Should I choose Hiberix or ActHiB for my 3 yr old DD? Urgent help needed please ... - Mothering Forums

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Old 05-14-2012, 10:34 PM - Thread Starter
 
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Hi,

 

Our DD (3 yrs) needs one more Hib dose considering she was 9 months when she got her first. That time single Hib shots weren't available at our peds and we went to the public health office nearby. Apparently now they have shut down their immunization clinics there because of lack of funding (eh?) and now I am not sure where can I find a single Hib Shot?

 

Other Peds' offices or someplace i am not thinking of/

 

TIA

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Old 05-15-2012, 08:17 AM
 
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At one time there was a shortage of single Hib shots. I think that's not the case anymore, but I could be wrong. Your pediatrician might have them now.

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Old 05-15-2012, 08:33 AM
 
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According to the CDC, currently there is no shortage of single doses of Hib.

 

http://www.cdc.gov/vaccines/vac-gen/shortages/

 

Here's some info about the past shortage.

 

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5824a5.htm
 

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Old 05-15-2012, 09:55 AM - Thread Starter
 
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Oh no.. not because of any shortage. Apparently my peds' office never stocked single HiB shots!

 

Yeah - I thought that was crazy too.. 

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Old 05-15-2012, 10:16 AM
 
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I thought the booster was a single dose? That's why they were recommending no booster during the shortage.
 

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Old 05-15-2012, 11:08 AM - Thread Starter
 
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Now I am confused.

 

OK.. so my DD (3 years) got only one Hib when she was 9 months old.

 

Now we want to give her another.

 

what should  it be?

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Old 05-15-2012, 01:53 PM
 
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Sorry, I didn't mean to confuse you. shy.gif  I just meant I thought the final dose (usually given between 12 to 15 months) was not as likely to be part of a combo shot like the ones given at a younger age usually are, so it would seem like pediatricians would have individual doses of Hib on hand. Also, it seems like they would need it for kids that are off schedule and who don't need it as part of a combo vaccine. Mine always seemed to to have single doses available even during the shortage for those that needed it. Maybe your pediatrician's office could order a single dose if they don't have it?

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Old 05-15-2012, 04:27 PM - Thread Starter
 
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I had recently taken my DD to her Peds' and had asked about a single Hib shot. He again reiterated that they always carried Pentacel and not single HiBs.....

 

But today I called them to see if they would know where else i could get a single dose since I don't wnat to do the Pentacel. Well since WA state is going through a Pertussis epidemic right now.. the nurse answered that they are out of Pentacels and can offer me a single Hib shot (very mysterious.. makes me suspect that they are withholding the single HiBs for some kind of a reason... they always said they don't carry them and I am a bit surprised they have stocked them so fast)

 

Anyway so I asked her which HiB vax it was.. she was very confused by the question (I thought that Hib was manufactured by Sanoufi, Merck and also GlaxoSmithKline...).. We had gotten ActHiB the first time....and I wanted the same..

 

..she came back with ..it is by Sanoufi.

 

If she says it is a single dose HiB (and not a combo) and by Sanoufi... it should mean ONLY ActHiB right? OR can it mean anything else?

 

I kind of read that with HiB we need to keep the conjugate vax the same as possible throughout the series....

 

..am confused! (Again)

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Old 05-15-2012, 10:37 PM
 
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As far as I can tell, ActHIB is the only monovalent Hib made by Sanofi. http://www.cdc.gov/vaccines/about/terms/USvaccines.html

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Old 05-15-2012, 11:15 PM - Thread Starter
 
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AbbyGrant (or anyone who knows)

 

 

When you mentioned a booster did you mean it as something different from the normal HiB series that are given to infants?

 

Example - a DTaP is the series given to infants and toddlers but a very different booster is given to kids 7 or older - TDaP.

 

 

When you mentioned that toddlers older than 15 months are given a HiB booster - did you mean a shot of a different kind? OR does the Act HiB she is about to be given on Thursday morning count as the booster???

