I'm thinking about getting my 3 y/o her first vaccines. The only one I am considering is DTaP. (My reasons are tetanus protection before she starts preschool, which is outdoors on a farm setting, and pertussis because there is a current outbreak in my area.) The CDC catch up schedule says to space them like this:
1 month between dose 1-2
1 month between dose 2-3
6 months between dose 3-4
6 months between doses 4-5
I am thinking about just doing 3, which is from what I read the minimum for protection and what seems to be all they do in Europe (3 doses) and then ask to get her titers to check immunity before doing doses 4 or 5 (which I wouldn't need it seems if I put #5 off until after she is 4, so another bonus there.)
What I am wondering is for the first 3, should I space them how the CDC catch up schedule recommends, 1 month between, or should I space them out further? And if so...How far? 6 weeks, 2 months?
I would like her to have at least the 3 doses before she starts preschool and our new baby is due in early September.
I'd also like to know if anyone had had the experience of starting vaccines at age 3, especially DTaP, and what was your child's experience? She is up to now completely unvaccinated.
Personally, I wouldn't do less than 2 months between first 3 doses, like the normal schedule, 2, 4, 6mos. I wonder why catch-up is only 1 month b/t? Just to get it in them faster? You still have time to do 2 months spacing and get 3 doses.
Yeah, I think I have also seen that if you wait for forth dose after she is 4yrs you do not need a 5th.
I wouldn't check titers unless you had some reason to get other things checked. Even if pertussis vax works as best as possible as it will for DD maybe the numbers won't even be particularly impressive, yk? Or who knows how much a 4th dose would help anyway...There seems to be a wide variation on how effective it actually is.
Perfect! Thank you both, you gave me something else I need to discuss with the pediatrician on Monday. I had no idea MDs posted to this forum, I'm really happy for your professional input, Dr. Gordon. I'm going to tell my daughter's doctor that after 3 years of not vaccinating we are ready to very selectively vaccinate, but just DTaP, just with Daptacel (I hope she uses it, otherwise I need to figure out how to order it), and I would like to do just 3 doses with 2 months of spacing in between. (I'd love to do 3 month spacing, but I really, really want her to have the 3 doses by the time the new baby is born and preschool starts. As it is, it wouldn't be that exact, If I start the series for her at the end of this month/beginning of May, her 3rd dose would be 2 weeks later after my EDD and the start of preschool (her first day is my EDD!) But it will be close enough.
I'm still going to ask for titers for the tetanus part after the 3 doses because why not? Then I'll have proof of immunity, that she was responsive to the vaccine, if I ever have to bring her to the ER and they find I did 3 doses instead of 4.
I'm still not 100% at peace with this decision. Maybe I never will be. However I do feel like it is something I want to go forward with. I've weighed out the risks and benefits multiple times, and while up to this point it never came out that the risks of vaccination outweighed the benefits, it finally went the other way based on the current situation with our upcoming life changes. It would however make me feel really, really reassured to hear even one anecdotal story from a parent (or doctor) out there that has experience with starting the DTaP series for an older toddler.
Big Surprise: Whooping Cough Spreads Mainly Through Vaccinated Populations
"A new study showed that 81% Of California B. Pertussis Whooping Cough cases in people under the age of 18 occurred in those who were fully up to date Onthe whooping cough vaccine (compared with 8% who were never vaccinated."
Vaccine effectiveness was only 41% in children aged 2-7.
I read that article. I know DTaP doesn't prevent transmission, I wish that was not the case, it would make deciding lots easier. At this point, I'm considering DTaP half for pertussis protection (I know it does not reduce transmission, but at least my toddler wouldn't be coughing all over the baby if she got a mild case) and half for tetanus protection (before starting preschool--It's Waldorf based and they are outdoors every day.)
But I have about 50% confidence I want to go ahead and do it, and 50% saying No, leave her unvaxxed. It's such a hard decision! DH says it's all up to me, he trusts my judgement. Pediatrician is very nice and says do all my research and I can make an appt to get her vaxxed anytime (they use Daptacel as well, which would be our preferred DTaP if we do it) or leave her unvaxxed but then I have to be vigilant for signs of pertussis and get every little wound cleaned and checked to see if it might be a risk for tetanus/needs TIG.
It's such a hard decision!! I can't stand it! It's almost too hard being aware and awake.
So that would be 6 to 9 months for minimal 3 dose protection in an area experiencing a pertussis epidemic and a newborn baby in the house expected to be in the house in 5 months (And someone new in early September!)...
It would seem sticking to the normal catch-up schedule might make more sense here:
Dose 1 -> 4 weeks to Dose 2 -> 4 weeks to Dose 3 -> 6 months to Dose 4
Vincent Iannelli, MD
About.com Guide to Pediatrics
Personally having the doses only a month apart is not within my comfort zone. Even 2 months seems awfully close together but at least gives me a bit more time to monitor for side effects.
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