Trying to double check my thoughts on vaccines...

[stardogs]

I'm currently not a mother, but the vaccine issue is so confusing, I've started researching things already (about 2 years prior to TTC lol). This will sound *really* odd, but I am coming at the vaccine issue for kids after doing extensive research on vaccination in dogs.

We have 4 dogs, all on a limited vaccine protocol that has us only giving one vax at a time, spreading boosters apart by at least a month, vaccinating for only core vaccines, and trying to avoid super combo vaccines (i.e. a 4 in one instead of a 7 in one for distemper/parvo). The vaccine info I have from dogs (and my studies as an animal science major in college) really colors my views on human vaccination.

I'm not anti-vaccine at all (I have gotten a DTaP booster, HPV, flu vaccine, etc. all in the past 10 years when I've made the vaccinate or not vaccinate decision for myself), but I'm very skeptical of the extent and way in which we vaccinate children.

A few questions from the dog side of things that I haven't found answers for in the human vaccine debate to date:
 

- why do we start vaccinating well before maternal antibodies are fading? My reading indicates that maternal antibodies in breastmilk start to fade around 6 months of age, so wouldn't vaccines given before this point be redundant if a child is still exclusively breastfed by a mother who is fully vaccinated? In puppies, we generally don't start vaccinating until after weaning for this reason, unless the puppies are in a high risk environment or mom dog was unvaccinated. According to the CDC's guidelines currently, kids are vaccinated for the same 8 diseases 2-3 times *before* 6 months of age! That seems crazy!

- Is it even truly possible to find human vaccines that split the typical combo vaccines into individuals (DTap, MMR, etc.)? I know some people do this, but in vet situations often they aren't available because vets can't justify buying a pack of individual vaccines for a single client and I'm wondering if the same is true in medical practices for humans. Is this a situation where having a doctor that is pro-limited vaccines is essential?

- I've seen titers mentioned a few times, but do people ever use them in place of vaccines (to determine whether a child is protected) when trying to follow a selective vaccine schedule? Do schools ever accept titers in lieu of vaccines?

- Similarly, do mothers to be ever get titers to ensure that they have enough antibodies to pass along to the LO in order to delay the start of vaccines?

Thanks for any insights!

[ma2two]

Originally Posted by stardogs 

I've started researching things already (about 2 years prior to TTC 

Excellent

- why do we start vaccinating well before maternal antibodies are fading? My reading indicates that maternal antibodies in breastmilk start to fade around 6 months of age, so wouldn't vaccines given before this point be redundant if a child is still exclusively breastfed by a mother who is fully vaccinated?

Policy makers approach human vaccines as a one size fits all. Since not all mothers breastfeed until 6 months, all babies are treated as if they are being formula fed. Also, maternal antibodies in breast milk are not as strong as they used to be. Mothers no longer have strong, natural immunity to these diseases. They have weaker immunity from vaccines, and this is often not enough to protect their babies.

- Is it even truly possible to find human vaccines that split the typical combo vaccines into individuals (DTap, MMR, etc.)?

The pertussis vaccine is only manufactured combined with at least diphtheria and tetanus. However, it is possible to get diphtheria and tetanus without pertussis, but the DT vaccine contains 0.3 mcg mercury. A tetanus-only vaccine is available starting at 7 years old, and it also contains mercury--either 0.3 mcg mercury from a single dose vial, or 25 mcg mercury from a multi-dose vial.

In the U.S., it is not possible to get separate measles, mumps, or rubella vaccines. Merck discontinued production of the monovalent vaccines for the U.S. market in December 2008.

- I've seen titers mentioned a few times, but do people ever use them in place of vaccines (to determine whether a child is protected) when trying to follow a selective vaccine schedule? Do schools ever accept titers in lieu of vaccines?

Schools will usually accept titers for measles, mumps, rubella, and chickenpox. New Jersey has a law encouraging doctors to inform parents that just one MMR is enough in 95-98% of children, and that parents have the option to check titers before giving the 2nd MMR.