 

I read in another thread about DTaPs that even though a 5th dose is not necessary if the 4th has been given after age 4 years ..many nurses do NOT know this and will offer a 5 th dose anyway .

 

I don't want a similar misunderstanding or ignorance to happen with the HiB and give my 3 year old a shot she may not need after all (or may need a different version of... )

 

Thanks

Hope I wasn't too unclear?

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Old 05-16-2012, 07:32 AM - Thread Starter
 
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Is there an age when a HiB vax becomes no longer relevant (because a toddler is past the dangers of the severity of the illness?)

 

I don't even know what I am asking really bawling.gif

 

I guess I am just scared about her getting vaxed tomorrow ... we have given her DTaP, IPV and a HiB so far and HiB was the vax I was most uncomfortable with (especially the - if you kill that particular bacteria more abhorrent bacteria take their place kind of reports)....

 

...DTaP and IPV are so much easier on me.

 

I hate to be in this state. I have no right or wrong stance - but we had decided to give DD a few select vaxes and this was one of them! I hate hate hate it!

 

Why cannot there be safer vaccines? 

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Old 05-16-2012, 08:01 AM
 
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I just seem to be creating confusion, so I should probably just shut up. lol.gif But I will just keep it very brief. It sounds like your pediatrician has ActHIB although it would be wise to confirm if that is what you want. One dose of ActHIB will complete the series (although technically I think you could use any Hib vaccine in this case). 

 

In case you don't know about it already, the CDC has an interactive catch up scheduler now where you just type in your child's age and what they've had and when they had it, and it will tell you what they need to get caught up. 

 

https://www.vacscheduler.org/scheduler.html?v=patient

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Old 05-16-2012, 08:07 AM
 
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Originally Posted by Blessed_Mom View Post

Is there an age when a HiB vax becomes no longer relevant (because a toddler is past the dangers of the severity of the illness?)

 

I don't even know what I am asking really bawling.gif

 

I guess I am just scared about her getting vaxed tomorrow ... we have given her DTaP, IPV and a HiB so far and HiB was the vax I was most uncomfortable with (especially the - if you kill that particular bacteria more abhorrent bacteria take their place kind of reports)....

 

...DTaP and IPV are so much easier on me.

 

I hate to be in this state. I have no right or wrong stance - but we had decided to give DD a few select vaxes and this was one of them! I hate hate hate it!

 

Why cannot there be safer vaccines? 

 

I think your daughter is entering a time where the vaccine may no longer be super relevant. It's not given after 5. I've read, although I don't have time right now to cite a source, that two thirds of cases are in children under 3 and that it peaks around 6 months. 

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Old 05-16-2012, 08:07 AM - Thread Starter
 
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I just seem to be creating confusion, so I should probably just shut up. lol.gif But I will just keep it very brief. It sounds like your pediatrician has ActHIB although it would be wise to confirm if that is what you want. One dose of ActHIB will complete the series (although technically I think you could use any Hib vaccine in this case). 

 

In case you don't know about it already, the CDC has an interactive catch up scheduler now where you just type in your child's age and what they've had and when they had it, and it will tell you what they need to get caught up. 

 

https://www.vacscheduler.org/scheduler.html?v=patient

 

 

Err.... the bolded part. That is what I am trying to do.....

 

..is that what I want?

 

OR should I be getting a more benign (I can hope, can't I?) booster at this age?

 

Her first and only was ActHiB at 9 months.

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Old 05-16-2012, 08:14 AM - Thread Starter
 
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I just seem to be creating confusion, so I should probably just shut up.  But I will just keep it very brief. It sounds like your pediatrician has ActHIB although it would be wise to confirm if that is what you want. One dose of ActHIB will complete the series (although technically I think you could use any Hib vaccine in this case). 

 

In case you don't know about it already, the CDC has an interactive catch up scheduler now where you just type in your child's age and what they've had and when they had it, and it will tell you what they need to get caught up. 

