Advice on letting older children decide on vaxes

[SweetSilver]

If this has already been hashed our before, please, link me with those older threads, and my apologies.

For those who haven't already read my decisions to not give my girls their boosters, the short story is that I was dealing with *extreme* needle shyness, and it was preventing us from establishing a trusting relationship with their nurse.  They used to cry and cry, even when they were done with their initial shots.  So as boosters approached, I had to question whether or not I should continue, because the time was coming when I could no longer say, "There are no shots expected today."

So, I have declined for years now.  I am not anti-vax, though my brain is truly reeling with all this information.  I do know that they are old enough that I feel wrong enforcing vaccinations upon them.  

I know there will be disagreements here, and I know the initial arguments that will come up.  Some of you are going to feel like I'm putting potentially life-threatening decision in the hands of children.  

If you want your children to decide themselves, what do you use to help them understand the issue?  At 8yo?  At 10?  14?

I posted here because I don't need all-support for my decision.  My conclusion is not likely to change, but I want to hear from all sides.

[chickabiddy]

I also have a 10yo who *hates* needles (I know nobody likes them -- I don't either -- but her reaction seems disproportionate), so I understand where you're coming from.

I believe vaccines are important for both her personal health and general public health.  She understands and agrees, even though she hates them.  She gets vaxes.

Basically, I'm not ready to let my 10yo make medical decisions for herself.  If she hated the dentist, she'd still have to go, just like I do (I have a dentist anxiety/phobia that probably compares to her needle anxiety.  I'd rather get a pap smear every day for a month than get my teeth cleaned).

[SweetSilver]

How did she come to understand and agree?  What kinds of conversations have you had?  And what kind of information did you present?

ETA:  For the record, I have allowed my daughters to make some medical decisions.  For one, I have allowed them to postpone booster vaccinations (thus the thread, sorry for being obvious).  I have also allowed them to decline some pre-orthodontic work (for example)--pulling primary teeth because their mouth is crowded.  I am not comparing orthodontic work to vaxes, but I just wanted to point out that indeed, I do allow them to make some decisions for themselves.

Edited by SweetSilver - 11/7/12 at 5:18pm

[tribalmax]

I suspect that it depends on the kids, their age, and their willingness to explore both sides of the issues. We don't vax...but some travel situations may present themselves where we will have to choose to vaccinate or travel. While I wouldn't give my kids complete control on this, I would definitely give them serious input.

If you are unlikely to change your opinion, I wonder if there are ways you can give them power in this situation. Perhaps they can choose the day of the week, when it happens, what they do before and after. Perhaps they can research different pain management techniques and decide which they want to use (distraction, ice, emla cream, music, meditation etc).

When my kids were younger (between the ages of 3 and 5) we had to do lots of allergy testing. This helped them feel some control about the situation.. I would even let them choose my clothes that day (we do that from time to time when they need power).

Good luck figuring out what you want to do!

Rachel

[SweetSilver]

To clarify, my decision has been to let them decide to whether they postpone their boosters further until they have enough information to decide for themselves.  (They are 6 and nearly-8 now and fully-vaxed through their initial shots.)

But how to go about that?  And when will they be mature enough to make a truly informed decision from the information I can (magically and wisely ) communicate with them, not one based on needle-fear?  (I know, "that depends", but it's still a question I ask myself.)

So, for now their decision is based off needle-fear.  This is not just nervousness.  My younger daughter had a vagus response to an antibiotic shot, admittedly much larger and more painful.  That was one decision I did not give her as she had a fast-moving cellulitis infection on her ankle, and she was already unable to walk on her leg for the pain.  

But at some point, they will be old enough to really consider this issue, at their own level, and I am pretty comfortable letting them wait while I do my own research and consider the issue.  At some point, though, I want them to have good information to consider.  I actually want that now, but how to present it to them?  How do I talk with them about this?

Does anybody allow their older children a say?  And when do they give it to them?  Are people more comfortable waiting until 16 or older?  

[japonica]

We're considering one or two vaccines over the next few years and that's it. I've always been of the mindset that if my kids want the extras, like hep B, flu, IPV, whatever, then after they turn 18, they can line up and get whatever they'd like. It's their decision by then.

[SweetSilver]

Definitely by 18.... but can they decide before that?  Or is the parents' primary view-- vax or non-- more important until that time?

