dtap consideration for unvaxed 2yo ds w/medical considerations? - Mothering Forums

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Old 10-15-2010, 01:07 PM - Thread Starter
 
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I hope some of you wise mamas can help me work through this. My 2yo ds is currently unvaxed...and we originally planned to keep him unvaxed. Pertussis has me a lil freaked out currently, & I am questioning my decision to not give him dtap.

WC is really the only thing that really frightens me with him. Because of a birth defect, he is susceptible to pneumonia. He was born w/esophageal atresia & tracheoesophageal fistula & has tracheomalacea -basically a floppy airway. He cannot process mucous the way a person w/a normal esophagus/trachea can & his coughs are largely unproductive. What would be a normal simple cold to you or I can turn into pneumonia for him. He had 4 pneumonias last year Dec-June..the first resulting in a week long hospital stay.

Anyway, our family doc supports us in our decision to not vax him prior to 2years, and would continue to support any decision we made re vax. Ds is a happy, strong, normal lil boy aside from the issues listed above. My goal was just to keep his immune system as strong as possible, and bf bf bf.
I had planned not to vax at all..but I am starting to question my judgement on the pertussis vax.. yet it is the vax that scares me the most. ugh.

Any thoughts?
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Old 10-15-2010, 05:14 PM
 
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That's a really hard choice, mama.

It's hard to say with certainty without being in your shoes, because I can only imagine how scary the thought of him getting pertussis must be for you. But I think I would be inclined to keep boosting his immune system naturally and learn how to lessen the symptoms of whooping cough using high doses of sodium ascorbate and other more natural methods. The DTaP is perhaps the vaccine that I would be least willing to consider for my children, as it seems to be one of the most reactive. The DTP archives here on MDC have lots of interesting posts about the DTaP and pertussis itself.


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Old 10-15-2010, 08:21 PM
 
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Pertussis can be a serious illness, not "is."

My first reaction is that I'd be considering the vax as well, as the vax decision is comparing risks to benefits. But if then end result is the same whether he has a cold or pertussis, is the risk from the vax worth it? If his problems are "structural" then it seems that the strength of his immune system would determine whether a clinical case of Pertussis develops.

Though my children do not have any health problems, I treated every sniffle and cough as though it may be Pertussis.

My son was vaxed and had it at 2yo, ebf. I was pregnant at the time and had a more severe case on the heels of what may have been the norovirus (the hospital didn't specify), and strep (my niece being the likely source of that).

"It should be a rule in all prophylactic work that no harm should ever be unnecessarily inflicted on a healthy person (Sir Graham Wilson, The Hazards of Immunization, 1967)."
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Old 10-16-2010, 10:27 AM
 
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I was worring about this too a few months back for a number of reasons. One we'll have a new lo in Jan/Feb, I have a ds w/asthma and when he has a cold usually needs (he hasn't needed any treatments the past 2 cold seasons- knock on wood!) neb treatments and I also have an older DD who suffers most winters w/at least one round of bronchitis or pneumonia- so 3 DC w/lung issues. Out of all our DC there is only one who is due for a booster.

We have a DS (1.5) that had 3 DTaP shots and on his 3rd round reacted, so he'll not be recieving anymore (for a good long time at least) and the new lo won't recieve any. This was a hard decision. We know the vax won't keep them from getting WC (and new babe will be too little anyways) but will keep it from getting "too" bad, but the risks of the vax for them is higher than the illness (if caught- which sometimes it isn't in those that are vaxed).

My plan of action this year- good hygiene, and talk to our ped about having on hand Albuterol (for the neb) if/when they do get sick (I know she'll be ok w/this), and a healthy diet. No shots. It won't keep us from getting it anyways, just make it not as bad. And it's all "ifs" anyways.

GL!
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Old 10-17-2010, 05:19 AM
 
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Heather, I just wanted to clarify about previously healthy adults having post tussive vomiting. To the best of my knowledge this is not true. In fact one of the biggest factors in adults being reservoirs for pertussis, is that the illness is so mild in adults it goes unnoticed.

This is not the same for young children and babies. They can vomit after coughing and the coughing can be really really horrible and scary to watch.

