Need your help!

[pampered_mom]

A close friend of mind and fellow MDCer just had the unthinkable happen to her family! Her son was run over by a car today and is in the hospital. He's actually doing fairly well all things considered. Their main concern is that his spleen is swollen - they are monitoring to make sure that it doesn't rupture.

The nursing staff had asked her when her ds' last tetanus shot was and she let them know that he hadn't had one and that they have chosen not to vax her children. The nurse said that it was something the doctor actually wanted to talk with them about. According to the doctor, because her ds' spleen has been compromised there are actually vaccines that he will have to have b/c it makes him more susceptible to getting the illnesses. She is skeptical (as am I anytime I get around a standard medical doctor) and is wondering if that is actually the case. I promised her that I would check into it.

I'm wondering if you ladies can help me. I am lost when it comes to vaccine issues as my son has been vax'd to this point. Can you point me in the right direction or let me know if there is any research along these lines? I'd like to get her armed with this information as soon as possible as I am certain this will come up again. Thank you in advance for your help!!!

[Deborah]

Two possible approaches:

1)Ask the doctor to point her to some medical research on spleen conditions, impaired immune systems and vaccines. Particularly whether there have been any studies of the safety of vaccination in children with impaired spleen function.

2)If she is uncomfortable asking the doctor, have her make her way to the medical library of the hospital (or if the hospital doesn't have one, try the local public library) and have the reference librarian help her do the research.

This is a very specific sort of question and I doubt if anyone here would have the answer on the tip of their tongue. My gut reaction is that the doctor is another one of the "any excuse to vaccinate" school and has little or no data to support his position, but I don't know that for sure.

Sorry, I don't have time to do the research myself! I have to work tomorrow and it is already past my bedtime.

Deborah

[pampered_mom]

Thanks, Deborah! That at least gives us a starting point. Do you think a search on PubMed would get me in the same direction? I'll try that route and keep my : for more insight!

[alegna]

No. There is no vax he will "have" to have. She has plenty of time to research that later- she shouldn't be pressured into anything.

Also, a bit to remember- none of the vaccines have been tested on anyone with injured or missing spleen.

-Angela

[jojospok23]

The theory behind this is that the spleen is the primary site of response to polysaccharide bacterial infections. With the spleen missing, one is more at risk for diseases such as the prevnar vax cover. The vax's conjugate the polysaccharide to a protein carrier, and thus the previously T-cell independant response becomes T-cell dependant. Conjugating in this manner means that an entirely different part of the immune system is called upon to fight an infection of this type, instead of the missing spleen.

However it fails to take into account the fact that not every single infection of this type has a conjugated vaccine for it, and therefore would be like plugging a hole in a dam with your finger.

I wouldn't vax, preferring lifestyle management instead. You could google "vaccine response in asplenic individuals" and print some things for your friend to read. You'll see things that tell you that response is unknown, that it depends on time since primary vaccination, time since spleen removal, patients age, general health and chronic conditions. But in short, they don't seem to know.

[pampered_mom]

Thanks, jojospok23 for your insight and getting me pointed in the right direction. The doctors are thinking it's highly likely that he will keep his spleen, just that it's been compromised. Given that he's 2 yrs old and if he keeps his spleen would I guess it stands to reason that he would still benefit from it?

[jojospok23]

Yes-even a kidney that is not completely healthy can contribute something to the body function. And likewise, if he keeps his spleen it will do some work. If the injury is severe enough it may not work to completely normal levels, because the liver is the only organ in the body that can heal to a completely normal and fully functional, pre-injury regenerated state. Scar tissue, anywhere in the body is not quite like the original tissue, but it patches up the damage.

I apologise if I am rambling or writing senselessly, but I am sleep deprived and running on empty

Even if he does lose his spleen-people live just fine without. Yes, it complicates life, but people cope with immunodeficiencies. Good luck to your friend, I really hope her little boy is ok.

[Plummeting]

It's like any other immunodeficiency - no vaccine is required to keep someone alive just because they have an immunodeficiency. The doctor is lying, of course, just like they always do when they know parents are vulnerable and in a position to be easily swayed.

[pampered_mom]

Originally Posted by jojospok23

I apologise if I am rambling or writing senselessly, but I am sleep deprived and running on empty

Even if he does lose his spleen-people live just fine without. Yes, it complicates life, but people cope with immunodeficiencies. Good luck to your friend, I really hope her little boy is ok.

No, you are not rambling - what you have posted is VERY helpful in clarifying things for me. I guess I didn't really realize how long lasting this injury would be or the impact it would have on his life. I can't even imagine facing this with my son if I were in her place.

I did do a search as you suggested and will print them out to take with me. I will also print out this thread so she has the discussion available.

Anyway...thank you jojospok23 for all of your help - it was wonderful in spite of your sleep deprivation! I hope you get lots of restful sleep soon.