I really would like advice--Thinking about giving 3 y/o her first vax before preschool and new baby

[nukuspot]

I keep going back and forth in my head.  I posted my long story, actually X-posted it on the other vaccination boards here at MDC and have gotten only one response which was basically a bunch of links I had already read.

I felt up to this point I made the right decision to not vax DD.  If I was not pregnant again I don't think I would be even thinking about this...But DD is going to be starting preschool in Sept in the exact week the new baby is due.  We are also in the middle of a record pertussis outbreak in our state, supposedly the highest since 1940.  I have many, many friends with pertussis at the moment (most are adults.)  If my 3 y/o DD got pertussis it would totally suck...But it's not her I am so worried about, it's the new baby.  I am NOT going to vax a new baby. 

I read online here how DTaP does not prevent transmission, and that is a bummer but I understand that point now.  However, I am still thinking of getting 3 y/o DD the DTaP because 1.)  If she does get pertussis, it will be less violent and she might cough less and thus spread the pertussis in the household less, plus it might be shorter lived.  Also, I would not have to deal with taking care of a very sick toddler and trying to keep new baby away from her alone while DH is at work.  2.)  Her preschool has a huge outside area with a sandbox and play area.  I wouldn't need to worry about tetanus if she gets hurt at school.

DH is getting the DTaP booster because as he says "Why not?"  I am on the fence myself.  I don't feel comfortable getting a vaccine during pregnancy or breastfeeding, but I would if it meant I would be transmitting antibodies to my newborn through my milk.  Does anyone know if that is true?  Can a newly vaccinated mother transmit vaccine aquired pertussis antibodies through her milk to the newborn?

However, I am very, very afraid of vaccines.  My heart breaks when I read stories about children who were forever changed after a vaccine.  This is the main reason I don't want to vaccinate an infant, it feels wrong deep in my gut to do this.  At 3 I know she is still a baby but she seems older, stronger, better equipped to deal with any adverse effects of a vaccine.

That said, I am about 50/50 on if I am going to go this route or not.  I have 4-5 months to decide.  Does anyone have information about adverse effects from toddlers getting DTaP?  Or positive stories?  Anecdotal stories really do help me a lot in my decision process. 

Thank you!

[slmommy]

When was last time you had dtp? I believe you can be tested to see how your immunity is. You would pass antibodies through placenta and breastmilk, if you have.

Quote:

For infants, transplacentally transferred maternal antibodies might provide protection against pertussis in early life and before beginning the primary DTaP series. Several studies provide evidence supporting the existence of efficient transplacental transfer of pertussis antibodies (7,11,12). Cord blood from newborn infants whose mothers received Tdap during pregnancy or before pregnancy had higher concentrations of pertussis antibodies when compared with cord blood from newborn infants of unvaccinated mothers (7,11). The half-life of transferred maternal pertussis antibodies is approximately 6 weeks (12).The effectiveness of maternal antipertussis antibodies in preventing infant pertussis is not yet known, but pertussis-specific antibodies likely confer protection and modify the severity of pertussis illness (13,14). In addition, a woman vaccinated with Tdap during pregnancy likely will be protected at time of delivery, and therefore less likely to transmit pertussis to her infant. After receipt of Tdap, boosted pertussis-specific antibody levels peak after several weeks, followed by a decline over several months (15,16). To optimize the concentration of maternal antibodies transferred to the fetus, ACIP concluded that unvaccinated pregnant women should receive Tdap, preferably in the third or late second (after 20 weeks gestation) trimester.

 

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6041a4.htm

Personally, the more I am reading about pertussis vax, the more useless it seems, but that's me and what I've been reading... I only have one DD, who is partially vaxed before I stopped at 6mos and was selective before that. I do not think I would vax her if I had a new baby coming.

[Bokonon]

Originally Posted by slmommy 

When was last time you had dtp? I believe you can be tested to see how your immunity is. You would pass antibodies through placenta and breastmilk, if you have.

Personally, the more I am reading about pertussis vax, the more useless it seems, but that's me and what I've been reading... I only have one DD, who is partially vaxed before I stopped at 6mos and was selective before that. I do not think I would vax her if I had a new baby coming.

This is how I feel as well.  I just don't trust the safety of the vaccine, especially in pregnant women.   For me, I don't know that potentially preventing pertussis is worth the potential lifelong risk of vaccination during pregnancy (for which there are no studies on, so it's a big question mark).

[slmommy]

I think you should 1. ask your hcp about testing your immunity, 2. if you don't do so already, check into boosting immunity especially for 3 yo, there's lots of other stuff around preschool, not vax preventable.... and then figure out next options after you have an idea whether or not you can pass antibodies to new baby.

