3 year old starting preschool in less than a month...currently unvaxed

[eightiesbabeyo]

My 3 1/2 year old DD is starting preschool next month, and she currently has had no vaccinations to speak of.  My dad likes to call me and scare me about things and about how I need to rethink my decision to not vaccinate.  I don't want to let him scare me into getting her vaccinated, but I figured I would look into it a little more and consider doing a couple...maybe.  So for those of you that delayed vaxing till school, what were your "bare minimum" vaccinations you felt most comfortable getting for your child and why?  It's been a while since I looked into all this info on vaxing (since around the time my first daughter was born), so I'm feeling pretty lost again!

BTW, we live in MI, so we can get a philosophical waiver if we chose to, so that's not part of the issue.

[LisaSedai]

My DS never went to daycare, he did go to pre K when he was 4. DTAP was the only vax he was fully current on (he only had one of Hib.) I did it b/c I could imagine him getting a puncture wound on a playground or whatever and being worried to death about tetanus, which though rare in the US does have a fairly high fatality rate (? 50%)

The only other VPD that concerns me enough to get a vax for at this point is meningitis, but it is not recommended for young children (yet.) The other childhood diseases (chicken pox, mumps, measles) aren't typically deadly and it is preferable to get them in childhood & get natural immunity IMO. At the time I was making vax decision for my DS, they were considering removing polio from the schedule since it is not in the US anymore so I didn't do it. Since then, there have been outbreaks in some places in Africa where people had stopped vaxing. I believe there has also been outbreaks in Afghanistan. Still I think it extremely unlikely it will come back to the US.

Rotavirus causes diarrhea, which if you are not living in a 3rd world country should be easy to treat. The vaccine is contaminated with DNA from a pig virus ( wasting piglet disease?) which doesn't concern the CDC apparently but after reading about the SV40 virus from the oral polio vax being found in human cancer tumors I wouldn't take a chance on it.

Are you worried about any disease in particular? If you don't want to be hassled about it by your father, have you tried just redirecting him when he brings up the subject? IE, "Dad, I know you are concerned and I hear what you are saying but you aren't going to change my mind so I'm not going to discuss it with you." OR you could always just lie and tell him what he wants to hear 

[eightiesbabeyo]

Thanks for your input!  There aren't any diseases I'm particularly concerned about, but I also worry that I don't know enough about some of them to know if I SHOULD be worried.  Like I don't know much about diptheria or polio because I never really hear those brought up.  And I've heard of a decent amount of cases of pertussis/whooping cough (my dad went nuts on the phone calls when that was all over the news), but from what I hear it's pretty easily treated?  I thought I had remembered my midwife saying that tetanus was a shot you could get after contracting the disease and still be fine...but I could be wrong on that.  I know that sending my daughter to preschool will probably raise the risk of her getting sick, and I know it can't - and probably shouldn't - all be prevented.  I just wasn't sure if there were some things more than others she might be more likely to get that were one of the very serious diseases she could be extremely sick from.  I can stand the thought of her getting chicken pox, I can't stand the thought of her having to be hospitalized, y'know? 

As far as my dad is concerned, he's just very easily worried by anything he sees on the news about diseases and "outbreaks".  Plus my aunt worked in a doctor's office for a long time and is very pro-vaccine, so anything she says freaks him out as well.  When I give him the other side of things, he sounds like he understands where I'm coming from and why I'm making these decisions, but he just still worries...which I get...but it still drives me crazy.  I did basically tell him to stop calling me with every disease scare he saw on the news or on "The Doctors" haha, and he apologized at that time saying he didn't know he was doing it so often, but he still continues to, so I'm not sure there is any stopping that unfortunately.  I just hate when he succeeds in freaking me out so that I start questioning if what I'm doing is right...since you never really know.

[Just Ducky]

As odd as this might sound, I would place chickenpox near the top of my vaccine "yes" list. MRSA (Methiciillin Resistant Staphylococcus aureus) is a staph infection that is antibiotic resistant and is responsible for deaths among young, otherwise healthy adults. It's also very common. According to the CDC, MRSA is now estimated to be responsible for approximately 12 million outpatient visits each year. Additionally, since staph bacteria lives on our skin and in our noses (it can be found on approximately 25%-30% of the general population) is is fair to say it's just about everywhere. In general it's not particularly problematic but when it enters the blood stream through an open wound (for example, a ruptured blister caused by chicken pox) it can be quite dangerous. And the disease (MRSA, not chickenpox) is particularly dangerous for young children. So I basically see vaccinating against chickenpox as a safeguard against CA-MRSA (community acquired Methiciillin Resistant Staphylococcus aureus). Also, if you do decide to allow your kiddo to be vaccinated against the chickepox, you might want to go the "varicella vaccine" route rather than the "MMRV combo vaccine" route as the MMRV combo vaccine is associated with a greater risk of adverse reaction than the varicella vaccine and the MMR vaccine administered separately.