But it isn't always.

That said, OP, I can really understand your concern. It sounds like a very scary position to be in as a mother.

Knowing that the DTaP is not very effective at preventing Pertussis, I would not rely on the vaccine alone. There is evidence that the vaccine reduces the severity and duration of the cough, but that is not going to be for every child. You cannot have any assurance that if you get the vaccine your child will not get pertussis.

If getting the vaccine leaves you feeling you have stacked the odds in your favour, go for it. In your position, I would be keeping my child's' immune system as strong as possible (lots of fresh wholefoods, good rest, outside play time, love and snuggles etc), regardless of whether you choose to get the vaccine or not. Having a well rested, fed etc child means that when/if he does get sick, he has a better chance of getting through the disease with as little suffering as possible.



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Old 10-18-2010, 10:41 PM
 
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I have removed several posts from this thread which were either not consistent with the guidelines for this subforum or which were responding to such posts. Please remember that the intended purpose of this subforum is to serve the needs of members who have chosen or are seeking input in order to choose not to vaccinate. Posts arguing against non-vax decisions are not appropriate for the subforum & will be removed.

Please also remember that it is not appropriate to post to a thread to address another member's behavior. If you feel someone has behaved inappropriately, please click the 'report post' button or simply PM a moderator.

Should the thread continue to veer off topic for the subforum, it will be closed to further discussion.

ETA: If you have any question as to whether your post might be appropriate for the forum or if you would like clarification regarding the guidelines, please feel free to PM me any time.
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Old 10-19-2010, 01:25 AM
 
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Originally Posted by ema-adama View Post
Heather, I just wanted to clarify about previously healthy adults having post tussive vomiting. To the best of my knowledge this is not true. In fact one of the biggest factors in adults being reservoirs for pertussis, is that the illness is so mild in adults it goes unnoticed.
I didn't get that information from looking up studies or anything. I was actually talking with people on another messaging board about pertussis, have you ever had it, etc. Many women talk about having it as an adult. A suprising number of them said that they coughed to the point of vomiting. And their coughing was so severe that they were afraid that they'd be unable to breathe. On lady even cracked her rib from her pertussis coughing! It was surprising to me because I, too, had thought it was fairly mild in adults. But I guess it can be bad for adults, too.
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Old 10-19-2010, 01:34 AM
 
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Originally Posted by ema-adama View Post
Heather, I just wanted to clarify about previously healthy adults having post tussive vomiting. To the best of my knowledge this is not true. In fact one of the biggest factors in adults being reservoirs for pertussis, is that the illness is so mild in adults it goes unnoticed.
I certainly had post-tussive vomiting (just got over a case of pertussis) in the paroxysmal phase. I'd have coughing attacks in the middle of the night that would last for up to an hour and I usually vomited during/after... and peed myself from the force of the coughing more than once. It wasn't nearly as rough on my 6 y/o.

--K
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Old 10-19-2010, 03:46 AM
 
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I would imagine it is not outside the realm of possibility that an adult would haver post tussive vomiting. Over a whole population, it would be unlikely that every adult would never vomit.

It is my understanding that it is unusual. From what I have read, adults present with atypical pertussis (no paroxysmal coughing, no vomiting etc - just a drawn out lingering cough).

I personally prefer not to rely on anecdote when it comes to the final decision. It is interesting to hear peoples stories. However, if it is in contrast with what I have understood in the medical literature, I would more likely rely on the medical literature than the anecdote.

OP, I hope you are able to come to a decision that leaves you feeling your child is at the best place they can be.

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Old 10-19-2010, 04:14 AM
 
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Interesting. Everything I've seen indicates that while adults don't typically have the "whoop", the paroxysmal coughing is common (though not universal). I totally agree with you about anecdotal evidence, but we're obviously reading different sources.

As for the original topic, I'm not sure what I'd do. I probably would get him the vax but I'm pretty much neutral towards most vaccines. (We selectively vaccinate.)

