Early-life Infections, Immunizations May Alter Childhood Asthma Risk - Mothering Forums

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#1 of 31 Old 06-12-2011, 10:29 PM - Thread Starter
 
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From later in the article:

 

 

 

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Dr. Thomson said she was not aware of other studies that reported an association between combined DT vaccination and asthma. She emphasized, however, that the study does not suggest a "causal link." Rather, it shows a statistical association "for which a range of explanations (some noted above) may apply."

 

"While chance is an unlikely explanation for the finding, it can not be eliminated completely; nor can unknown or recognized confounders for which we lacked data be definitively excluded," Dr. Thomson said.

 

Importantly, she added, the association between combined DT and the later development of asthma "should not deter parents from immunizing their children when weighted against the benefits."

 

The study also found that oral polio immunization in the second year of life was associated with a decreased risk of asthma at 6 years (crude RR, 0.60; adjusted RR, 0.63).

 

"Early childhood immunizations that are administered orally such as Sabin and/or more recently introduced immunizations such as the rotavirus vaccine may offer benefit in preventing the development of childhood asthma and other allergic diseases," Dr. Thomson said.
Pediatr Allergy Immunol 2010.

 

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#4 of 31 Old 06-13-2011, 06:55 AM
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It would be pretty weird for doctors to tell patients that vaccines can cause asthma based on one study in which asthma was statistically linked to one combo vaccine given to, if I read it correctly, two percent of patients.

I have only ever dealt with my own doctors and my children's. I have no idea what doctors, in aggregate, always or never say. Doctors I have worked with have always been willing to answer my questions and respond to my concerns. There is a list of circumstances under which vaccination is contraindicated. I have been shown it, though I didn't memorize it.

Diphtheria is pretty darn bad. Asthma is pretty manageable. New Zealand, where this study was conducted, is a small country in Oceania. Doctors there may need to account for a relatively high possibility that their patients will travel to developing nations where diphtheria is a more serious risk.

I think the potential connection between asthma and gastroenteritis is intriguing. Thank you for sharing the article.
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It would be pretty weird for doctors to tell patients that vaccines can cause asthma based on one study in which asthma was statistically linked to one combo vaccine given to, if I read it correctly, two percent of patients.

I have only ever dealt with my own doctors and my children's. I have no idea what doctors, in aggregate, always or never say. Doctors I have worked with have always been willing to answer my questions and respond to my concerns. There is a list of circumstances under which vaccination is contraindicated. I have been shown it, though I didn't memorize it.

Diphtheria is pretty darn bad. Asthma is pretty manageable. New Zealand, where this study was conducted, is a small country in Oceania. Doctors there may need to account for a relatively high possibility that their patients will travel to developing nations where diphtheria is a more serious risk.

I think the potential connection between asthma and gastroenteritis is intriguing. Thank you for sharing the article.


I would never describe my 30 year battle with asthma that way. It was scary, painful, expensive, frequently life threatening, and constant for nearly three DECADES. The hospital staff knew my family, as I showed up there several times a month, unable to breathe. I was on several drugs a day for 30 years. I spent most of my childhood on the sidelines watching kids play, because if I joined them I would wind up on a nebulizer. My asthma had a laundry list of triggers, as well as spontaneous onset.

 

I'm not singing the praises of diphtheria. I'm just saying don't be so flip about asthma. People need to weigh which illness they are more comfortable handling, should their child develop a case. Full information of risks would be nice so parents can make an accurate decision.

 

If diphtheria is only a risk if the individual is traveling, then maybe that is the only time it should be looked at.

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My dd has asthma, and I don't take it lightly either.  I just agree with the researchers' conclusion that the benefits of diphtheria vaccination outweigh the risks, and that it is not yet clear why there is a correlation between ONE combination vaccine for diphtheria and later asthma, and not between asthma and other combination vaccines that also protect against diphtheria.  

 

I think it's also worth noting that, if one reads the article summary as a whole rather than picking out a single sentence, the researchers found another vaccine that's correlated with lower risk of asthma.  

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And many might feel that given their living situation, the risk of diphtheria is pretty much zero, so any risk of anything else (like asthma) isn't worth it.