[nukuspot]

Thanks guys!  I'm already one step ahead of you, I've already called the lab and asked if they have a titer for pertussis antibodies (they do but told me it would cost 300 dollars if my insurance wouldn't pay for it).  I then called my insurance and they WILL cover it!  So I emailed my PCP and asked if she can write me a lab slip.  I hope to go in to get my blood tested this week.  My last vax for pertussis was when I was about 10.  However, I got my titer run for Hep B when I was in MW school and I was still immune from my childhood, so maybe, just maybe I will be from pertussis too.

But if not, I'm not sure where to go from there.  I absolutely don't feel comfortable with the following things 1.)  Getting vaxxed while pregnant and 2.)  Getting my newborn vaxxed.  So my choices are (if I'm not immune) to vax myself with a booster postpartum, and give my 3 y/o her first vaxxes ever, or do nothing.  I keep wavering back and forth.  If we weren't about to have a new baby in the middle of a pertussis outbreak with DD starting preschool I wouldn't even be thinking about this!  I'm truly not comfortable with vaccines.  However, I am also not comfortable with the risk my newborn could get pertussis.  So that's my situation.  Any more words of advice are greatly appreciated.

[nukuspot]

And I already give DD 800mg Vitamin D daily, Udos probiotics, fish oils, and she eats a whole foods, organic diet (toddler style), and I give her vitamin C and elderberry tincture when she is sick,  so I think I'm doing as much immune boosting as I can?  What else would you recommend for a 3 year old?

[Bokonon]

I completely understand it feels like a no-win situation!  But the current outbreak might be over by the time your baby is born.  You have some time to monitor the number of cases and make a decision based on your titers as well.

My son was in preschool when the H1N1 hysteria was going on and my daughter was born, and then the flu vax was being pushed that fall.  There ended up being all of 1 confirmed case of H1N1 in his preschool, but the only other communicable illnesses in the school/daycare were Coxsackie, pink eye, strep, and a stomach virus, none of which were vaccine-preventable.

[emmy526]

You ask, Why not?  here's some information to consider..

[slmommy]

Quote:

Originally Posted by nukuspot 

So my choices are (if I'm not immune) to vax myself with a booster postpartum, and give my 3 y/o her first vaxxes ever, or do nothing.  I keep wavering back and forth. 

One thing to consider/research is how quick/effective a pp booster will be, if you have no immunity... I think the link I posted above says it takes a few weeks...?

...and on the same hand... I think it would take several rounds of DTaP for 3 y/o to probably have decent pertussis protection... If you wanted to do full round with decent spacing, that might be something to start sooner than later. I agree with you about vax during pregnancy. 

Hope you do have some immunity left!! 
 

[nukuspot]

Originally Posted by Bokonon 

I completely understand it feels like a no-win situation!  But the current outbreak might be over by the time your baby is born.  You have some time to monitor the number of cases and make a decision based on your titers as well.

My son was in preschool when the H1N1 hysteria was going on and my daughter was born, and then the flu vax was being pushed that fall.  There ended up being all of 1 confirmed case of H1N1 in his preschool, but the only other communicable illnesses in the school/daycare were Coxsackie, pink eye, strep, and a stomach virus, none of which were vaccine-preventable.

I was not worried about H1N1 in the slightest...I thought it was just hype.  Pertussis for an older child (like my toddler) I'm also not overly concerned about (though it would SUCK).  It's just the newborn, babies under 4 months old especially since they count for basically almost all of the mortality/morbidity associated with the disease.  I want to say that I am usually not super concerned about most VPDs in general, it's just because I'm going to have a new baby and there lots of pertussis going around.  Every week one of my FB friends posts that they or their older kids have pertussis.  When DD was a newborn I didn't go out much for the first few months (not because of disease fears, just being a new mama), so she didn't seem to have a lot of exposure, and there wasn't a high epidemic going on.  So I wasn't very worried about her as an infant getting pertussis.  With baby #2, there is no way I can do that, I am a SAHM!  Baby has to come with me and DD #1 everywhere....

[nukuspot]

Originally Posted by slmommy 

Quote:

One thing to consider/research is how quick/effective a pp booster will be, if you have no immunity... I think the link I posted above says it takes a few weeks...?

...and on the same hand... I think it would take several rounds of DTaP for 3 y/o to probably have decent pertussis protection... If you wanted to do full round with decent spacing, that might be something to start sooner than later. I agree with you about vax during pregnancy. 

Hope you do have some immunity left!! 
 

