Remember the age limit on many vaccines

[heartmama]

This was a HUGE problem I ran into when delaying vax for ds. I did not know that many of the vax options expire after a certain age. After that, the child gets the adult dose.

Check the age range of the vax you are interested in getting.

The choices for adults are limited. Adult vax may still contain mercury, for example.

Until last year there was NO vaccine in America for pertussis after the age of 7. Now they have one, but that means a 7 year old and a 30 year old get the same vax. IMO, I would rather my 6 year old get the dose given a 6 month old, than give my 7 year old what an adult would have...assuming I have decided to get that vax for my child.

Anyway, just a reminder, know the age range for any vax you study.

[LongIsland]

Originally Posted by heartmama

Until last year there was NO vaccine in America for pertussis after the age of 7. Now they have one, but that means a 7 year old and a 30 year old get the same vax.

There is no pertussis vaccine indicated for children from 7-9 years of age.

Tdap (Boostrix) is from 10+
Tdap (Adacel) is from 11+

Diptheria & Tetanus covers all age groups:
Td (7+)
DT (up to age 7)

Originally Posted by heartmama

This was a HUGE problem I ran into when delaying vax for ds. I did not know that many of the vax options expire after a certain age. After that, the child gets the adult dose.

They have a limit on the indication age for Hib vaccine because by age five almost all children will have acquired immunity to Hib . . . so Hib risk is essentially a non-issue if the child is over five. Hib disease is age dependent - the older you get (even in the infant/toddler years), the less the risk. Hib risk peaks in infancy - I believe around 10 months.

Otherwise, the only other age issue is pertussis - a gap from 7 to 9 years of age and Prevnar. There's another pneumococcal vaccine (Pneumovax23) indicated from age 2+ (that one is typically used for high risk groups since pneumococcal disease is not prevalent to begin with), hence the age limit on Prevnar brand.

So, if a parent were to delay vaccination, Hib and pneumococcal are going to be non-issues after a certain age anyway.

That leaves the pertussis gap from 7-9 years of age.

[LongIsland]

Originally Posted by heartmama

The choices for adults are limited. Adult vax may still contain mercury, for example.

The only vaccine an adult would not be able to get is Hib. Otherwise, all diseases for which a vaccine exists are available to adults.

All vaccines indicated for adults have thimerosal free formulations with the exception of Japanese Encephalitis.

[comfybuns]

Thanks LI. Great info!

[heartmama]

I wasn't clear on my point, sorry. Parents need to find out what is available in their area. Particularly those of us in rural states, what is being manufactured and what is actually available may be very different. A mercury free version of an adult vax may exist, but is it being used in your state? Are they using up backstock of older adult vax? Find out.

Generally speaking even in rural area's, pediatric vaccines are widely available in the mercury free form. I cannot underscore the importance of finding out~now~what your local doctor has available, even if your vaccine plans are years away.

[LongIsland]

Originally Posted by heartmama

A mercury free version of an adult vax may exist, but is it being used in your state? Are they using up backstock of older adult vax? Find out.

With the exception of influenza vaccine, the only vaccines an adult may receive containing full strength thimerosal would be TT and Td.

Whether or not a thimerosal free version is available depends on the doctor or facilities preference and/or need. Most doctors and hospitals carry only multi-dose formulations, so the liklihood of getting a thimerosal containing TT and Td vaccine is high unless your doctor specifically orders the TF version.

Keep in mind that you won't be able to get Td much longer because the manufacturer already stated that Tdap would replace Td.

That leaves the TT vaccine as the only vaccine an adult would receive which may contains 25 micrograms of thimerosal. However, if you went to the ER today for a tetanus shot, you would likely get Tdap instead.

[heartmama]

The only way to know what is available locally is to check locally. It's not something that can be answered in response to my post without sidestepping the point entirely. Parents need to check with their doctors and ask what options that doctor has available. My experience doing this showed that what I read online and what was actually available in my area were very different. If a parent has any plans to vax they need to contact their health care provider directly and go over this issue in detail.

[LongIsland]

Originally Posted by heartmama

If a parent has any plans to vax they need to contact their health care provider directly and go over this issue in detail.

There is no "issue" or "options" to go over in detail unless you plan on getting your child the pediatric DT vaccine, which may or may not contain 25 micrograms of thimerosal, depending on the provider.

There are no routinely administered infant/child/adolescent vaccines containing full strength thimerosal on any shelves - anywhere.

There is also no "issue" with adults vaxes either. Again, the only adult vaccine which would contain full strength thimerosal would be TT, but you would be given Tdap instead. The CDC now recommends Tdap in place of TT and Td vaccines. In fact, an adolescent/adult would likely be given Tdap without even knowing they received Tdap if they were in the doc's office or ER for a tetanus shot. Regardless, if I had to chose between a full strength thimerosal-containing TT or Tdap, I would take the Tdap.

[Ruthla]

Is there a difference in dose between "adult vax" and "pediatric vax"?

Another factor in favor of delayed vax is that, for some vaccines, fewer doses are needed past a certain age.

