Should I choose Hiberix or ActHiB for my 3 yr old DD? Urgent help needed please ... - Page 2

[Blessed_Mom]

That we would see the package of the vax is a given Taximom... we always do that and very thoroughly.

I wouldn't say my peds' office was dodgy (honestly she wasn't).. She just was a doofus. The nurse I spoke to that is. One of many airheads.

OFF-topic and don't read this if you don't have time: I originally called to find out where else I could find single HiB shots for my DD (since just 2 weeks back my Ped said they didn't have any). So the nurse calls back and says they usually don't stock up on single HiBs but because there is a Pentacel shortage in the WA state they would be "willing to separate out the HiB shot for me" Now maybe it is just a dialect or something but I didn't understand the "separate out" part of her speech. Like in "physcially separate" from Pentacel in a clumsy in-office manner. OR did Pentacel come in 3 different vials originally and she could choose to dose my DD just one HiB vial? I didn't understand.

So i asked her what she meant by separate? She repeats the whole spiel (swear to God!) about Pentacel being out-of-stock and that their office would be willing to separate the HiB for me. No difference in terminology and am still confused!

Back to topic: Anyway - so I ask her what was the name of the single HiB they were carrying. She is absolutely baffled by my question. She says "single dose of HiB"- what do you mean? I then told her that HiB was manufactured by many companies so which one were they carrying (losing every hope in her competence... they are one of the better Ped offices around Bellevue.. if you can believe that. We aren't even in some rural area).

So she comes back with..it is manufactured by Sanofi Pasteur...is that what you want? I said yes.. because I thought Sanofi makes only ActHiB as the single dose. 

But later I was reading up and it seems like they do manufacture some others (as combos though) so do have to make sure it is ActHiB

BUT now my main concern is : Is she too old for ActHiB anyway and I am just dosing her a worthless dose? Should she be getting the booster? So far what I read on Hiberix is worse than ActHiB - although I haven't come up with anything conclusively.

Also should I give her any HiB at all? I am reading all about serotype replacement and what-nots and that she will be more susceptible to Pneumonia if she gets a HiB and needs to be given Prevnar (another Vax I hate!!!!!!!!)

Second , third guessing myself and driving myself crazy!

[Blessed_Mom]

And read this: http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM109841.pdf

The first lines: ActHIB®, Haemophilus b Conjugate Vaccine (Tetanus Toxoid Conjugate), produced by Sanofi Pasteur SA, is a sterile, lyophilized powder which is reconstituted at the time of use with either saline diluent (0.4% Sodium Chloride)

OR Sanofi Pasteur Inc. Diphtheria and Tetanus Toxoids and Pertussis Vaccine Adsorbed (whole-cell pertussis vaccine DTP)

OR Tripedia®, Sanofi Pasteur Inc. 

So HiB comes as a powder and the Peds' office can choose to mix it with either just saline solution or a DTP combo or a Tripedia combo.

Now if they do any of the 3 - does it still state ActHib on the vial (does the name on the vial reflect the solution or the powder - which is ActHib)?? Then that vial will be useless to me right? I wouldn't know which of the 3 I am getting....when I want only the ActHiB?

Or does the vial reflect the name of the solution and thus I can clearly tell the difference?

What if they make a mistake while mixing (that doofus nurse would!) and I get Tripedia when I want ActHiB?

[nukuspot]

Ugh. I'd hate to be in your position, it seems that the nurse really is frustrating. So I think she's saying they don't usually give HIB alone, just mixed with DTaP. But they are out of DTaP (which is frankly concerning since we're supposed to be knee deep in pertussus around here) so she is willing to give HIB alone. It seems to me they always carried it, it just wasn't policy to give it alone. I'd ask if you can talk to your doctor before getting anything from the doofus nurse. Just call and request it, they should not say no. Just say you want to confirm. And...I was always under the impression HIB was no longer a concern after the age of 3. And I've heard many peds (Dr. Gordon especially) say that HIB is rarely ever seen anymore in their practice. Just my 2 cents

[Blessed_Mom]

Originally Posted by nukuspot 

Ugh. I'd hate to be in your position, it seems that the nurse really is frustrating. So I think she's saying they don't usually give HIB alone, just mixed with DTaP. But they are out of DTaP (which is frankly concerning since we're supposed to be knee deep in pertussus around here) so she is willing to give HIB alone. It seems to me they always carried it, it just wasn't policy to give it alone. I'd ask if you can talk to your doctor before getting anything from the doofus nurse. Just call and request it, they should not say no. Just say you want to confirm. And...I was always under the impression HIB was no longer a concern after the age of 3. And I've heard many peds (Dr. Gordon especially) say that HIB is rarely ever seen anymore in their practice. Just my 2 cents

So - does Pentacel not come as a combo but is left at the discretion of the nurses to be mixed - for DTaP, IPV and HiB?

