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Prevnar and Pentacel - help me wade through these waters please

post #1 of 15
Thread Starter 

A few days back my DD 3 yrs had a bout of viral illness (or 'flu) which lasted 6 days and she ran pretty high and consistent/persistent fevers.

 

The docs we visited (2 visits..one with ped and another with a horrible scary doc) kind of pressurized us to get her the Prevnar vax which we haven't because I read so many negative things about it.

 

Well the second emergency doc was very horrid and used some scare tactics but all in all she was kind of persistent and made me feel we narrowly escaped something horrible because they were kind of looking for Pneumonia and all (she even got x-rayed which came back negative)

 

Anyway.. am a bit shaken. thoughts?> I thought Prevnar was recommended for children under 2 yrs - right? I mean not that it isn't given to children above 3 but...

 

..Also I read that one dose of Prevnar is very very effective ..so am kind of wondering if we should get her one dose?

 

She is due for her last Hib and last DTap dose so the doc is strongly recommending Pentacel so as to get her all 5 in one...

...Her first Hib was a separate shot for only Hib.. I read in a CDC site that they should keep the same conjugate vaccine throughout the schedule.. so am not sure what the individual Hib vax contained and what Pentacil may contain and if they would be the same or not.... but that is secondary.

 

Primary is - should we go the Pentacil route at all? Am not feeling comfortable giving 5 vaxes at once ...

 

http://www.cdc.gov/mmwr/preview/mmwrhtml/00041736.htm#00001680.htm

 

. Ideally, the same conjugate vaccine should be used throughout the entire vaccination series (according to the schedule outlined in Table_4). No data exist regarding the interchangeability of different conjugate vaccines with respect to safety, immunogenicity, or efficacy. However, situations will arise in which the vaccine provider does not know which type of Hib conjugate vaccine the child to be vaccinated had previously received. Under these circumstances, it is prudent for vaccine providers to ensure that at a minimum an infant 2-6 months of age receives a primary series of three doses of conjugate vaccine. These recommendations may change as data become available regarding the response to different conjugate vaccines in a primary series.


Edited by Blessed_Mom - 5/6/12 at 10:58am
post #2 of 15

Personally, I also wouldn't be very concerned about hib or prevnar for  2+

 

Pentacel is Hib, DTaP and IP. Because it is combo shot, you get more aluminum at once than if you spaced out those shots and did them separately.

 

The DTaP component in pentacel also has more pertussis antigen than DTaP by same brand (Daptacel)

 

Quote:
Pentacel and DAPTACEL vaccines contain the same pertussis antigens, manufactured by the same process, although Pentacel vaccine contains twice the amount of detoxified pertussis toxin (PT) and four times the amount of filamentous hemagglutinin (FHA) as DAPTACEL vaccine

 

Daptacel has no mercury, as opposed to other DTaP brands which have trace amounts or more aluminum.


Edited by slmommy - 5/3/12 at 6:06am
post #3 of 15
Thread Starter 

I wouldn't have been so worried about either Hib or Prevnar had we not very recently been in her ped's office where my very sick DD was taken to get her x-ray done all the while the doc telling us that they were checking for meningitis (symptoms) and pneumonia (x-ray). 

 

Made me feel very bad and I wouldn't have been able to forgive myself if it could have been prevented by a vax :-(

 

We were ok with Hib but Prevnar was never on our schedule. Now I find myself rethinking it... and wondering if we should risk giving her the one shot (which seems rather effective after only 1 shot). 

 

But since my last comment I am not feeling the Pentacel myself. I think we will give her the last Hib next and mull more about Prevnar.

 

Anyone want to sway me (Oh I know what it means in MDC.... all the naysayers will try and sway me wink1.gif ) one way or the other?

post #4 of 15
Thread Starter 

Another note: She has had 3 Daptacels so far. I think the efficacy after 3 shots is as good as 4 (4 is only marginally better)? Is that right?

 

Should we stop at 3 or go on and give her the 4th?

post #5 of 15
Thread Starter 

OK

 

I am really really sorry but my first post is very confusing for the reason that I was thinking Pentacel = DTaP +Hib +Prevnar

 

Duh!

 

Anyway - yes ..no Pentacel.

 

Definitely Hib  .. and definitely IPV

 

Maybe 4th dose of DTaP?

 

...and will think very very hard about Prevnar (I wish I didn't have to give it OR wish it were one of the safer ones)

 

Thoughts?

post #6 of 15

3 doses of Daptacel gives about equal immunity has 4, according the the product insert, involving study of Swedish children who had 3 vs. American children with 4.

 

How many ips has she had?

 

Honestly, I don't really know much about prevnar, it has never been on my radar.

post #7 of 15

I'm currently researching DTaP..  3 doses are considered a full series for the D and T parts.  The US considers 4 (or 5 if the child is under 4) a full series for the P part.  But as slmommy wrote, they has studied 3 doses as a full series in Sweden, while at the same time adding dose #5 over here in the US.  I am planning to do 3 doses of DTaP and then get titers checked for my DD.

 

Sorry I also can't help about prevnar.  In my research the only vax I have ever considered as maybe having an acceptable risk/benefit ratio is DTaP so that's all I've researched.

post #8 of 15
Thread Starter 

Her vaccinations so far...

 

 

IPV so far = only one. She was 12 months at that time.

