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Kids, 10+, what's important? Also: getting kids informed

post #1 of 67
Thread Starter 

We entirely skipped the elementary boosters for various reasons.  They were almost fully vaxxed the first round, both have had the chicken pox vax.  Regrets there, but honestly even our non-vaxxing friends haven't had the pox, so I'm not sure if natural immunity was an easy option anyhow.  For the elementary round, because of needle shyness and some research to back up my decision, I've simply dropped vaccinating and relied on the partial immunity they received from the first round.  No flu shots.

 

In a year or so, we will be coming into the later rounds of boosters, and I'd like to both consider them, and educate my kids on vaccinations.  Hopefully they will be beyond, or nearly beyond the age where they want to refuse a shot because of the needle alone.  So, flexibly I am looking at restarting the conversation soon, aiming at 11-13yo to resume some vax.  Part of that needs to be which vaxxes will be the most important at that age.  I'm leaning towards measles and tetanus/whooping cough (or just tetanus) and possibly chicken pox unless I can find a pocket of it floating around very soon.  I think I'll be joining them as well, excepting CP.

 

So, 

 

1.  Which vaxxes would you choose and why and

 

2.  How would you begin a conversation with your older kids about vaccinations?  

If you are familiar at all with some of my posting history, you'll know this is a *very* important issue for me and responses like "you do what needs to be done and the kids don't have a say" doesn't resonate with me regarding vaxxes.  I guess that illustrates where on the S/D vaxxing spectrum I stand.  I also think such a conversation would make them more likely to consider vaccinations as adults.  (Most of us were never allowed in to the decision as children, and how many vaccinations have we had, collectively, as adults?  Uh-huh.)

 

Beyond that, all perspectives are welcome.  Resources that address this strange arrangement would be welcome.  I find that as much as I love Dr. Sears' book (and I will be reviewing it again) he doesn't address such alternative arrangements.

post #2 of 67

Bumping up for input. Anyone have advice to offer?

post #3 of 67

I'm in a slightly different boat as my kids are starting their primary courses of vaccines (9, and almost 6), and can't get the next one, the dT, until over age 10, but I imagine if I were doing booster for ages 10-15, I'd probably consider the MMR as the mumps portion tends to wane in effectiveness by the teen years (the measles portion is generally longer lasting, I suppose if you were really curious a titre test could tell you, but it means another needle for the kids). 

 

Here, they're also big on the Tdap for teens, mainly for the pertussis aspect. 

 

I know on the Aussie schedule they have listed dTpa (Tdap), Varicella, and hep B boosters and the primary course of HPV. I suppose the place to start is to see what's recommended and what you agree/disagree with. I can see the logic of Tdap, MMR, hep B, and varicella boosters. I suppose if my kids had been vaccinated in accordance with the Aussie schedule, I'd probably agree with all of it. As mine just got their MMR and will not get their dT until age 10, for teen vaccines, I'd probably be checking their MMR associated titres and be considering varicella. I'd have a conversation with them about the hep B as the evolving risk factor is obviously sexual activity as they move through their teen years. 

 

Which leads to your second question, we're having to have this conversation with our older child. In our case, just telling a nine year old, "because you have to!" doesn't really fly when a needle is involved. I've explained that it may help her to stay healthy and reduce her risk of getting measles/mumps, whatever. I don't say "won't get it" outright in case that comes back to bite me later. I've explained, in a way a nine year old can understand, how the vaccination process is supposed to work in the body to induce some immunity against those diseases. Still, at this age, it can be tough to conceptualise that the pain from the needle is worth the potential benefit of protection against disease without some additional enticement. 

post #4 of 67

Sweet Silver, do you have boys or girls?  Because the risk of RA associated with the Rubella aspect of the MMR goes up to 1:4 in a girl's early teens  (As per the CDC pink book.)  So if you have girls and want them to get an MMR booster, I'd say do it before age 13.  I agree with Japonica--Checking their titres for the MMR makes so much sense, they might still be immune and a booster not needed.

post #5 of 67

Japonica---Since you are doing a very delayed primary series, I am curious which ones you are doing for your older kids?  You don't have to give much detail, I am just curious what they got as their primary series at that age.

post #6 of 67

Sweet Silver….given the gender of your children, I would look into rubella and Chicken pox.  Rubella can be dangerous for fetuses, but really does not circulate very much.  It is part of the MMR shot, which is fairly reactive.  It also has an arthritis (or arthritis-like ) risk associated with it, which increases in adolescence.  If you really feel you might want to give MMR, I would do it sooner rather than later.  