AND - yes it does seem like they always must have carried it right - but always refused as matter of policy? Because in the 3 years whenever I asked they said they never had/carried HiB alone but now that Pentacels are in shortage the nurse says "We can separate it out for you" (Although technically if there is a shortage of Pentacel and she 'separates' out an ActHiB for me then isn't she making one Pentacel 'null and void'? )

I am not sure what she meant by 'separate' at all!!!!

Maybe they just received a fast-delivery shipment of ActHiBs and she meant 'we will go outside of our normal policy and give you the ActHiB which is what you want"??

And about Pentacels - she said the demand had exceeded supply and there was an acute shortage so their strict instructions were to only give to infants under 9 months old (I think she said)

[nukuspot]

As far as I read, the HIB is a powder mixed with either a Tripedia or a Pentacel. So it has always been seperate. This is what makes me feel like they are either untrustworthy or uninformed if they now will be willing to mix a HIB with saline and before only with another combo vaccine. So try to get ahold of your doctor to ask. Usually IMO they can be much more forthcoming than nurses in specific vaccine questions like this.

[nukuspot]

Isn't Pentacel just Daptacel with IPV added, then they mix HIB in on site? Now I'm getting confused. Why are you mentioning Tripedia? That's just a DTaP only vaccine that I believe was discontinued in 2008?

[Blessed_Mom]

I am confused by your above two posts.

In post #25 you acknowledge that HiB can be mixed with Tripedia (which is what I read too.. is why I am mentioning it..read my concerns about what they may mix the ActHiB in - in post #22 here.

In post #26 you ask why I am mentioning Tripedia - although you do acknowledge that it CAN be mixed with ActHiB... ? :)

[Blessed_Mom]

Originally Posted by nukuspot 

Isn't Pentacel just Daptacel with IPV added, then they mix HIB in on site? Now I'm getting confused. Why are you mentioning Tripedia? That's just a DTaP only vaccine that I believe was discontinued in 2008?

See I didn't know this. So it makes sense that she used the word 'separate'.

ALTHOUGH - if their policy is to ALWAYS administer Pentacels - then it couldn't be that they are now administering ONLY Daptacels and thus have leftover HiBs - right?

If they are responding to the new epidemic and people are asking for Daptacels - they can just as easily give Pentacels - right? Which means the separating out a HiB makes one Pentacel 'void'.

OR - maybe some sel vaxers are asking for only Daptacels and they are giving in - where as earlier they wouldn't... and thus are left with leftover HiBs?

[Taximom5]

That nurse must be the one who got fired from OUR ped's office!

Seriously, the misuse of language is just amazing when it comes to vaccines.

Doctors STILL say that "thimerosal was removed from pediatric vaccines.".

No, it wasn't removed. They didn't go in there with a little Thimerosal Removal Kit and remove it. They began to produce single-dose vaccines WITHOUT thimerosal. They also continued producing them WITH thimerosal, either for adults or for export to third-world countries.

I suspect it's the same misuse of language with your nurse, who says she can "separate it out." (One wonders how she passed organic chemistry?)

[Blessed_Mom]

My 3 questions are:

1. Should I give ActHiB or Hiberix to my DD? Which is more benign relatively?

2. Should I give any HiB shot at all or is she out of danger zone since she is 3 years old? A balanced view would be nice... 

3. If I choose to give her the ActHiB is there a chance that the nurse could accidentally mix HiB powder in with the DTaP solution rather than just the saline solution??? Should such simple mistakes be allowed to happen? I am thinking the smart way for Sanofi to sell this would be - the solution vials should say - ActHiB, DTaP or Tripedia and whichever vial the powder is mixed in - will reflect the right name...that way less chance of a mistake. 

[Blessed_Mom]

Originally Posted by nukuspot 

Isn't Pentacel just Daptacel with IPV added, then they mix HIB in on site? Now I'm getting confused. Why are you mentioning Tripedia? That's just a DTaP only vaccine that I believe was discontinued in 2008?