This site provides a good overview on MRSA if you're interested in reading about it: http://www.uptodate.com/contents/patient-information-methicillin-resistant-staphylococcus-aureus-mrsa

My best advice if you are going to do some vaccines is to read about their potential (confirmed) side effects. The CDC has that information available and they even list possible vaccine-associated reactions that are not confirmed to have been caused by the vaccine. Then you can have a good idea of how potentially harmful the vaccine itself is and you can do your best to weigh it against any potential risk caused by the disease (i.e. the prevalence and severity of the disease in question).

[Jugs]

My priority list is based on which diseases are more likely to be circulating. For me:

Top priority

(may not be inherently dangerous, but they are highly contagious and worth avoiding)

chicken pox

flu

pertussis

rota virus -if not too old to start vaccine series

Moderate priority

(more serious, but not as common)

measles

pneumococcus

hib

hep a

Low priority

(highly unlikely to encounter)

polio

hep b

[sosurreal09]

I don't have any real advice for you but my DD got all the rotovirus vax and had rotovirus 3x! IMO NOT worth it.

[~Charlie's~Angel~]

I am going with what is bottom-line required in order for my children to attend public school.  So Polio, DTap, Hep B, MMR, Varicella.  Im equally as afraid of the shots as I am of the diseases.  (Not chicken pox) But I feel more confident now that my kids are older, neurologically stronger, and Matthew has about grown out of his allergies (Im still going to talk to his ped about that before he gets any shots)

Meninghitis scares me, sure, however there are numerous strains that can mame and/or kill you that there are no vaccines for. Therefore I would rather NOT take the the chance with the vaccine when it is only recommended, but not required. 

[kathymuggle]

Originally Posted by Just Ducky 

 In general it's not particularly problematic but when it enters the blood stream through an open wound (for example, a ruptured blister caused by chicken pox) it can be quite dangerous. And the disease (MRSA, not chickenpox) is particularly dangerous for young children. So I basically see vaccinating against chickenpox as a safeguard against CA-MRSA (community acquired Methiciillin Resistant Staphylococcus aureus). 

Couldn't any cut be a pathway for MRSA, though?

[sosurreal09]

Yes ^ MRSA is ridiculously common. I'm a "carrier" just from being a nurse aide....

[Jugs]

Originally Posted by kathymuggle 

Couldn't any cut be a pathway for MRSA, though?

Sure, but which presents more opportunity for MRSA infection: a break in skin caused by a random cut or scrape, or a few hundred breaks in skin caused by chicken pox lesions?

[kathymuggle]

Originally Posted by Jugs 

Sure, but which presents more opportunity for MRSA infection: a break in skin caused by a random cut or scrape, or a few hundred breaks in skin caused by chicken pox lesions?

Don't know - I was genuinely asking Just Ducky as she seems to have some knowledge of MRSA.

Chicken pox do include many breaks in the skin, but CP is short lived.  Over time I have probably had more cuts than chicken pox lesions but of course it does not have to be an either/or thing.  If you are OK with vaxxing it might be worth looking into the MRSA/chicken pox connection to determine the risk.  

Edited by kathymuggle - 8/16/11 at 10:56am

[sosurreal09]

If your child has CP why would they be around MRSA? Wouldn't they be "quarantined"?

[Jugs]

1 in 4 healthy people are colonized with staph; unless the child is holed up in a hermetically-sealed bubble, chances are s/he will come in contact with the bacterium right in their own home.

[Bokonon]

Originally Posted by Jugs 

Sure, but which presents more opportunity for MRSA infection: a break in skin caused by a random cut or scrape, or a few hundred breaks in skin caused by chicken pox lesions?

Wouldn't just getting the shot be an opportunity for MRSA infection?  A puncture in the skin at a doctor's office with MRSA likely everywhere?

I think a child would be just as likely to contract MRSA at the playground at school as from having CP.  Maybe even more so.

OP, FWIW, when my son was at preschool at a daycare, the only illnesses that were ever posted about as one or more kids having been diagnosed with were: 1 kid had H1N1 (this was in 2010), a few cases of respiratory or gastrointestinal illnesses, and Coxsackie virus.  My son was there for a year and a half and never got anything beyond run-of-the-mill viruses.  I don't know what the vax percentages were of the 200 or so kids at that daycare, but I'm in California where philosophical exemptions are not uncommon.

