I have a nine-week old first (and likely only) child. Like y'all, I am struggling so much as to which vaccinations and when. I've read through a lot of posts, read Dr. Sear's book, and looked at the CDC website for each vaccination. Here is what I'm thinking -- please respond as specifically as possible if you think I've overlooked something for any vax.
My baby is breastfed (well bottle fed pumped breastmilk -- we never got a latch after *tons* of trying and LC's, etc.), and I work mostly from home so she is around the same few caregivers consistently. Although she is not in daycare, I realized the other day, when I stopped to get coffee on the way to a meeting and saw a little toddler play area in the cafe, that I don't want to feel paranoid about hanging out with other moms and their babies/toddlers and about her maybe licking a something that another child has touched. Plus there's the hygiene hypothesis -- I don't want a kid who is never exposed to any germs. So, while I know daycare isn’t a good developmental choice, that doesn’t mean she won’t be around other kids/germs ever. Bearing in mind all of that, here is what I am thinking:
1. HIB -- According to Sears, there were 25 cases in 2006. According to CDC "In 2007, among children younger than 5 years of age, 22 cases of invasive disease due to Hib were reported in the United States." And then, according to the CDC website, in the pre-vaccine era, most children acquired immunity naturally by age 5-6 without getting HIB ("In the prevaccine era, most children acquired immunity by 5–6 years of age through asymptomatic infection by Hib bacteria."). Also, you can't get HIB from a toy (again from CDC, "Hib does not survive in the environment on inanimate surfaces."). Then, HIB tends to occur in young children, often before they can even be vaccinated ("In 1998–2000, approximately 44% of children younger than 5 years of age with confirmed invasive Hib disease were younger than 6 months of age and too young to have completed a three-dose primary vaccination series" - CDC). Finally, the CDC lists several risk factors, none of which we have: Risk factors for Hib disease include exposure factors and host factors that increase the likelihood of exposure to Hib. Exposure factors include household crowding, large household size, child care attendance, low socioeconomic status, low parental education levels, and school-aged siblings. Host factors include race/ethnicity (elevated risk among African Americans, Hispanics, Native Americans—possibly confounded by socioeconomic variables that are associated with both race/ethnicity and Hib disease), chronic disease (e.g., sickle cell anemia, antibody deficiency syndromes, malignancies, especially during chemotherapy), and possibly gender (risk is higher for males)."
SO ... Even though HIB is a "milder" vax, I can't totally wrap my head around why we would get it. The risk seems infinitesimal of my baby getting HIB. Much more so than other diseases. Is there something I'm missing? At the very least, it seems better to wait until her system is more mature.
2. Polio. So many people on this site are opting for the Polio vaccine. I don't understand why. At this point, I'm not willing to vaccinate my little infant for herd protection, and I feel she can get the vax when she's older and her body is stronger for travel ling purposes. Again, am I missing something?
3. PC (Pneumococcal Disease). Dr. Sears says all babies will encounter this germ and it just depends how serious the affects are. The CDC says the relationship between being and carrier and contracting the disease is unclear. However, many people are carriers. Also, the CDC website indicates it is a somewhat common cause of ear infections. It is also responsible, pre-vaccine, for pneumococcal meningitis in rates of 10 per 100,000 children under one. However, 11% of children receiving the PCV7 booster (with DTaP at the same time) reported fevers higher than 102.2.
SO ... I absolutely cannot decide. One thing I'm thinking about is waiting until seven months, when the dosage drops by one. "Unvaccinated children aged 7 through 11 months should receive two doses of vaccine at least 4 weeks apart, followed by a booster dose at age 12 thorugh 15 months" (CDC) .
4. Rotovirus. Here's what confuses me about this. It's super common. Most kids get it. BUT, it seems like, although it’s more severe in infants, most kids get it between two and five years old. BUT, the vaccination only lasts one or two seasons. So, one would think, “I’ll vaccinate my child at two-years old for this.” However, you can’t vaccinate past eight months. What’s the deal with that? Also, in California, where I live (L.A.), we get Rotovirus in the fall and winter. Meaning it’s nearly passed for my two-month-old, so why would I want to vaccinate her now. Next fall, when she’s slightly too old, is when I would consider vaccinating her. I really don’t understand this one. Who has insight?
5. DTaP. For DTaP, my only concern is with the Pertussis part of it (just out of curiosity, does anyone know the rationale behind why there is not a separate Pertussis vaccine?). One thing I learned from the CDC site is that the all of the infant fatalities due to whooping cough occur in infants younger than six month (with three months and younger accounting for 86% of deaths). Since she is breastfed and not in daycare, I wonder if I can be extra protective her first six months, and then avoid this vax. Then again, there were over 25,000 cases reported last year (or the year before, don’t remember), so maybe it’s worth vaccinating against. Having trouble deciding.
I’m going to cross the MMR bridge when I get to it, and definitely no on hepatitis/hpv until teenage years and then it’s her choice.
I look forward to the collective wisdom!
-Julie and Zoey Ellis (nine weeks)