- Similarly, do mothers to be ever get titers to ensure that they have enough antibodies to pass along to the LO in order to delay the start of vaccines?

I've never heard of this being done, however, most women are tested for rubella immunity during pregnancy. If their titers are low, they are encouraged to get the MMR right after giving birth. I think it is very rare for a woman to be informed of the risks of the MMR to herself and to her breastfeeding baby. But they are listed in the package insert. http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM123789.pdf

Edited by ma2two - 7/29/12 at 4:27pm

[stardogs]

Good info! I feel like my background both helps and hurts in these situations - gives me a good base to start from, but leaves me with really unusual questions that most people don't seem to think of! LOL

[kathymuggle]

Originally Posted by stardogs 

A few questions from the dog side of things that I haven't found answers for in the human vaccine debate to date:
 

- why do we start vaccinating well before maternal antibodies are fading? My reading indicates that maternal antibodies in breastmilk start to fade around 6 months of age, so wouldn't vaccines given before this point be redundant if a child is still exclusively breastfed by a mother who is fully vaccinated? In puppies, we generally don't start vaccinating until after weaning for this reason, unless the puppies are in a high risk environment or mom dog was unvaccinated. According to the CDC's guidelines currently, kids are vaccinated for the same 8 diseases 2-3 times *before* 6 months of age! That seems crazy!

There are a bunch of reasons.  Here are a few:

-not everyone breastfeeds

-compliance rates are way higher in infants - so, from the public health point of view, it makes sense to do it in infancy

-some diseases really are dangerous for infants and endemic, so waiting makes little sense.  Pertussis can be one. 

-there is the whole issue of how much immunity is conferred through breastfeeding.  Most mothers never had many VPDs as they were vaxxed themselves.  I am 40 yrs old - I had chicken pox and german mealses (rubella).  Despite being completely breastfed, my then 3 month old daughter caught chicken pox from her brother.  That is one anecdote, though, I do not know what the stats say on "chances of catching xyz if fully breastfed and mommy had xyz as a child."  I do not think vaccines the mother had confer immunity through breastmilk, but I could be wrong.  Here is an interesting thread from yesteryear on the topic:  http://www.mothering.com/community/t/615597/breastfeeding-passive-immunity-and-titers/60

- Is it even truly possible to find human vaccines that split the typical combo vaccines into individuals (DTap, MMR, etc.)? I know some people do this, but in vet situations often they aren't available because vets can't justify buying a pack of individual vaccines for a single client and I'm wondering if the same is true in medical practices for humans. Is this a situation where having a doctor that is pro-limited vaccines is essential?

Not around here (Canada).  Europe, maybe.  

- I've seen titers mentioned a few times, but do people ever use them in place of vaccines (to determine whether a child is protected) when trying to follow a selective vaccine schedule? Do schools ever accept titers in lieu of vaccines?

I assume you are in the USA?  Quite frankly, exemption might be the easy way to go (depending on the state you live in) and then your kids won't need unnecessary pokes.  I would certainly do exemption before titres (but titres before a vaccine)  My kids have  exemptions.  Given this, the only way I would do a titre would be if I was considering a vaccine.  Ex:  if there was a pertussis outbreak and I was worried about it for one reason or another, but thought I might have had pertussis, I might get a titre before a shot. 

- Similarly, do mothers to be ever get titers to ensure that they have enough antibodies to pass along to the LO in order to delay the start of vaccines?

I did not.  It would be interesting to know ahead of time if previous vaccines confer immunity.  If not, then you would only draw titres for diseases you had.  You might want to consider the severity and prevalence of the VPD before bothering with titres.  

Thanks for any insights!

Edited by kathymuggle - 7/30/12 at 7:36pm

[EmbraceLife]

Lots of great insight.  We are WONDERING if we should ever vaccinate again at this time. 

Our children have some special needs and I am concerned that vaccines could make things worse.  Frightening stuff!  Difficult decisions.