Continuing after interruption - VERY confused

[springmum]

Wondering if anyone has any insight for me as I try to sort this out.

I'm in Canada (ontario) and my son recieved a 5 in 1 combo at 2.5 months (DTaP-IPV-Hib) he had prolonged high pitched screaming that afternoon for about 2 hours, so we stopped vaccinating him.

The problem is that we frequent a farm/farm settings (rodeo's etc) very often and it's just a matter of time before he gets a wound that doesn't get cleaned right away (right now my watchful eye gets them right away, but he 4.5 and won't be by my side forever) I grew up on a farm and had my share of non-bleeding puncture wounds, but I was fully vaxxed.

I would really like to continue with the tetanus,but I've learned that this is valid for all of ontario now

http://www.toronto.ca/health/professionals/pdf/adacel_ipv_may_2012.pdf

I'm reading more on Adacel and seeing it's only approved as a booster one time dose, not to continue multiple doses in a series.

Quadracel was the one previously used (but now replaced by Adacel) , I can't find clear info if this is approved for a single dose or multiple dose?

It also says that it;s important to stay with the same manufacture if possible (I'll have to check with the Dr about which name it was under - I think it was Pentacel)

Here is our schedule including the catch up one 

http://www.health.gov.on.ca/en/public/programs/immunization/docs/schedule.pdf

So I'm between a rock and hard place. We can't avoid that farms or the wounds (it's part of our family) and I'm deligent about wound cleaning, but as he gets older I won't be witness to all of them and I can't guarantee that he will care for them properly for many years (seeing as now he already doesn't notice half his cuts) I know tetanus is rare, there has been 1 case in ontario last year and the year before, but we will be in the "higher risk" category for sure.

I've contacted our health unit with similar questions, so I'll see what they say, but I thought I should get some opinions as I know others research as much as I do and the health until will likely give me a standard response.

Any opinions on what you would do in my shoes?

[emmy526]

how about a pediatric Dt?

http://www.emedicinehealth.com/drug-diphtheria_and_tetanus_toxoids_vaccine_dt_pediatric/article_em.htm

[kathymuggle]

You could delay until he is older/you figure it out - particualry as it seems you are mostly vaxxing for the tetanus. 

How old is your son?  A babe in arms is extremely unlikely to get tetanus, even if he does frequent farms.  

Another thought - are you near Manitoba, Quebec of NY state?  You might be able to get the formula you want if you cross a border - although you will need to pay for it.  

Kathy (also in Ontario)

[springmum]

Thanks ladies..excuse typos...NAK

Am I remembering right that the ped Dt has thermisol?

My son is  very wild and active 4.5 years old....cuts and scraps a regular thing, so is getting dirty at the farm. In a perfect world every little cut and scrap would get cleaned immediately and properly, but there is too much potential and deep puncture wound opportunities up there.  I'd like to get it for his 5th year checkup

He's too old to get the combo with the Hib, and he hasn't completed enough of the series to just get the booster (and too young for the 7 and up Td...)

Hopefully the health unit can give me more insight into what's available for an interruped schedule like that- should here back in a few days.

[Pookietooth]

I think that tetanus is not any more common on farms than it is in cities, but I could be wrong about that. Is the concern that you figure your child will be out away from home for hours and in situations where he likely to be injured and not tell you about it?

[springmum]

Originally Posted by Pookietooth 

I think that tetanus is not any more common on farms than it is in cities, but I could be wrong about that. Is the concern that you figure your child will be out away from home for hours and in situations where he likely to be injured and not tell you about it?

Yes- I'm doing the best I can to teach proper wound care, even at this young age, but there are already many scrapes and cuts that I only notice at bath time etc. (not all from the farm, just regular active day stuff)

I wonder if tetanus is as common in cities - I do have a preconceived notion that the farm harbours more tetanus than dirt in any playgrounds here, not based on any facts of course.

The nurses were not terribly helpful. They advised that Adacel could be given as a multi-dose even though it's not licensed for multi-doses! She said it just depends on the individual...so it didn't sit well with me that she would advise giving a product in a manner it's not licensed for...unless I'm wrong, and how it's licensed really doesn't matter?

She recommended another dose of Pediacel (with the HIB) which he doesn't need b/c, he doesn't need HIB at age 5. Also, that's the one he had a bad high -pitched screaming reaction to.

She said Quadracel could be ordered, even though there is a short supply. I couldn't find out if it's licensed for multi-dose though - does anyone know?

I'm literally between a rock and hard place deciding if I risk a reaction the same/worse than the initial one I mentioned or the tetanus "risk"? 

I wish I had a magic answer, but I do appreciate everyones input :)

[Minerva23]

http://www.beyondconformity.co.nz/resources/tetanus

Makes a nice read. Once you start pondering about how people lived and survived pre-Tetanus vaccines, you will probably be not so concerned about it anymore. What you should be concerned about and from your post, I noticed, you are, is good wound care. The vax is no guarantee that you will not contract tetanus. I myself are more worried about sepsis than tetanus.