 

I would look into Chicken pox as well.  I knew a woman who had chicken pox during pregnancy and it did harm her fetus.  You need to look up stats, though…I just know it is a possibility.

 

I would look up the meningoccocal vaccine once they are well into their teens. Here is a recent thread on it:

http://www.mothering.com/community/t/1396349/meningitous-and-teens-young-adults-talk-to-me

 

As per talking to kids about vaccines, I will be subbing.  

 

I will say that where disease risks are quite small, I think the decision should ultimately be theirs and waiting until they are the age of consent is fine.  It is their body.

post #7 of 67

Oh, I just saw the gender of your kids was in your sig!  Sorry :)

post #8 of 67
Quote:
Originally Posted by nukuspot View Post
 

Japonica---Since you are doing a very delayed primary series, I am curious which ones you are doing for your older kids?  You don't have to give much detail, I am just curious what they got as their primary series at that age.

 

They did not have any vaccines until this past November.

 

They received the MMR at that point. My DD had just turned nine and I was also concerned about the rubella/arthritis-arthralgia connection (even the product insert mentions that the risk is higher for adolescent girls than in children), so we decided to go ahead. My DS got it at the same time, although if I were to do it again, I would probably wait on his until he were nine or ten as well purely to try and maximise any effectiveness of the mumps portion and avoid the need for a booster in his teens. We'll run a titre in their teen years and time will tell I suppose.

 

Both kids will get the dT as a primary series after they turn ten. There is no childhood DT available any longer in Australia and the physicians here will not give the dT to children under age ten (even though doctors in the US and Canada may do so if they wish, according to the manufacturer and immunisation guidelines). We're avoiding the pertussis vaccine because one child has had it naturally already and second, based on published research here, the vast majority of serotypes turning up in samples of reported cases are not covered by the current vaccine. 

 

Perhaps polio. Undecided on that one. If they go to Asia, they'll need it. Possibly meningococcal as well in their teen years just because of how quickly it strikes and the high rate of mortality and complications and the risk factor rising once again in the 15-24 age group. The majority of reported cases here seem to be serotype B for which there is no vaccine available. Authorities did note that serotype C is reported again in the teen years, but whether that's from waning immunity to the infant meningococcal series or teens/young adults who were never immunised when men C was added to the schedule in 2003, I'm not sure. 

 

No to flu, HPV, hep B, and they're too old for Hib, Pc, rota. We're holding off on varicella to see if they get it naturally. If not, then we'll consider that as they move further into their teen years.

 

Philosophy-wise, we're reluctant vaxers. We're doing the minimum amount for VADs that we consider the children at higher risk for based on our location and their lifestyle (including their classmates' propensity to travel). We also try to maximise any possible immunity through timing (ie. waiting for later childhood) and try to reduce the need for boosters if possible. 

post #9 of 67

Japonica,

I think you have a excellent plan.  I consider myself a reluctant non-vaxxer, and I always am in research mode to acertain if we should selectively start.  My kids are much younger than yours, however.  I think we will be thinking much more about things once they get more independent.  I am sad to hear you cannot get the pediatric DT series there.  It is so odd how vaccines differ by country, both with schedule and availability.

post #10 of 67
Quote:
Originally Posted by nukuspot View Post
 

Japonica,

I think you have a excellent plan.  I consider myself a reluctant non-vaxxer, and I always am in research mode to acertain if we should selectively start.  My kids are much younger than yours, however.  I think we will be thinking much more about things once they get more independent.  I am sad to hear you cannot get the pediatric DT series there.  It is so odd how vaccines differ by country, both with schedule and availability.

 

Thanks. The schedule and recommendation differences are both intriguing (ie. food for thought…why does one country do things a certain way) or frustrating, depending on your POV.

