Input on vaccination schedule living in São Paulo Brazil - Mothering Forums

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#1 of 8 Old 06-14-2007, 11:44 AM - Thread Starter
 
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Let me start by saying that yes, Brazil is a third world country, but we live in its largest city, which is as modern as most other big cities in the world. The official vaccination schedule here is:

Birth-1 month: BCG and Hep B
1 mo after 1 st vaccine: Hep B
2 mos: OPV, DTwP+Hib, Rotavirus
4 mos: OPV, DTwP+Hib, Rotavirus
6 mos: OPV, DTwP+Hib
6 or 7 mos: Hep B
9 mos: Yellow fever (not us, only in certain regions)
12 mos: MMR
15 mos: OPV, DTwP
4-6 years: DTwP, MMR
6-10 years: BCG booster

I gave the first two dose of Hep. B and BCG because I hadn´t decided what to do. There is a chance of running into legal problems even for delaying, but we will do so. In private clinics we can get the DTaP, IPV and any other "extras": Prevenar, Hep A, mening. C, Chickenpox, etc.

DD´s ped has agreed to delaying, and me deciding when to start. But he wants me to keep them at the right intervals on each specific vaccine. I will NOT give the rotavirus, and can´t decide on the MMR because DH has Crohn´s disease so the vaccine makes me nervous, but so do the illnesses, and there is no such thing as monvalent vaccines here for this. So, the schedule I´m considering is:

7 mos: Hep B booster (since I started ped. says to finish)
8 mos: DTaP
9 mos: IPV
10 mos: DTaP
11 mos: IPV
12 mos: DTaP
15 mos: Hib
17 mos: IPV
20 mos: DTaP
24 mos: MMR (IF I decide to get it).
Beyond this I have no clue

A few other factors in this include that we do regularly visit poor areas with not-great sanitation, and we go once a week to visit an orphanage where the children have ALL the vaccines on the first list, and come from very poor sanitary backgrounds, one boy came in paralyzed due to meningitis, etc.
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#2 of 8 Old 06-14-2007, 01:19 PM
 
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I'd wait until the teen years to do HepB, if your going to do it. Just because you've already started isn't a good reason to finish now, since little kids basically never just "catch" HepB, and it might wear off by the time there are actual risk factors.
Getting the DTaP instead of the DTwP is a good idea.

What's your thinking on IPV?

The risk of invasive Hib disease is basically gone by 15 months, so if you're going to get it, you should get it earlier. Or not at all.

Is there measles in Brazil? If not, you can delay the MMR longer.
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#3 of 8 Old 06-14-2007, 01:28 PM - Thread Starter
 
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There was a major measles outbreak just a month ago near here. On the other hand, I don´t know how serious any of the diseases themselves would be. I guess I´m concerned about rubella and pregnancy in the future, so maybe I could wait longer, although I may have trouble with her staring school if I don´t get it.

As far as the polio vaccine, besides the ones mentioned on the reg. schedule, beyond that they give it to all kids under 5 twice a year. And if you take them on that day, sometimes tehy´ll give extras. My first dd got a booster of MMR when she was 3 because there had been another outbreak and they were doing mass vax for the whole area. But my concern is that exposure to the polio virus through poor sanitation could be an issue. And IPV opposed to OPV because of the risk of the OPV giving the actual disease.

A side note, my kids have to go to private schools because the government sends extra vax to public schools and give them to everyone without even getting parental consent. They just did this with leftover flu vax from the vax drive for people over 60. They´ve done it with MMR before. They do it with the chickenpox vax which isn´t even on the calendar.....

And on the issue of continuing because we started...I started the pneumonococos vaccine on my sons before I "knew better". They are 21 mos old due for the second shot...I though I HAD to do it now. Should I?
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#4 of 8 Old 06-14-2007, 01:40 PM
 
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If you're actually worried about polio, I'd probably go ahead and do OPV. IPV might not even work at all. The risk of getting paralytic polio from OPV is one in a million in general, and probably much lower in a very healthy kid (assuming your kid's healthy) who eats well.

I'd wait till later to worry about rubella and pregnancy, Same with mumps. Those two diseases are very, very "not scary" in kids.
Measles is a bit worse, though, although it's usually not a big deal, either, The risk of a serious complication/death is about one in 1,000. Which isn't super-scary or totally benign. Measles can really suck, though. But a dad with gut problems would make me pause, too. So I don't know what to tell you there.

How many doses of prevnar have your son's gotten so far?
Prevnar is very, very effective. If they've already gotten 2 or 3 doses, they're probably as immune as they're going to get, anyway.
But I'm not a big fan of that vax, period. So I'd say skip it from now on no matter what. The vax is effective for the bacteria the vaccine is for, but it just opens up an ecological niche for other bacteria to fill, and do the same things. So it's working really well and totally not working at all, at the same time, if that makes sense.,
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#5 of 8 Old 06-14-2007, 04:00 PM
 
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Originally Posted by heatherj81 View Post
And on the issue of continuing because we started...I started the pneumonococos vaccine on my sons before I "knew better". They are 21 mos old due for the second shot...I though I HAD to do it now. Should I?
I see no reason to continue to get doses of anything, if you've decided you don't need it. There is no additional risk from stopping before you've finished the series. The worst that can happen is that they don't become immune.

And as mamakay said about prevnar, even one dose is highly effective. In the efficacy trial, NO ONE (out of more than 17,000 vaccinated, if I recall correctly) had a case of infection by the vaccine serotypes, even after just one dose. My ds had a few doses of Prevnar, but we stopped getting them after 12 months. Dunno if we'll get any with the next baby, but we certainly won't get all of them.

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#6 of 8 Old 06-16-2007, 01:44 PM
 
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. In the efficacy trial, NO ONE (out of more than 17,000 vaccinated, if I recall correctly) had a case of infection by the vaccine serotypes, even after just one dose.
Does anyone have a link to this study? I tried to tell my ped about this and he thought I was nuts. I thought maybe I'd give him a copy of a couple of studies when I quit the practice.

mom to 4 kids, ages 20 mos to 11 years

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#7 of 8 Old 06-18-2007, 12:14 AM
 
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Does anyone have a link to this study? I tried to tell my ped about this and he thought I was nuts. I thought maybe I'd give him a copy of a couple of studies when I quit the practice.
I don't have time right this minute to look it up, but it was the information released by the manufacturer of Prevnar. You should be able to find it with a search online, that's how I found it. It's very long, and it's all in medicalese, but there is a lot of data there.

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#8 of 8 Old 06-18-2007, 10:09 AM
 
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Here's the link: http://www.wyeth.com/content/ShowLabeling.asp?id=134

The info I was talking about is in Table 1. I had remembered the numbers slightly wrong: in this part of the study Prevnar was given to 18,906 children, and the "control" vaccine to 18,910 children. As the table shows, none of the Prevnar children were infected with the vaccine serotypes at any point during the vaccination process, as opposed to 17 of the control group after all the shots, and 5 more during the course of the shots. One child in the Prevnar group got a different strain during the vaccination process, and two afterwards.

Now, that efficacy study is not long-term. It's possible that the vaccine wears off more quickly if you get fewer doses, but they didn't test how long immunity lasts with all four doses, either. Since the disease is more risky in younger children, I wouldn't really worry about it.

We didn't get the fourth dose for my son, after I found this research. If I had found it sooner, we might have had even fewer shots.

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