 

https://www.vacscheduler.org/scheduler.html?v=patient

 

 

Tee Hee.. that link is sooo sucky! (I don't mean anything mean to you AbbyGrant.. thank you for that link)

 

..but it gave me all vaxes to get today as a Catch-up dose in red lol.gif  Yeah right!

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Old 05-16-2012, 08:30 AM
 
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Oh I didn't mean it like you should look into whether you really want that one like there was something wrong with it.  I just meant it would be wise to confirm with them that that is indeed what they have if you are set on wanting to do the same vaccine as she had before. There is certainly nothing wrong with wanting to do that. It's my understanding that any of the available Hib vaccines would work in this particular case though. I have no idea if Hiberix (the booster only dose) is "more benign."

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Old 05-16-2012, 08:33 AM - Thread Starter
 
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Ah-ha!

 

Finally :)

 

So Hiberix is what is the 'booster' is it?

 

Off to research!

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Old 05-16-2012, 08:34 AM
 
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Tee Hee.. that link is sooo sucky! (I don't mean anything mean to you AbbyGrant.. thank you for that link)

..but it gave me all vaxes to get today as a Catch-up dose in red lol.gif  Yeah right!

 

Oh yeah, I should have mentioned to just ignore the ones you don't want.  orngbiggrin.gif  I've found it helpful to confirm if I've interpreted some of the more cryptic footnotes correctly on the schedule though. 

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Old 05-16-2012, 08:46 AM - Thread Starter
 
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Old 05-16-2012, 08:54 AM
 
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Blessed Mom, if you go through with the actual appointment to give your child the vaccine, PLEASE ask to see the package and package insert of the vaccine.

 

It doesn't matter how much you annoy the nurse. Or doctor, for that matter.

 

They are human. They make mistakes.  And sometimes they are not honest.

 

Back in 2004, our pediatrician's nurse INSISTED that all their vaccines were thimerosal-free, but I watched her draw up the syringe from a multi-use vial.  
It took me at least 10 minutes of arguing to convince her to show me the package insert, where I showed her where thimerosal was clearly listed as an ingredient. I don't think she was being dishonest--I think she honestly didn't know.  It's not part of nursing school to learn about vaccine ingredients, unfortunately.  The most they're taught is to have a patient at-risk for reactions to stay in the office for 15-30 minutes in case of fainting. And that's only this year's nursing school/nurse-practitioners who have been taught this in school.

 

Some pediatricians give older children adult versions of vaccines--same strength, but the adult version comes in the less expensive, multi-use (thimerosal-preserved) vials. Thimerosal has only been discontinued in pediatric vaccines sold in the US.  Adult vaccines sold in the US can be thimerosal-preserved, as are pediatric vaccines made in the US and exported to third-world countries.

 

Given that your pediatrician's office has already been a bit dodgy regarding which vaccine they actually stock, well, that raises red flags for me.

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Old 05-16-2012, 09:16 AM - Thread Starter
 
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That we would see the package of the vax is a given Taximom... we always do that and very thoroughly.

 

I wouldn't say my peds' office was dodgy (honestly she wasn't).. She just was a doofus. The nurse I spoke to that is. One of many airheads.

 

OFF-topic and don't read this if you don't have time: I originally called to find out where else I could find single HiB shots for my DD (since just 2 weeks back my Ped said they didn't have any). So the nurse calls back and says they usually don't stock up on single HiBs but because there is a Pentacel shortage in the WA state they would be "willing to separate out the HiB shot for me" Now maybe it is just a dialect or something but I didn't understand the "separate out" part of her speech. Like in "physcially separate" from Pentacel in a clumsy in-office manner. OR did Pentacel come in 3 different vials originally and she could choose to dose my DD just one HiB vial? I didn't understand.

 

So i asked her what she meant by separate? She repeats the whole spiel (swear to God!) about Pentacel being out-of-stock and that their office would be willing to separate the HiB for me. No difference in terminology and am still confused!