 

Daptacels = 3

 

Hib = One .. (but she was 9 months at that time)

post #9 of 15
Thread Starter 
Quote:
Originally Posted by slmommy View Post

Personally, I also wouldn't be very concerned about hib or prevnar for  2+

 

Pentacel is Hib, DTaP and IP. Because it is combo shot, you get more aluminum at once than if you spaced out those shots and did them separately.

 

The DTaP component in pentacel also has more pertussis antigen than DTaP by same brand (Daptacel)

 

 

Daptacel has no mercury, as opposed to other DTaP brands which have trace amounts or more aluminum.

Slmommy

 

I wanted to make sure I read two of your statements right - I keep meaning to ask.

 

When you write that personally you wouldn't be very concerned about giving Hib or Prevnar for 2+ you meant that you don't see the need to - am I right?

OR did you mean .. you wouldn't see a concern in giving them Hib or Prevnar?

 

Secondly in the last sentence you write Daptacel has no mercury and less Aluminum than other brands right? (Not that it has more Al than other brands)?

Thanks

post #10 of 15

Daptacel has less Aluminum than Infantrix.  But more than Tripedia.  However Tripedia still has mercury so to me it makes sense that Daptacel is the logical choice out of the 3.  Plus they stopped making Tripedia a few years ago, though there are probably some still out there.

post #11 of 15
Quote:
Originally Posted by Blessed_Mom View Post

Slmommy

 

I wanted to make sure I read two of your statements right - I keep meaning to ask.

 

When you write that personally you wouldn't be very concerned about giving Hib or Prevnar for 2+ you meant that you don't see the need to - am I right?

OR did you mean .. you wouldn't see a concern in giving them Hib or Prevnar?

 

Secondly in the last sentence you write Daptacel has no mercury and less Aluminum than other brands right? (Not that it has more Al than other brands)?

Thanks

 

Yes, I was saying that I wouldn't probably do hiv or prev for a child over 2 yrs old, but I think we all need to weigh our personal circumstances.

 

I would be more comfortable with daptacel than other brands, like Nukuspot said.

 

I did get my DD pentacel when she was a baby... I wouldn't choose that again, but at the time my reasoning was I wanted IP and DTaP and at the time I was reading Dr Sears book, and Hib doesn't appear to have any terrible ingredients, so I figured 1 shot instead of 2...

But I think now that spacing out the aluminum exposure would be the route I would take if I were to vax like that again. 

post #12 of 15
When a child presents with a fever, it is considered the standard of care to test for a uti, pneumonia, and do a blood draw to look for an elevated wbc. The next tier of testing, in the presence of symptoms, is menengitis. My understanding is that this is protocol for a vaxed or unvaxed child. The vaxes only protect against a few strains of the virus.

When we have sought medical care for a prolonged (more than 3 days) fever, we only start with a blood draw. If there are no symptoms of menegitis, then the purpose of all the testing is to rule out a bacterial infection. By doing a blood draw, we can use the wbc to see if we even need to look further. If there is not evidence of a bacterial infection, then regardless of the illness, a virus simply requires supportive care.

So, I don't see the urgency from your experience. Did the doctors ever do anything to help your daughter? Or did they just do a bunch of tests, scare you, and then wait it out?
post #13 of 15

Just1More, that was my experience (and I don't have much), when DD had a high fever for more than 3-4 days, we also did blood draw and urine. It was bacterial and we started antibiotics.

post #14 of 15
Thread Starter 

Just1more,

 

We went to the docs twice during her 6 day illness. Once on the second day (because we almost always go the second day to rule out something early or catch something). This was her ped who isn't x-ray happy and just told us that her illness seemed typical of what he was seeing - fevers for 3 days and cough for another 3-6 days.

 

He said if her fevers persisted or cough got worse or she got worse then to bring her in again.

 

By the 5th day when her fevers weren't subsiding (except with Ibu and that too that day her fever came back after just 3 hours of Ibu...) we ran to an emergency apptment with a very pro-vax doc (who had earlier tried to scare us abt vaxes.. We had forgotten her name else we would never have seen her again)

 

She ordered an x-ray for DD and kept commenting about Pneumonia and Meningitis and what-nots and we were already agitated and distressed. thankfully the x-ray came clean but she talked abt Meningitis symptoms and sent us home to watch over DD.

 

She also said she was going to send the x-ray to the radiologist to confirm her diagnosis and call us- which she did on the 6th day (by which time DD was over her fevers).... Well she again kept talking vaccines.

 

So yes - I know she used scare-tactics and was a bully but we ourselves were aware that we had kind of gotten lax about her second Hib which was on our agenda anyway and we kept delaying it longer than we should have.

 

Prevnar was never on our schedule but she insisted we give her atleast one shot.. so we are vaguely uneasy about that.

post #15 of 15

My experience: when dd was 5 weeks old, she developed a high fever that lasted several days.  

Being a dutiful mum, I called the pediatrician as instructed when the fever went over 100.7. 

They sent us to the ER, who did not look for pneumonia or UTI, but immediately started treating her as though it was meningitis.  They admitted her, started IV antibiotics, Tylenol AND ibufrofen, did a spinal tap (which was negative), the whole 9 yards. She was there 5 days (I stayed with her, of course).

 

On day 4, they said that she did not have meningitis, but Fifth Disease.

 

I understand that with very young infants, they do not have a decent window of time in which to diagnose meningitis before it's too late.  But it was an absolute nightmare, and the medical treatment had repercussions that were fairly long-term (reflux and projectile vomiting).  As is typical with US medicine, I was never informed of any possible risks from the treatment, though at least once the reflux and PV started, the hospital staff had no problem admitting that they were caused by the treatment.

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