs". Ultimately, I just couldn't get past tetanus and polio. Tetanus--I found myself worrying over every splinter and scrape. And I realized I just couldn't do that anymore. Polio--again because of places we travel. I just couldn't deal with the anxiety any more. So tetanus and polio became my first priority vaxxes. 

As for the others, you know, it is something we will continue to re-visit. Not vaxxing does not need to be a FINAL decision. Vaxxing, however, IS a final decision--once it goes in, you can't take it out. 

So go as slowly as you need to. Think about which diseases concern you the most and evaluate how legitimate that concern is. If there is a disease that keeps you awake at night no matter how you try to console yourself, then that is likely a disease you will want to consider vaxxing for. At least that's how I finally decided. 

And potential reactions ARE scary. For me, the best solution is doing ONE shot at a time both to minimize the risk of reaction, as well as to know what CAUSED the reaction, should one occur (although, in our case, we did the DTap/Polio combo, I would also generally avoid combo vaxxes for the same reason--but this one I consented to as the Polio portion is very unlikely to cause a reaction, so should one occur, I would know with some degree of certainty that it was the DTaP). 

[carriebft]

I know diabetes can be an issue if they get influenza, is there evidence that pertussis is a problem for diabetics? that could help in your decision with that one. You could choose to "cocoon" him instead by vaccinating those around him. this would also work with the flu to some extent I would think, though that I would consider the risks of getting it and being diabetic.

[shelley4]

pretty much any illness is a big problem for us... even a common cold can send his blood sugars either super high, or super low. he can develop ketones, which are super bad news as well. if he had a major illness, like pertussis, he would have to be hospitalized, and it would be a huge ordeal to go through. of course, his diabetes doc. thinks that all children should be vax'ed, no matter what. that's why i thought that if i did want to go through with this, i'd go to our family doc, who is much more open minded, and not push for him to get all up to date on his shots. this is such a confusion decision for us... i wish i knew the right answer...

[carriebft]

I would definitely go with getting another opinion that you feel would be "tailored" to you, kwim? I think "one size fits all" doesn't make a lot of sense, even when you have a vulnerable child. You want someone who will provide personalized reasons and a personalized schedule, that kinda thing. Plus, if you go to the family doctor, because he sees youir whole family, he might have some good advice about which would be good to "cocoon" and get the family instead.

[Lauren31]

I think that if your diabetes doctor recommended the vaccines I would listen to them. They probably are aware of  any effect, if any,  vaccines have on diabetes.

Edited by Lauren31 - 2/2/11 at 4:00pm

[Lakeeffectsnow]

I'm a health care professional, a registered nurse.  Health care professional covers a wide array of professions, experience, and training.  I personally have never been "trained by vaccine companies" either.

OP, oldest daughter had rather terrible reaction to her  DTaP as an infant.  My children have had a few of the vaccines I think are absolutely necessary for them.   I am not a fan of most vaccinations.  However, I think you need to look at each situation and child and realize vaccinations are not a one size fits all scenario. Some kids need certain vaccinations.  If my child had a serious illness, such as Type 1 diabetes, I would consider some vaccines a necessity.  I'd strongly consider the DTaP or at least the tetanus.  I'd definitely think about the influenza vaccine as well.  Only you know your child and your child's doctor.  You know if you can trust the information the doctor gives you or if you need additional information to make an informed choice for your child.  It's a tough place to be and I hope things go well for you and your son whatever you choose.

[kaylee18]

There is very little evidence that the pertussis vaccine prevents transmission of pertussis bacteria; the shot only reduces the severity of symptoms. Usually the symptoms are then mild enough that pertussis is not diagnosed, so the person has no idea that he may have exposed others to the disease, and there is a perception of community immunity when the reality is that pertussis bacteria are still very common.

So there is not likely to be a "cocoon effect" for pertussis. You either get the shot, or you are not protected. For someone as vulnerable as your 9 year old, that's a good argument for the pertussis shot, particularly since he'd only need one (Tdap; the other doses would be given as Td since he's over age 7).  

I was planning not to vaccinate, but have started with Hib and Prevnar 13. It's fine to take it slow and to go to a care provider that supports you in a customized schedule for your family.