I do know that pertussis is becoming more commonplace. I think most of the time it's not *that* big of a deal but I could see how it could be more serious in your son. It was pretty unpleasant for us, I'll say that, but I'm feeling a little disillusioned about the DTaP after my 6 y/o got a nasty case of pertussis despite having had all five of the recommended DTaP shots.

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Old 10-19-2010, 08:15 AM
 
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Originally Posted by ema-adama View Post
I would imagine it is not outside the realm of possibility that an adult would haver post tussive vomiting. Over a whole population, it would be unlikely that every adult would never vomit.

It is my understanding that it is unusual. From what I have read, adults present with atypical pertussis (no paroxysmal coughing, no vomiting etc - just a drawn out lingering cough).

I personally prefer not to rely on anecdote when it comes to the final decision. It is interesting to hear peoples stories. However, if it is in contrast with what I have understood in the medical literature, I would more likely rely on the medical literature than the anecdote.

OP, I hope you are able to come to a decision that leaves you feeling your child is at the best place they can be.
I thought I remembered reading the same research, but now that I'm looking again I can't find it. Would you mind sharing the research you've found that shows that adults usually do not experience post-tussive vomiting? TIA!
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Old 10-19-2010, 09:58 AM
 
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Pretty high percentages of adults with vomiting (need full access to see complete charts)

http://www.jstor.org/pss/30110029

http://www.jstor.org/pss/4482633

stats in abstract- better break down in full article:

http://www.springerlink.com/content/q3r57634k7416617/

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Old 10-19-2010, 10:09 AM
 
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It is easy enough to find on google scholar. I am not aware of this being information that is difficult to find. Almost every article or opinion piece that I have read on pertussis mentions how the disease mostly has an atypical presentation in adults.

This does not mean that some adults will not be very sick with it. However, just because some are, does not mean all will be, of course.

Perhaps you can start another thread on pertussis in adults and leave this thread for the OP to discuss her concerns specifically to her child and the vaccine.

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Old 10-19-2010, 10:57 AM
 
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edited because I didn't realize this was in nonvaxing. If interested in discussing cocooning and possible benefits, PM me or post in selective or main forum

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Old 10-19-2010, 01:28 PM
 
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Originally Posted by minmoto2 View Post
I hope some of you wise mamas can help me work through this. My 2yo ds is currently unvaxed...and we originally planned to keep him unvaxed. Pertussis has me a lil freaked out currently, & I am questioning my decision to not give him dtap.

WC is really the only thing that really frightens me with him. Because of a birth defect, he is susceptible to pneumonia. He was born w/esophageal atresia & tracheoesophageal fistula & has tracheomalacea -basically a floppy airway. He cannot process mucous the way a person w/a normal esophagus/trachea can & his coughs are largely unproductive. What would be a normal simple cold to you or I can turn into pneumonia for him. He had 4 pneumonias last year Dec-June..the first resulting in a week long hospital stay.

Anyway, our family doc supports us in our decision to not vax him prior to 2years, and would continue to support any decision we made re vax. Ds is a happy, strong, normal lil boy aside from the issues listed above. My goal was just to keep his immune system as strong as possible, and bf bf bf.
I had planned not to vax at all..but I am starting to question my judgement on the pertussis vax.. yet it is the vax that scares me the most. ugh.

Any thoughts?
In your case, I would possibly consider it. You say he's healthy, but that's a lot of pneumonia for one person to have had so young. If the vaccine does help to lessen the severity of the illness, then it seems like it may something to look into.

When I was trying to decide for my 3rd child if I wanted the dtap for him, the naturapath exlained that one shot would help and I would not have to do boosters. Most healthy people will be protected with one and boosters are to catch the ones who didn't get immunity with the first shot for whatever reasons.

With my 4th son, I'm a solid non-vaxxer, but actually had a moment a few months ago where I thought I wanted him to get the dtap. He's perfectly healthy and I decided against it after talking with my naturapath and some non-vaxxing friends. If I felt that way with my healthy child, I can imagine how you feel.

Another thing to consider is schooling regulations. If you don't have many options for exemptions, can you do this vaccine "under the table" and not have it put on any registries or on the shot record? Also, if you're feeling this way because of the news, you shouldn't be watching the news. News is like a big scary advertisement. Read the package insert and see if that helps you make a decision. For me, whenever I start to fear a disease, I read the package insert for the vaccine that prevents that disease. Usually, that re-assures me in my decision not to vax.