ETA: japonica, will you be talking with your kids about future vaxes--the ones they will decide on when the time comes?  Are you having conversations with them now?

[rnra]

I wouldn't present it as being their decision until age 18.  If they were 15+ and decided of their own will to put together a logical and well-supported argument, I'd be willing to let them make that decision.

FWIW, I was EXTREMELY needle shy as a child.  Even worse than what has been described above.  Due to a traumatic hospitalization as a child (due to shingles) the mere thought of a needle prick caused me to have pretty severe panic attacks to the point of vomiting, diarrhea, severe sweating, and sometimes passing out until the age of 22 or so.  However, I got over it.  There wasn't one event or thing that led me to get over it.  It just kind of happened.  Eventually I realized that it just didn't warrant all that because it wasn't that bad.  That said, if I had never been exposed to needle pricks during that time I doubt I would have been able to get over it and I anticipate the fear would have intensified.  In my case, I'm glad that my parents didn't use my fear of needles as an excuse to stop getting me vaccinated, having blood draws, etc.

[kathymuggle]

Originally Posted by SweetSilver 

Definitely by 18.... but can they decide before that?  Or is the parents' primary view-- vax or non-- more important until that time?

Can they decide before that?  I think some kids, if they have an interest in such things, may be able to make an informed decision before that.  I suspect most won't bother looking up all sorts of info on vaxxes though - that seems to be something us moms do as we are charged with keeping them healthy.  My 13 year old likes to look at fashion, my son - politics and movies.  Neither would be overly willing to research vaccines.  I don't feel a pressing need to insist they research it - they can research it when (if) they feel called to get vaccinations.

I understand making vax decisions for babies.  Some vaccines are primarily to keep them healthy - pertussis, hib, rota.  Those are not decisions that can wait until they are old enough to consent.

I do not agree with making vax decisions for older children, unless there is a pressing medical need. It is their body,and they can make the decision for themselves when they are of age (which is not necessarily 18 - it is when they feel called to vaccinate, and can make an informed decision)  If there was a pressing need (say an epidemic of a worrisome VAD) and I decided the VAD threat was higher than the vaccine threat, I would insist on vaccination - even if it induced needle fear, anxiety, etc.  It would have to be a real threat though, for me to over-ride a childs right to say what happens to their body.

[chickabiddy]

Originally Posted by SweetSilver 

How did she come to understand and agree?  What kinds of conversations have you had?  And what kind of information did you present?

Pretty much the stuff that's so hotly debated here -- vaxes offer protection against disease as well as strengthening herd immunity to protect kids/babies who can't be vaxed.

[SweetSilver]

Originally Posted by chickabiddy 

Pretty much the stuff that's so hotly debated here -- vaxes offer protection against disease as well as strengthening herd immunity to protect kids/babies who can't be vaxed.

Thanks.

[kathymuggle]

Originally Posted by rnra 

FWIW, I was EXTREMELY needle shy as a child…..That said, if I had never been exposed to needle pricks during that time I doubt I would have been able to get over it and I anticipate the fear would have intensified.  In my case, I'm glad that my parents didn't use my fear of needles as an excuse to stop getting me vaccinated, having blood draws, etc.

I outgrew my fear of needles (and yes, I was fairly fearful) but it was not because of exposure.  I rarely had needles as a child or teen - a few for dental work, one for a blood draw and one vaccine at 17 (and all those needles were *nightmares*).  What made me get over my fear of needles was giving birth!  I figure if I could handle giving birth, I could handle a needle.  Self-talk around needles can help us to put things in perspective. The other piece of self talk I do on myself (and on my children when need be) is to tell myself the truth.  The needle will hurt - for about 10 seconds.  You can handle ten seconds of pain.  Perspective, perspective, perspective.  When I was younger people used to tell me needles did not hurt  - that they just pinched a bit (why oh why do people lie to kids???).  

As for practical advice - I find looking away from the needle helps, and letting the nurse know you are bad with needles.  My Dh is too proud to let them know he is wimpy (said with love) with needles - and they always seem to just jab the needles into him.   I confess my fears and no one ever "jabs" needles into me - I am always handled with kid gloves.  

[MichelleZB]

I don't know, like 16? Is sort of the age where kids should sort of be making their own medical decisions, within reason? Like, for instance, if my hypothetical daughter wanted to go on the pill at that age (or not), I'd sort of let that be her call.