[LongIsland]

Originally Posted by Ruthla

Is there a difference in dose between "adult vax" and "pediatric vax"?

Another factor in favor of delayed vax is that, for some vaccines, fewer doses are needed past a certain age.

There are no vaccines for adults which require fewer doses, except certain Hep B vaccines. Then you have Tdap, but that's a booster. IPV is not recommended for 18+, but it still gets administered to adults regardless.

For the varicella vaccine, two doses are needed for individuals 12+ years. But's that moot now because a second dose varicella recommendation was just made for all children 12+ months.

The only vaccines indicated for children which have age limitations are Hib and pneumococcal (Prevnar brand). Dosing is dependent on age.

[Ruthla]

What I meant was: is there an actual difference between the adult vax and the pediatric vax? Is there a smaller amount of "inactivated virus" or "adjucants" in the ped version? I'm wondering if this is a valid concern:

Originally Posted by heartmama

IMO, I would rather my 6 year old get the dose given a 6 month old, than give my 7 year old what an adult would have...assuming I have decided to get that vax for my child.

[Plummeting]

Originally Posted by Ruthla

What I meant was: is there an actual difference between the adult vax and the pediatric vax? Is there a smaller amount of "inactivated virus" or "adjucants" in the ped version? I'm wondering if this is a valid concern:

In the adults' Tdap there is LESS pertussis antigen and diptheria antigen than in the children's DTaP. The amount of tetanus antigen is the same. I don't know about other vaccines, but that's the case with this one.

[LongIsland]

Originally Posted by Plummeting

In the adults' Tdap there is LESS pertussis antigen and diptheria antigen than in the children's DTaP. The amount of tetanus antigen is the same. I don't know about other vaccines, but that's the case with this one.

The same would apply to Td (age 7+) as opposed to DT (pedicatric up to age 7).

The Td has less diptheria antigen, but the same amount of tetanus toxoid as DT.

[lyttlewon]

Originally Posted by Plummeting

In the adults' Tdap there is LESS pertussis antigen and diptheria antigen than in the children's DTaP. The amount of tetanus antigen is the same. I don't know about other vaccines, but that's the case with this one.

Why does the manufacturer reduce the dosage? It makes me wonder if a stronger dosage inappropriate for age might be a bad thing depending on why the manufacturer reduced the dosage.

[alegna]

The larger doses are too reactive in adults.

-Angela

[lyttlewon]

Originally Posted by alegna

The larger doses are too reactive in adults.

-Angela

So if it is too reactive in an adult wouldn't it mean too reactive in a 7 year old?

PS I am not trying to debate the OP I am trying to understand the reasoning behind age limitations.

[alegna]

Originally Posted by lyttlewon

So if it is too reactive in an adult wouldn't it mean too reactive in a 7 year old?

PS I am not trying to debate the OP I am trying to understand the reasoning behind age limitations.

Two theories:

1. a child's immune system isn't as reactive as an adult's

or

2. Babies don't complain.

-Angela

[Dar]

I'm thinking the former... here's an article I found that compares pertussis antibody response after one adult dose vs. three infant doses. The adults have a much higher level of antibody response, despite getting only one smaller dose.

Dar

[heartmama]

There is no "issue" or "options" to go over in detail

I'm sorry but I must strongly disagree with that statement. In real life, parents of an unvaxed child often have few health care providers willing to support a selective vax schedule. I'm sure many parents here can relate to that problem.

If you have researched and selected the specific vax you want, and know when you want it, I am urging parents not to wait until the moment is upon them to contact their health care provider.

No one in this thread can possibly assure parents that no issues may arise that conflict with the parent's selective vax plans.

I had one lone pediatrician willing to work with us (drove an hour each way to see him). The only way he could provide the newest version of a vax I wanted was if I found a dozen other parents to split the cost of a special order with me.

I never anticipated that! What we say here online, and what a parent will run into out in the real world may conflict, and parents need to prepare for that. I think it's good advice and hopefully nobody found that part of my post controversial....

I can appreciate that people want to discuss the current age limits and vax options in response to my post. Go for it

[LongIsland]

Originally Posted by heartmama

I'm sorry but I must strongly disagree with that statement. In real life, parents of an unvaxed child often have few health care providers willing to support a selective vax schedule. I'm sure many parents here can relate to that problem.

I'm not talking about the issue of selective vaccination, I'm talking about the "issue" of thimerosal-laced "backstocked" vaccines you claimed were on the shelves. The only vax a parent would have to worry about being on the shelves which may contain full strength thimerosal is DT and TT (FTR, DT and TT are not routine vaxes). And the only adult vax a person would need to worry about is TT.

All routinely administered vaccines do not contain full strength thimerosal. That's what I was referring to when I said there was no "issue" or "options" to discuss. It is what it is - either your ped orders a thimerosal free DT or a full strength DT. There's no other "issue" with respect to full strength thimerosal-containing vaccines.

Addtionally, I've already corrected and/or shared the necessary information pertaining to age limits on vaccines, in order for a truly informed discussion to continue in this thread regarding age limits.