 

 

Back to topic: Anyway - so I ask her what was the name of the single HiB they were carrying. She is absolutely baffled by my question. She says "single dose of HiB"- what do you mean? I then told her that HiB was manufactured by many companies so which one were they carrying (losing every hope in her competence... they are one of the better Ped offices around Bellevue.. if you can believe that. We aren't even in some rural area).

 

So she comes back with..it is manufactured by Sanofi Pasteur...is that what you want? I said yes.. because I thought Sanofi makes only ActHiB as the single dose. 

 

 

 

But later I was reading up and it seems like they do manufacture some others (as combos though) so do have to make sure it is ActHiB

 

BUT now my main concern is : Is she too old for ActHiB anyway and I am just dosing her a worthless dose? Should she be getting the booster? So far what I read on Hiberix is worse than ActHiB - although I haven't come up with anything conclusively.

 

Also should I give her any HiB at all? I am reading all about serotype replacement and what-nots and that she will be more susceptible to Pneumonia if she gets a HiB and needs to be given Prevnar (another Vax I hate!!!!!!!!)

 

Second , third guessing myself and driving myself crazy!

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Old 05-16-2012, 09:25 AM - Thread Starter
 
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And read this: http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM109841.pdf

 

The first lines: ActHIB®, Haemophilus b Conjugate Vaccine (Tetanus Toxoid Conjugate), produced by Sanofi Pasteur SA, is a sterile, lyophilized powder which is reconstituted at the time of use with either saline diluent (0.4% Sodium Chloride)

OR Sanofi Pasteur Inc. Diphtheria and Tetanus Toxoids and Pertussis Vaccine Adsorbed (whole-cell pertussis vaccine DTP)

OR Tripedia®, Sanofi Pasteur Inc. 

 

So HiB comes as a powder and the Peds' office can choose to mix it with either just saline solution or a DTP combo or a Tripedia combo.

 

Now if they do any of the 3 - does it still state ActHib on the vial (does the name on the vial reflect the solution or the powder - which is ActHib)?? Then that vial will be useless to me right? I wouldn't know which of the 3 I am getting....when I want only the ActHiB?

 

Or does the vial reflect the name of the solution and thus I can clearly tell the difference?

 

What if they make a mistake while mixing (that doofus nurse would!) and I get Tripedia when I want ActHiB?

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Old 05-16-2012, 10:03 AM
 
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Ugh. I'd hate to be in your position, it seems that the nurse really is frustrating. So I think she's saying they don't usually give HIB alone, just mixed with DTaP. But they are out of DTaP (which is frankly concerning since we're supposed to be knee deep in pertussus around here) so she is willing to give HIB alone. It seems to me they always carried it, it just wasn't policy to give it alone. I'd ask if you can talk to your doctor before getting anything from the doofus nurse. Just call and request it, they should not say no. Just say you want to confirm. And...I was always under the impression HIB was no longer a concern after the age of 3. And I've heard many peds (Dr. Gordon especially) say that HIB is rarely ever seen anymore in their practice. Just my 2 cents smile.gif

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Old 05-16-2012, 10:20 AM - Thread Starter
 
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Ugh. I'd hate to be in your position, it seems that the nurse really is frustrating. So I think she's saying they don't usually give HIB alone, just mixed with DTaP. But they are out of DTaP (which is frankly concerning since we're supposed to be knee deep in pertussus around here) so she is willing to give HIB alone. It seems to me they always carried it, it just wasn't policy to give it alone. I'd ask if you can talk to your doctor before getting anything from the doofus nurse. Just call and request it, they should not say no. Just say you want to confirm. And...I was always under the impression HIB was no longer a concern after the age of 3. And I've heard many peds (Dr. Gordon especially) say that HIB is rarely ever seen anymore in their practice. Just my 2 cents smile.gif

 

 

So - does Pentacel not come as a combo but is left at the discretion of the nurses to be mixed - for DTaP, IPV and HiB?