 

In my case, my own country (Canada) recommends that children over age seven who need "catch up" immunisation for diphtheria, tetanus etc. be given the adult formulations NOT the infant combos because in their estimation, the risk of reactions is higher for older children with infant combos. Australia says it's fine for kids up to age 10 to receive infant combos. I argued this point with my GP, but Australian regs are Australian regs and he has to wait (he contacted TPTB, ie. the government authority who determines all of these regulations and they said infant combos only until age 10). So, we wait. It's a bit frustrating for me because the kid who is in the dirt and getting scrapes more often and who could use a T vax has to wait 4 more years for it because there's no paediatric DT and I won't do an infant combo on him (he's nearly 6 and given my home country says 7 and over is absolutely not recommended, it makes me uncomfortable). 

 

Yeah, things were more black and white (LOL) when they were home with me (SAHM), BFed, all that and we weren't worrying about field trip injuries, school trips to Asia, or globetrotting classmates. :wink It can get more complicated as they get older and we're always re-evaluating our options, which I suppose is a good thing.

post #11 of 67

I was wondering if you could just fly home to visit family in Canada and get him the adult dt there.  But then I realized flying every few months from Australia would not be financially an option of most humans.  The deviation between recommendations between countries just floors me.  It is one of the things that causes my vaccine questioning for myself.  You are doing a great job to be so on top of it.  The DT or dt (for the tetanus) is one of the vaccines I contemplate for my own kids, but at this time being young and home with me and the older one being homeschooled, it's filed under my "later" pile.  But for sure I agree with you about the adult dt only being safe for over age 7.  That is specifically recommended by the US CDC in their pink book too!  So strange about Australia not having similar recommendations.

post #12 of 67
Thread Starter 

Wow, thanks ladies!  I'm realizing I have more research to do than I thought.

 

So, MMR sooner for the girls?  How long is that immunity supposed to last?  What do adults get to vaccinate against the measles?  

 

Taking time to process all this, so sorry if my responses are slow.  This is great, thanks!

post #13 of 67
Quote:
Originally Posted by nukuspot View Post
 

I was wondering if you could just fly home to visit family in Canada and get him the adult dt there.  But then I realized flying every few months from Australia would not be financially an option of most humans.  The deviation between recommendations between countries just floors me.  It is one of the things that causes my vaccine questioning for myself.  You are doing a great job to be so on top of it.  The DT or dt (for the tetanus) is one of the vaccines I contemplate for my own kids, but at this time being young and home with me and the older one being homeschooled, it's filed under my "later" pile.  But for sure I agree with you about the adult dt only being safe for over age 7.  That is specifically recommended by the US CDC in their pink book too!  So strange about Australia not having similar recommendations.

 

Yes. I even thought about flying back just so we could start that dT series at age 7, but it's just not possible financially for us to fly back to Canada from Australia 3x in one year. Sigh.

 

The difference in schedules and recommendations is a good starting point for asking WHY things are the way they are. Presumably, government health departments are all making these decisions based on science. It just shows that the interpretation of said science and the corresponding recommendations is not one size fits all, right? :wink 

post #14 of 67
Quote:
Originally Posted by SweetSilver View Post
 

So, MMR sooner for the girls?  How long is that immunity supposed to last?  What do adults get to vaccinate against the measles?  

 

Taking time to process all this, so sorry if my responses are slow.  This is great, thanks!

 

AFAIK, there is only the MMR for adults as well. Maybe a monovalent measles vaccine is available in Europe (perhaps someone can post if it is), but from what I've seen in Canada, the US, and Australia, it seems MMR is the only option (with the related potential for the arthritis/arthralgia risk for adult women from the rubella component).

 

Perhaps Kathy or some of the others would have some hard facts on immunity, but just off the top of my head, I've heard of a number of problems with rubella (ie. women not seroconverting/showing no demonstrated immunity after repeated boosters), mumps immunity waning by teen years, and it seems the one with the least number of issues is measles (although even then there's reported cases of fully vaccinated and UTD teens and young adults coming down with measles). Again anecdotally, I had a rubella booster back in the 80s as a pre-teen (when they still made individual vaccines apparently) and I was still deemed immune in all my rubella titre b/w almost 30 years later, so apparent long lasting immunity may be possible (well, in my case, case study of 1). :thumb 

post #15 of 67
Quote:
Originally Posted by japonica View Post
 

 

 

Perhaps Kathy or some of the others would have some hard facts on immunity, but just off the top of my head, I've heard of a number of problems with rubella (ie. women not seroconverting/showing no demonstrated immunity after repeated boosters), mumps immunity waning by teen years, and it seems the one with the least number of issues is measles (although even then there's reported cases of fully vaccinated and UTD teens and young adults coming down with measles).