I hope I do too!  My PCP still hasn't called me back about getting me the lab slip for the titer.  I'll give her one more day then call her again.  I agree with you, DD would need multiple rounds of vax if I am going to give her any, so if I decide to do this (which I have totally not decided one way or the other) I need to start soon so she is at least partially protected before September.

Basically, the only things we have decided on are 1.)  DH is going to get a DTaP booster (because he needs a tetanus booster anyway, he is a woodworker and cuts himself deeply on rusty tools about once a day--So he might as well just get the DTaP instead of the TD.  2.)  I am going to get my blood tested for a pertussis titer.

Everything else is still up in the air.  I don't rush into decisions but I am aware this is kind of time sensitive.
 

[shiningpearl]

this is a great article on WC, http://vaccinationcouncil.org/media/The-Vitamin-C-Treatment-of-Whooping-Cough.pdf

and if were me, as much as I would want to limit the sickness in the older child, I would want to know if they were sick and not just spreading the bacteria.  If your older daughter is showing signs of WC and you take her and get tested and she is positive for it, they will treat the whole family, but if she is vaccinated and not really sick, you might never know until it's too late and they won't be as quick to test her because she is "Immune", but the majority of cases lately are in the vaccinated population.

this is from Australia, http://www.geelongadvertiser.com.au/article/2012/03/14/312921_news.html newborn almost dies from vaccinated sister.

One of my personal opinions is this is the first year they have approved and PUSHed adults to get the DPT and cocooning you baby by all the parents, grandparents etc getting the booster.  This has been the highest record of WC and not just confined to one state, but all over the country!  Shouldn't the rates be going down.

[nukuspot]

and if were me, as much as I would want to limit the sickness in the older child, I would want to know if they were sick and not just spreading the bacteria.  If your older daughter is showing signs of WC and you take her and get tested and she is positive for it, they will treat the whole family, but if she is vaccinated and not really sick, you might never know until it's too late and they won't be as quick to test her because she is "Immune", but the majority of cases lately are in the vaccinated population.

That is a really good point...I am going to bring this up with her pediatrician when I go in to talk with her next week.  She is a standard MD but has been very supportive of our decision so far to not vaccinate.  I was really happily suprised.

[heatherfd]

Sorry , can I just correct that Comment " newborn almost dies from vaccinated sister " Vaccinated sister wasn't the illness , pertussis was .

NO vaccine is 100% effective , that is a fact . Just as the fact is that 92% of deaths form pertussis are in the under 3 months age group .

[stik]

The risk of pertussis for an infant is higher than I am comfortable with.  I would prefer the vaccine.  I'm not thrilled with it's efficacy in preventing transmission, but it does do a good job of reducing severity of the illness, which helps cut down on opportunities for transmission a bit as well. 

[cyberfish]

Originally Posted by stik 

The risk of pertussis for an infant is higher than I am comfortable with.  I would prefer the vaccine.  I'm not thrilled with it's efficacy in preventing transmission, but it does do a good job of reducing severity of the illness, which helps cut down on opportunities for transmission a bit as well. 

Do you have a reference for this?  Thanks...

[stik]

No I don't have a reference for that right now.  I have read it somewhere, but mainly a shorter illness will generally have a shorter period of germ-spreading coughing, which means fewer opportunities for transmission of the illness.  

[Amanda1]

I have no great ideas for you but I am so glad you posted.

I am just across the boarder from you in BC so we are experiencing the same outbreak and its freaking me out. My DS is 2 and will have a new one in Oct so the exact same thing has been on my mind. I think we will go ahead an get him the vaccine for peace of mind and the fact that my TCM (who is mostly anti vac is in favor of everyone getting a Tetnus vaccine). He is going to give me some homeopathics that kind of contain the vaccine? I don't really know how it works but I trust him 100%

Anyways, good luck in your decision, I'll be reading to help finalize my decision

[nukuspot]

Originally Posted by stik 

No I don't have a reference for that right now.  I have read it somewhere, but mainly a shorter illness will generally have a shorter period of germ-spreading coughing, which means fewer opportunities for transmission of the illness.  

This is what I believe to be true as well, which is why health care professionals will tell you vaccination helps lessen transmission.  However I would counter this was mainly applicable to a public setting, and not an intimate setting like a household where the family members are kissing and touching in more close confines.

[nukuspot]

I still haven't come to any conclusion by the way other than DH is going to get a Tdap booster because he needs a tetanus booster for work anyway and the adult Td still contains thimerasol so it is actually in his best interest to get the Tdap!

Not sure what myself and DD will do but still researching madly.