My mother did not get us vaccinated past a certain age, so I didn't get any boosters as an adolescent. When I turned eighteen, I chose to get all of them.

[japonica]

Originally Posted by SweetSilver 

Definitely by 18.... but can they decide before that?  Or is the parents' primary view-- vax or non-- more important until that time?

ETA: japonica, will you be talking with your kids about future vaxes--the ones they will decide on when the time comes?  Are you having conversations with them now?

I am talking with the eldest child now since she might be getting the first shot in the series before the next school year (school starts in February in Australia). I'm discussing why we would be getting it, what is involved, how many visits to the GP etc. She's not had much experience with needles beyond blood draws as a toddler, so it will be interesting to say the least.

Her school usually offers students in high school a trip to Asia in Year 11 (I believe). We will be having lengthy discussions well before that point about necessary travel vaccinations and it will be her decision if she wants to go, with the knowledge that she will have to undergo a series of shots to participate.

I think the birth control analogy is a good one. If the teen is fairly mature, responsible, has a good grasp of all the issues involved and the whole risk-benefit aspect, then there's grounds for letting someone 15-16+ have a say in her own health choices.

[chickabiddy]

I would probably let a 16yo make her own decision, but would require her to do the work on a medical exemption and to discuss a religious exemption with our pastor.  I do not know if I would sign off on a religious exemption -- she and the pastor would have to convince me, since our religion is not anti-vax.  I would also probably seek a new doctor if ours approved a medical exemption, since we have no history that would justify it.

[kathymuggle]

Originally Posted by chickabiddy 

I would probably let a 16yo make her own decision, but would require her to do the work on a medical exemption and to discuss a religious exemption with our pastor.  I do not know if I would sign off on a religious exemption -- she and the pastor would have to convince me, since our religion is not anti-vax.  I would also probably seek a new doctor if ours approved a medical exemption, since we have no history that would justify it.

This is very interesting.

I think that if your state has a mature minor rule in effect, she would be able to sign off on her religious exemption on her own.  

If you do not live in an area with mature minor rules around medical consent  (i.e. parents are 100% in control of medical decision for those under 18) you may be in the position of having to sign a religious exemption, homeschooling, or somehow insisting a child get a vax (which I would not feel comfortable doing with in an older teen who has researched the issue and decided against it).

I know all of the above is theoretical, but it is still interesting to think about.

[Mirzam]

Originally Posted by chickabiddy 

I would probably let a 16yo make her own decision, but would require her to do the work on a medical exemption and to discuss a religious exemption with our pastor.  I do not know if I would sign off on a religious exemption -- she and the pastor would have to convince me, since our religion is not anti-vax.  I would also probably seek a new doctor if ours approved a medical exemption, since we have no history that would justify it.

Exemptions would only apply for mandatory vaccinations. A 16 yo would not need a religious or medical exemption for Gardasil and other non mandatory vaccinations.

My DD refused Gardasil at 18, she didn't even bother to tell me she had declined until well afterwards.

ETA, I just checked my states' requirements and the only mandatory additional vaccine for middle school and high school is Tdap for 6th grade, there are no additional vaccines for 16 year olds.

Edited by Mirzam - 11/8/12 at 7:33am

[chickabiddy]

Some colleges require certain vaxes, and it is possible my daughter will be going to college before she is 18.

[Mirzam]

Originally Posted by chickabiddy 

Some colleges require certain vaxes, and it is possible my daughter will be going to college before she is 18.

That's nice that you know this for your 10 year old.  As far as I know all colleges require vaccines or exemptions. It does strike me as somewhat hypocritical that you would allow your DD to make a choice, but then make it hard for her to carry through her choice by refusing or making getting an exemption near impossible. Kind of stacking the deck against her.

I would probably let a 16yo make her own decision, but would require her to do the work on a medical exemption and to discuss a religious exemption with our pastor.  I do not know if I would sign off on a religious exemption -- she and the pastor would have to convince me, since our religion is not anti-vax.  I would also probably seek a new doctor if ours approved a medical exemption, since we have no history that would justify it.

[chickabiddy]

If she's old enough to make the decision, she's old enough to do the work that comes with the decision -- finding a doctor to approve a medical exemption with no history of severe vax reactions or explaining to me why she holds a sincere religious exemption (because I will not sign off on a *religious* exemption that comes down to "don't want a shot").