[carriebft]

actually there is a growing body of evidence on pertussis transmission interruption and ability to actually prevent the disease as opposed to just lessen severity. Here are some studies to look at:

http://stg.jfponline.com/Pages.asp?AID=3776&issue=January_2006&UID=

This is a great efficacy study because it follows vaccinated and unvaccinated adults and tests all coughing illnesses to see if they are pertussis using PCR. So there is not worry that they missed the "hidden cases"  kwim?

They found the vaccine to be 63-92% effective in preventing pertussis.  where you prevent pertussis, you can also prevent transmission.

Two works here by the same author also conclude an interruption in transmission from the vaccine:

http://www.ncbi.nlm.nih.gov/pubmed/10675078

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981935/?tool=pubmed

people who have the pertussis vaccine have also been shown to produce less bacterium and spew less bacterium when they cough and cough less; hence, less transmisson. I know i have a good cocooning study here somewhere, I will post when I find it.

HOWEVER, I agree with PP that having the 9 yr old get the shot is the most effective way to prevent pertussis or a severe case of pertussis.

[Jennifer Z]

I would think that with Diabetes I would probably get the Tetanus in pretty fast, since wounds can go south so easily with Diabetes anyway, even without tetanus risk.  (IIRC).  We did tetanus for our first vaxes for the kids because they are at a higher, more real risk of getting it because they spend time on my parent's farm.  There was a tornado that came through the place when I was a kid and there are still lots of sharp pointy things that like to embed themselves in your foot (I had a big rusty nail that went into my heel, through my shoes and socks one time...that was seriously unpleasant).  The only downside of getting tetanus first is that it is one of the more painful ones and can be more challenging to get them back into the office easily IME.  If you have a kid that freaks out about pain, you might want to start with one that isn't as dramatic.

Other than the tetanus, we spoke to our doctor about what order we should get them in, specifying that we want to go very slowly.  He devised a plan for each kid, but each plan was slightly different based on their individual risk factors and ages.  (some of the vaccines aren't given, or given in different forms at different ages).  The CDC schedule was the starting point though...we just rearranged a few things from there.

I saw no long term changes in either of my previously unvaxed kids, either in health or behaviors, after the vaccines.   One child is typically developing, and the other has Autism.  In the very short term there was a little redness and grumpyness for a day or two.  Then, totally back to normal. (the kids were both grumpier when they had a mild case of Chicken Pox than they were for the vaccines)  My Autistic kid even made some significant language gains a few days later, although I doubt it had anything to do with the vaccine, other than it wasn't hampered by it in any way.

[shelley4]

thank you everyone for your very thoughtful replies.  i feel like we are leaning in the direction of a few, selective, and very far spaced out vaxes.  i will set up an appointment with our nice, open minded family doctor (who has supported us with non-vax, even though he doesn't believe in it!) to see what kind of schedule he recommends, and then we will tweak it from there.

i really appreciate everyone's comments, thanks for not making me feel crazy for even considering this, lol.  (it still feels crazy to me!)

[Jennifer Z]

I just realized I might have been unclear when I said "CDC Schedule", I meant the "CDC Catch up Schedule", not the infant vaccination one, especially for my 9 year old.  My 5yo is sort of in between...we are delaying some where the recommendations change soon, and getting ones where the recommendations don't vary as much, but prioritizing the ones where there is a greater local risk of contracting the illness.  (I hope that makes sense, I really need more coffee. lol)

[amnesiac]

I have removed several posts from this thread which were either not consistent with our guidelines or which were responses to such posts. Please keep in mind that the guidelines for this subforum do not permit posting to argue against the decision to vax. Please also avoid posting to take direct issue with another member, casting suspicion on another member or any other manner which is insulting or rude.

[cdmommie]

I agree that selective vaccination is a good option for your family to keep your son safe. We took some time off of vaxing to research our options and look at the pros and cons. in the end we decided that several vaccines are important to us. We don't do the flu shot, however for your son I think that would be a very important one to start with. And the same goes for tdap. I say this because pertussis and flu are very prevalent and could be potentially life-threatening in his situation. I would also caution you to consider vaxing the entire household because no vaccine is 100% successful in every person. Keeping the people around your son vaccinated will help keep him safe if for some reason his system doesn't respond to a vaccine.
Good luck however you decide to do it and I hope that you find lots of love and support from the people around you. Whether you vax or don't vax there will always be someone to judge you, so I find selective-vaxing to be especially difficult since both sides come at you.