My son was fully vaxed when he started school.  My daughter hasn't been vaxed since her 2 month visit except for one DTaP.  I have no plans on getting her vaccinated further just to start preschool, though she may be vaccinated later on if I change my mind.

As far as your dad is concerned - really, it's none of his business.

[Jugs]

Originally Posted by Bokonon 

Wouldn't just getting the shot be an opportunity for MRSA infection?  A puncture in the skin at a doctor's office with MRSA likely everywhere?

Again, one small puncture with a bandage on it, versus several hundred open lesions; ie: several hundred more points of entry. Not to mention that steps are taken to prevent infection at the injection site, which incidentally heals quicker than a chicken pox lesion. 

Edited by Jugs - 8/16/11 at 3:22pm

[Just Ducky]

Originally Posted by kathymuggle 

Don't know - I was genuinely asking Just Ducky as she seems to have some knowledge of MRSA.

Chicken pox do include many breaks in the skin, but CP is short lived.  Over time I have probably had more cuts than chicken pox lesions but of course it does not have to be an either/or thing.  If you are OK with vaxxing it might be worth looking into the MRSA/chicken pox connection to determine the risk.  

First, yes, any break in the skin is a potential pathway for sepsis. But like Jugs said, CP increases the risk within a given time frame. Additionally, while you may have a few hundred cuts in your first 25 years of life, CP basically turns a young child into a walking open wound for a week or two. Additionally, having CP doesn't decrease the number of cuts you get. So in addition to those few hundred cuts in your first 25 years you'd also have a few hundred CP lesions. So CP is a bit like buying more tickets for the MRSA lottery. There's no guarantee you'll "win" so to speak, but it just increases your odds. And it's worth keeping in mind that older children, teens, and young adults all have a much better survival rate where MRSA is concerned. Young children don't hold up as well against it.  (This is just an aside, but CP is also responsible for roughly one third of Arterial Ischemic Strokes in children: http://stroke.ahajournals.org/content/32/6/1257.abstract)

Originally Posted by Bokonon 

Wouldn't just getting the shot be an opportunity for MRSA infection?  A puncture in the skin at a doctor's office with MRSA likely everywhere?

MRSA is everywhere. There's even a special term for MRSA acquired from a completely non medical setting: CA-MRSA (the "CA" stands for Community Acquired). And yes, MRSA is more common in hospitals, nursing homes, ambulatory surgery centers, and dialysis centers (it thrives in places where people with weak immune systems spend long periods of time). But I personally haven't come across anything regarding an increased rate of it in doctors offices.

That said, a shot is a fairly clean thing (I'm not talking about the stuff in the shot right now, just the procedure itself). The needle is sterile. The area to be injected is rubbed with alcohol (which kills anything in that area). The sterile needle punctures the now sterile skin. And a sterile band-aid is immediately used to cover the puncture. That's why while you may hear about reactions to the stuff that's in the vaccines that kids receive, you rarely (if ever) hear about the injection site becoming infected.

So no, I wouldn't be particularly concerned about a single instance of broken skin (injection) that occurs in a doctor's office under fairly sterile circumstances putting a child at greater risk of MRSA than multiple instances of broken skin (chickenpox) that occur at home.

[LisaSedai]

Ironically, one of the possible side effects of the chicken pox vaccination is an outbreak of chicken pox. Oh they say it's a "mild" case- only 50 lesions instead of 100's but if it's MRSA you are worried about, the child is able to get it through a vaccine acquired case of CP easier than a wild case, because wild cases are pretty rare nowadays AND you may be exposed to chicken pox and not get it. ( I was exposed, my child was exposed last year- we didn't get the disease.)

[Jugs]

Outbreaks stemming from varicella vaccine viral shedding aren't particularly common. Breakthrough infections occur in about 15% of vaccinees, and the vaccine-virus is half as contagious as the wild virus.

http://jama.ama-assn.org/content/292/6/704.abstract

Also, breakthrough infections tend to only reach the maculopapular stage of the rash; fewer burst lesions = less chance of MRSA infection.

[nia82]

DS is in preschoool and will be 3 soon. He only is "current" on HiB. He has had one DTaP and will have titers run next week and we decide from there if he will get another DTaP. He didn't get his until 30 months so chances are good for decent titers. I would reluctantly give MMR if there is a measles outbreak to protect DD. Otherwise both of them will get a measles shot in Europe on the next trip (DD will be 18 months, young, but I have no other timing choice).