 

AND - yes it does seem like they always must have carried it right - but always refused as matter of policy? Because in the 3 years whenever I asked they said they never had/carried HiB alone but now that Pentacels are in shortage the nurse says "We can separate it out for you" (Although technically if there is a shortage of Pentacel and she 'separates' out an ActHiB for me then isn't she making one Pentacel 'null and void'? lol.gif)

 

I am not sure what she meant by 'separate' at all!!!!

 

Maybe they just received a fast-delivery shipment of ActHiBs and she meant 'we will go outside of our normal policy and give you the ActHiB which is what you want"??

 

And about Pentacels - she said the demand had exceeded supply and there was an acute shortage so their strict instructions were to only give to infants under 9 months old (I think she said)

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Old 05-16-2012, 10:29 AM
 
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As far as I read, the HIB is a powder mixed with either a Tripedia or a Pentacel. So it has always been seperate. This is what makes me feel like they are either untrustworthy or uninformed if they now will be willing to mix a HIB with saline and before only with another combo vaccine. So try to get ahold of your doctor to ask. Usually IMO they can be much more forthcoming than nurses in specific vaccine questions like this.

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Old 05-16-2012, 10:34 AM
 
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Isn't Pentacel just Daptacel with IPV added, then they mix HIB in on site? Now I'm getting confused. Why are you mentioning Tripedia? That's just a DTaP only vaccine that I believe was discontinued in 2008?

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Old 05-16-2012, 10:41 AM - Thread Starter
 
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I am confused by your above two posts.

 

In post #25 you acknowledge that HiB can be mixed with Tripedia (which is what I read too.. is why I am mentioning it..read my concerns about what they may mix the ActHiB in - in post #22 here.

 

In post #26 you ask why I am mentioning Tripedia - although you do acknowledge that it CAN be mixed with ActHiB... ? :)

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Old 05-16-2012, 10:45 AM - Thread Starter
 
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Isn't Pentacel just Daptacel with IPV added, then they mix HIB in on site? Now I'm getting confused. Why are you mentioning Tripedia? That's just a DTaP only vaccine that I believe was discontinued in 2008?

 

See I didn't know this. So it makes sense that she used the word 'separate'.

 

ALTHOUGH - if their policy is to ALWAYS administer Pentacels - then it couldn't be that they are now administering ONLY Daptacels and thus have leftover HiBs - right?

 

If they are responding to the new epidemic and people are asking for Daptacels - they can just as easily give Pentacels - right? Which means the separating out a HiB makes one Pentacel 'void'.

 

OR - maybe some sel vaxers are asking for only Daptacels and they are giving in - where as earlier they wouldn't... and thus are left with leftover HiBs?

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Old 05-16-2012, 10:53 AM
 
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That nurse must be the one who got fired from OUR ped's office! orngbiggrin.gif

Seriously, the misuse of language is just amazing when it comes to vaccines.

Doctors STILL say that "thimerosal was removed from pediatric vaccines.".

No, it wasn't removed. They didn't go in there with a little Thimerosal Removal Kit and remove it. They began to produce single-dose vaccines WITHOUT thimerosal. They also continued producing them WITH thimerosal, either for adults or for export to third-world countries.

I suspect it's the same misuse of language with your nurse, who says she can "separate it out." (One wonders how she passed organic chemistry?)
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Old 05-16-2012, 11:59 AM - Thread Starter
 
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My 3 questions are:

 

1. Should I give ActHiB or Hiberix to my DD? Which is more benign relatively?

 

2. Should I give any HiB shot at all or is she out of danger zone since she is 3 years old? A balanced view would be nice... 

 

3. If I choose to give her the ActHiB is there a chance that the nurse could accidentally mix HiB powder in with the DTaP solution rather than just the saline solution??? Should such simple mistakes be allowed to happen? I am thinking the smart way for Sanofi to sell this would be - the solution vials should say - ActHiB, DTaP or Tripedia and whichever vial the powder is mixed in - will reflect the right name...that way less chance of a mistake. 

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