Hello Dr. Sears,
Our 3 m/o daughter is being evaluated for closed neural tube defects / spina bifida occulta / tethered spinal cord, etc. due to a sacral dimple (shallow, fully closed skin) and hair tuft. We were not planning on vaccinating her until later in childhood for only a few select vaccines. If she ends up being diagnosed with any of the conditions associated with her symptoms, would you suggest we reconsider vaccinating her with any of the vaccines that help prevent meningitis? Is her risk of meningitis higher than other children?
In case the info is relevant, we also intend to have her kidneys re-examined. There was significant enlargement in one kidney as well as renal pyelectasis (she also had a second soft marker - Echogenic intracardiac focus - but does not have any obvious signs of down syndrome, etc.; amniocentesis was not done) in utero, both of which resolved by early 3rd trimester. I understand that kidney issues and NTDs can occur simultaneously during early development.
Thanks for your help!
The kidney issue doesn't apply to the vaccine decision, but I'm not sure about neural tube defects and risk of meningitis from one of the vaccine-preventable types. It's an interesting question. I don't ever remember learning this. You could try searching for medical studies on the risk of meningitis in such kids.
I thought meningitis was only a risk with an open neural tube defect, because of the spine being exposed to the air before the surgery is done, in the case of mylomenengicile. So I wouldn't worry about it with a closed spina bifida.
Thanks for your help! The ultrasound came back normal so it looks like the sacral dimple and hair are just that, no other spinal involvement, so we can continue with our original vaccination decisions.