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how long to wait from the time a child had a virus to do a vax?

post #1 of 9
Thread Starter 

The V-day (vax day) is coming up, April 16th.  My DD just had a HORRIBLE respiratory virus over this last week.  (We actually thought it was pertussis, which I was almost excited about since then she would get natural immunity and I wouldn't have to do the vax...But she's almost better in 1 week so I am sure it was just a virus.)  She's basically 99% better but still coughs every once in awhile.  I am wondering how long from the time she is totally well to the time of the vax is OK?  I don't want to stress her immune system out, but we are on a time constraint, as we are trying to get 3 doses of DTaP, spaced 2 months apart before the new baby comes (and DD1 starts preschool) in September.  We are concerned about the major pertussis epidemic in our area and having a newborn right at the projected peak of cases. 


My ND friend says a week between a viral illness and a vax is totally fine.  And he gives vaxes in his practice so I want to believe that, but just curious what others have been told or experienced?

post #2 of 9

Umm, if it was April 16, I think you missed it?


I don't see any reason to even consider a pertussis vax unless you have already done titers and established that she is not already immune.


I would agree that a week of good health (between the END of an illness) and a vaccine is a must, but I do worry that a child could be coming down with a virus 2-3 days with no symptoms 1-3 days before a vaccine, and you wouldn't know--which makes it something of a gamble no matter what.


But if she has positive titers, no need for the vaccine.

post #3 of 9
Thread Starter 

OOPS, May 16th. 


And obviously you have not been following my postings on here for the last month.  I've done extensive research and come to the conclusion that we are going to do the vaccine for my 3 y/o.  There is a huge pertussis outbreak in my state right now, expected to peak in September right when our new baby is born.  Normally I don't vax and wouldn't really think of doing so, (not anti-vax, just haven't seen that the risk/benefit ratio made sense so far) but I am not willing to take the chance that my older DD could get it and pass it to the newborn in this distinct situation.  So I am not asking for that sort of opinion on this posting. 


There is no point in doing the titer for her, she has never had pertussis.  I am sure of that.  How would I not know?  Plus the titer does not show amount of antibodies (like the tetanus or diptheria  or Hepatitis do) the pertussis titer just shows if antibodies are present or not present.  So a tiny amount of antibody could be present and it would show up as a positive titer but it would not be enough to form a good immune response if she was exposed the the bacteria.  This is I know because I just got my pertussis titer run after myself and my MD researched it extensively.  I got mine run because I had probable pertussis 4 years ago and I really wanted to know if it was in fact pertussis, as then I would still have naturally aquired immunity for 5-10 years from infection, since naturally aquired and passively aquired antibodies have the same time frame of length in the body (CDC MMWR 2008).  I knew that because I was never vaccinated for pertussis as an infant, and I never had any pertussis like disease before 4 years ago, that if it came back positive I would know for sure that my self dx was correct (I was not medically diagnosed because I was out of the country, doing a clinical rotation in the South Pacific when I got sick.)  And so it was.  My MD said this was one of the few cases where the pertussis titer made sense to run.  So I didn't get an adult Tdap but my DH did and so will any other adult who will be around the newborn in the first few months.  (It's called "cocooning" and it's the safest thing to do in a pertussis outbreak situation, especially because we will NOT be vaxxing the newborn, and even if we did, she wouldn't be protected from the vax anyway in the first few months of life.)

post #4 of 9

I wasn't trying to talk you out of the vaccine--I just wanted to mention the titer option.  I didn't know the titer wouldn't show amount of antibodies, so I'm glad you mentioned it.  It's too bad, because it IS possible to "have" a virus, and have such a good, quick immune response that you wouldn't have obvious symptoms.


I wonder why the titer wouldn't show amount of antibodies?  Not arguing here, just curious.

post #5 of 9
Thread Starter 

Just like the pertussis vaccine, the titer is frustrating.  The vaccine doesn't make one immune all the time, just reduces the symptoms one will get.  The titer doesn't show a number that has been proven to confer immunity to pertussis, because there is no medical consensus on that that level of antibody would be.  I think that is why they can't make a more effective vaccine, because they don't know the answer.  I had lots of titers run in my life.  Rubella when I got pregnant, Hep B and A as well as tetanus and diptheria before I went overseas to work in a hospital...All came back with exact numbers and an explanation such as (levels over 1.0 confer full immunity to disease x).  The pertussis titer is the only one I've ever seen that does not say that.  It just gives IGG, IGM, and IGA antibody results as positive or negative.  Like my doctor said, it is only useful if you know or highly suspect you had pertussis in the last 5 years and know you were never vaccinated or had it before.  In my case it was true.


My DD has only had 2 horrible coughing illnesses in her 3 years.  Both times we took her in to the ped and they did a nasalpharyngeal swab to check for pertussis and parapertussis.  Both times were negative.  So I really do know in this circumstance she has never had pertussis.


She's basically better today, just a tiny bit of phlegm/cough.  Her appointment in in one week from today.  Unless anyone can give me any articles or any research that a week between illness and vaccine is too short, I guess we will go for the appointment.  As you can see, I'm really thrilled.  LOL.

post #6 of 9



Nukuspot... in so many ways our lives are moving in parallel ways :P


Anyway..maybe you have read - my DD had a viral illness which ended 11 days ago. I still haven't scheduled her HiB because I want her to be completely better but I wasn't sure what was a good time-frame

post #7 of 9

nukuspot, I am interested to know who your ND friend is that does vaxxes. We were going to take our DD to a ND last month but he did not treat infants.

post #8 of 9
Thread Starter 

Sorry, I just saw this!  His name is Elias Kass, he is an ND/LM at Treehouse Family Medicine in Seattle.

post #9 of 9

Thanks for the referral.

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