 

 

Here is an interesting study on rubella and effectivness.  

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770316/

 

and one on mumps:

http://wwwnc.cdc.gov/eid/article/13/1/06-0649_article.htm

 

Honestly, though, efficacy is not a huge factor for me in MMR (like it is in flu or pertussis). I would focus on whether or not rubella and measles circulate enough to cause me any worry.  The answer for me is no.  I would keep an eye on rates and re-address if they spike for any consistent period of time.  

 

I would read the rubella study, though, to determine if immunity wanes.  Then you might have to weigh waning effectiveness (which would suggest a later vaccination date - closer to childbearing years) versus the risk of an arthritis type vaccine reaction if you delay vaccination.

post #16 of 67
Thread Starter 

So, to be clear, the arthritis-type reaction is for all women from adolescence on up?  Starting to read through all these links before I respond again.

post #17 of 67
Thread Starter 

It looks like both girls missed their MMR booster.  I swear they got so many shots, they hit this one but I know the records are right.  But it looks like if that's out of the way, then meningococcal vaccine and the tetanus are the ones to get.  Meningitis is scary, for sure, and dh's 2yo sister died from it and is the main reason I was so adamant about starting vaxes in the first place.  But if the vax only covers a small portion of the bacterial types and primarily affects certain populations, then that one could *possibly* be saved for later in adolescence if they wanted.  The other recommended one is HPV, which I am not advocating for them.  The girls appear to have had their full Hep B series (that's one of the ones I would have skipped in my fantasy do-over), except sometime between dd1 and dd2 they added a 4th round, which we did not get.  So, sex risk talk, for sure, but not in relation to vaccinations necessarily.

 

So, really, my big question is not the 11-13 range, but right now (MMR) and later towards college.  

 

ETA: oops, and probably varicella at some point.

post #18 of 67
Thread Starter 

Looking for the information regarding the adolescent girls and the MMR vax.  Agree, doing a titres test (or whatever it's called) might be a good one for this one.  Link anyone on that side-effect?  (Couldn't find it, but did find info that makes me not want to give them the MMRV vax.)

post #19 of 67
Quote:
Originally Posted by SweetSilver View Post
 

Looking for the information regarding the adolescent girls and the MMR vax.  Agree, doing a titres test (or whatever it's called) might be a good one for this one.  Link anyone on that side-effect?  (Couldn't find it, but did find info that makes me not want to give them the MMRV vax.)

Well, if your kids had MMR, there is a good chance titres will show their immunity is suffecient.  There are no side effects from a titre test, other than the small risks from needle pricks.  

 

You could run a titre test and then make any decisions about vaccination.  It is what I would do if my kids had one MMR and I was considerring a second.

 

Here is the package insert for MMR and the blurb on arthritis type reactions:

 

"Following vaccination in children, reactions in joints are uncommon and generally of brief duration. In women, incidence rates for arthritis and arthralgia are generally higher than those seen in children (children: 0-3%; women: 12-26%),17,52,53 and the reactions tend to be more marked and of longer duration. Symptoms may persist for a matter of months or on rare occasions for years. In adolescent girls, the reactions appear to be intermediate in incidence between those seen in children and in adult women. Even in women older than 35 years, these reactions are generally well tolerated and rarely interfere with normal activities."

 

https://www.merck.com/product/usa/pi_circulars/m/mmr_ii/mmr_ii_pi.pdf

post #20 of 67
Quote:
Originally Posted by japonica View Post

 

 

The difference in schedules and recommendations is a good starting point for asking WHY things are the way they are. Presumably, government health departments are all making these decisions based on science. It just shows that the interpretation of said science and the corresponding recommendations is not one size fits all, right? :wink 

I could not agree more.  The discrepancy between countries is one of the many things that first got me questioning routine vaccination.

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