According to this link.. updated May 2 2012..Tripedia is still very much available.

http://www.vaccinesafety.edu/thi-table.htm#*#*

On the other hand...why are there no numbers for JUST ACTHiB??? anyone know?

[nukuspot]

Originally Posted by Blessed_Mom 

I am confused by your above two posts.

In post #25 you acknowledge that HiB can be mixed with Tripedia (which is what I read too.. is why I am mentioning it..read my concerns about what they may mix the ActHiB in - in post #22 here.

In post #26 you ask why I am mentioning Tripedia - although you do acknowledge that it CAN be mixed with ActHiB... ? :)

I was just restating what you wrote in post 25.  You were the one who posted the link that it can be mixed with Tripedia.  I didn't know that.  So that is why I asked in post 26 why you were mentioning it.  Dr. Sears has stated many times that they are phasing out Tripedia as of 2008-9.  The only 2 choices for DTaP still being made he says are Daptacel and Infantrix.  But he says there are still doses of Tripedia floating around, in use, they just aren't making more.

[nukuspot]

Originally Posted by Taximom5 

That nurse must be the one who got fired from OUR ped's office!
Seriously, the misuse of language is just amazing when it comes to vaccines.
Doctors STILL say that "thimerosal was removed from pediatric vaccines.".
No, it wasn't removed. They didn't go in there with a little Thimerosal Removal Kit and remove it. They began to produce single-dose vaccines WITHOUT thimerosal. They also continued producing them WITH thimerosal, either for adults or for export to third-world countries.
I suspect it's the same misuse of language with your nurse, who says she can "separate it out." (One wonders how she passed organic chemistry?)

Or they just "washed out" the thimerasol.  I still wonder how they do that.  Vaccines with the thimerasol "washed out" are the ones that say they contain a trace (0.3mcg) since they can't wash out everything.  I say yay, better than 25 mcg, but why can't they just make new totally thimerasol free versions?

[Taximom5]

Originally Posted by nukuspot 

Or they just "washed out" the thimerasol.  I still wonder how they do that.  Vaccines with the thimerasol "washed out" are the ones that say they contain a trace (0.3mcg) since they can't wash out everything.  I say yay, better than 25 mcg, but why can't they just make new totally thimerasol free versions?

In those instances, thimerosal or a thimerosal-preserved ingredient was used in the initial processing, but was not meant to be an ingredient in the final product, as opposed to the multi-use vials of vaccine, in which thimerosal is meant to be in the final product as a preservative.

[nukuspot]

Interesting!  I still hate that they can call them "thimerasol free" when obviously a trace is still something!  They wouldn't call an oat cereal gluten free even though oats have just a "trace" gluten...

[Taximom5]

Originally Posted by nukuspot 

Interesting!  I still hate that they can call them "thimerasol free" when obviously a trace is still something!  They wouldn't call an oat cereal gluten free even though oats have just a "trace" gluten...

Actually, they are allowed to call foods "gluten-free" that contain up to 20 ppb (more than a trace!) of detectable gluten.     

[AbbyGrant]

What did you decide to do today Blessed Mom?
 

[Blessed_Mom]

Originally Posted by AbbyGrant 

What did you decide to do today Blessed Mom?
 

Cancel her appointment AbbyGrant :P

Surprised anyone?

Her b'day is coming up May 31st and we decided to at least postpone it till after then...

Better to forego and give/not_give later than give and regret - right?

I still haven't found out the answer to my 3 Qs above... 

[AbbyGrant]

Originally Posted by Blessed_Mom 

Cancel her appointment AbbyGrant :P

Surprised anyone?

Her b'day is coming up May 31st and we decided to at least postpone it till after then...

Better to forego and give/not_give later than give and regret - right?

I still haven't found out the answer to my 3 Qs above... 

Nope, not surprised. You seemed really stressed, so I think postponing was a good move.

I wish I could help you more with your questions. I don't know much about Hiberix to be honest though other than it's relatively new (2009ish?).  My youngest got ActHIB, and I was comfortable with that.

[LANENA1982]

I'm not sure why your peds office would mix the ActHIB with anything than it's own diluent that comes with the vaccine itself.At our pediatrics office every vaccine is used but I usually administer HIB,Prevnar and Dtap at 15 months of age and for my babies I use pediarix(Dtap,IPV,Hep B)