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Old 10-19-2010, 02:52 PM
 
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It is easy enough to find on google scholar. I am not aware of this being information that is difficult to find. Almost every article or opinion piece that I have read on pertussis mentions how the disease mostly has an atypical presentation in adults.
If it's so easy to find, I'd love to see a link, because what I'm finding on Google Scholar are the same studies linked by carriebft, which show a vomiting rate (in adults) of about 45%.

YES, everything I've seen as far as articles, etc., does mention that adults have an atypical presentation. I haven't seen any that say adults specifically are less likely to have paroxysmal coughing or post-tussive vomiting, however. Plenty mention that adults usually don't have the "whoop".

It's also notable that while pertussis does got undetected in adults a lot, the rate of subclinical infection (such that it would be too mild to be noticed) is in the low teens. It's not so much that no one realizes these folks are sick, it's that it's misdiagnosed as more common causes of coughing like postnasal drip from allergies or sinusitis. The (very) old clinical pearl, "When you hear hoofbeats, look for horses, not zebras" is probably more at fault than the mildness of the disease presentation in adults. Especially since the "whoop" effect is less common in adults, and when people (even physicians) think of pertussis/whooping cough, they think of the "whoop".

I'm pretty sure the only reason my daughter and I (neither of us had the "whoop") were tested and diagnosed is that I tailored my chief complaint to make sure it would bring to mind what I thought was wrong. "Doctor, I've been coughing at night for weeks!" doesn't sound like pertussis nearly as much as "Doctor, I'm having coughing fits so severe that I vomit and pee myself!" Both statements were entirely true, though.

--K
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Old 10-19-2010, 11:32 PM
 
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Another thing to consider is schooling regulations. If you don't have many options for exemptions, can you do this vaccine "under the table" and not have it put on any registries or on the shot record?
This is a very important point. If the OP is in NY and has a religious exemption I would strongly suggest she not get the vax unless she is ready to go full vax.


I don't see how adult cough or reactions to the disease has any relevance in this thread, since we are talking about a child.
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Old 10-21-2010, 05:36 PM - Thread Starter
 
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Thanks for all the thoughts. I am still going rounds in my head about this. Mostly for this reason:
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Originally Posted by Emmeline II View Post
But if then end result is the same whether he has a cold or pertussis, is the risk from the vax worth it? If his problems are "structural" then it seems that the strength of his immune system would determine whether a clinical case of Pertussis develops.
If ds gets the vax and still ends up w/wc, what's the point? I am also slightly concerned because of a family hx of auto-immune disease. But, then I wonder if it actually does prevent in his case-or even makes the symptoms more mild, am I nuts for withholding it? and round and round we go. ugh.
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Old 10-21-2010, 05:41 PM
 
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For a kid with these health problems, and that history of pneumonia, I would do a lot of things to reduce the risk of respiratory illness.
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Old 10-21-2010, 05:46 PM - Thread Starter
 
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In your case, I would possibly consider it. You say he's healthy, but that's a lot of pneumonia for one person to have had so young. If the vaccine does help to lessen the severity of the illness, then it seems like it may something to look into.
Yes, it is a lot of pneumonia, but it is because of the way his trach/esoph functions vs his immune system. I think 1 pneumonia is too many The lessened severity is exactly what interests me right now.

Quote:
Another thing to consider is schooling regulations. If you don't have many options for exemptions, can you do this vaccine "under the table" and not have it put on any registries or on the shot record? Also, if you're feeling this way because of the news, you shouldn't be watching the news. News is like a big scary advertisement. Read the package insert and see if that helps you make a decision. For me, whenever I start to fear a disease, I read the package insert for the vaccine that prevents that disease. Usually, that re-assures me in my decision not to vax.
We homeschool, so I am not concerned with schooling regs.

I do have to admit the media, msg boards (including mdc), etc. are getting to me. Though, I actually don't know anyone irl that has had whooping cough in the last ten years.
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