 

One major problem with the current vaccine schedule is that it is one-size fits all. But that is absurd. If a child is at an increased risk for asthma (say genetics, city they live in, whatever) and at virtually no risk for diphtheria, and a study shows an increased risk of asthma (even if it's slight) associated with a certain vaccine, then that child shouldn't get the vaccine. But no vaccines are addressed this way, and that is of great concern to me. It's never about what's best for my child, and my child has very different risk factors than children in general.

 

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yes, but if everyone who could possibly be at risk for asthma didn't get diptheria vaccine, then it wouldn't be a zero chance, would it? eventually it would find its way in from the other countries.

 

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This study indicates that children with an increased risk for asthma should get a different diphtheria vaccination other than the DT.  The study didn't identify a cause for the correlation between asthma and DT combo vax, but it did show that other combos with the diphtheria vax aren't linked to increased risk of asthma.  So parents with a family history of asthma might want to look out for that.  No clinical recommendations are going to change based on an inconclusive observation about 2% of the subjects in a study published in a tiny journal.  Remember, the researchers saw a correlation affecting a small number of the children in the study and did not feel they had enough information to identify the cause of the correlation.  They don't have the data to say that the DT is causing asthma.  It's entirely possible that some other factor is causing children who are likely to get asthma to also be likely to get the DT vax.  Could be geography, or plans for travel to the developing world, or pre-existing history of respiratory conditions, or something else equally random.  This was an observational study of the relationship between asthma and gastroenteritis, not a study of the impact of vaccines.  Correlation is not causation.  Nonetheless, asking for the DTP or DTaP instead of DT won't be an issue unless there's another shortage.  I suppose you could also request the oral polio vax, as it's correlated to lower asthma risk (again, inconclusively) though that one's unusual in the US.  It can't hurt to try.

 

If you're confident that your child will neither travel to a country where diphtheria is endemic, nor have contact with anyone who has traveled to a country where diphtheria is endemic, you might be safe skipping that vaccination.  There hasn't been a human case in the US since 2003.  The CDC is concerned about asymptomatic carriers continuing to circulate the infection, and about the possibility of outbreaks among older adults.  So I guess you could look out for that.  

 

My doctors are completely willing to address vaccines as they relate to the risks to my particular children and their personal and family histories.  And my doctors are pretty mainstream.  I'm sorry you've had trouble with yours.  

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It's not about doctors being willing to address risks for particular children if their parents bring it up. Individual assessment should be the standard from the beginning. It's not. That's wrong. Every child deserves to be given a custom risk/benefit analysis, and not given the responsibility to take a risk to protect everyone else.

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I disagree.  Like snowflakes, every child is unique, but also like snowflakes, they all have a lot in common.  From an immunological perspective, the really special ones tend to stand out.  

 

In the vast majority of children, a careful, individualized analysis would lead doctors to recommend administering the typical vaccines on the typical schedule. Carrying out millions of individualized risk/benefit analyses on healthy children every year would dramatically reduce the time that physicians have available to spend on patient care with no measurable benefit, because adverse reactions to vaccines are rare and unpredictable.  

 

As with any situation in which you receive a service, if you want something special, you have to ask.  

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Quote:

Originally Posted by stik View Post

I disagree.  Like snowflakes, every child is unique, but also like snowflakes, they all have a lot in common.  From an immunological perspective, the really special ones tend to stand out.  

 

In the vast majority of children, a careful, individualized analysis would lead doctors to recommend administering the typical vaccines on the typical schedule. Carrying out millions of individualized risk/benefit analyses on healthy children every year would dramatically reduce the time that physicians have available to spend on patient care with no measurable benefit, because adverse reactions to vaccines are rare and unpredictable.  

 

As with any situation in which you receive a service, if you want something special, you have to ask.  

 

We're not talking about doctors administering one vaccine here or there. We're talking about 6 to 8 vaccines at one visit! That certainly calls for some heavy-duty risk/benefit analysis IMO.  Forget the doctor's precious time, although you're right, doctors don't take the time to look at each child individually and I think that is sad.  They just inject and wash their hands of it.

 

You can't tell what underlying health issues a child has when they are first born, even at 2, 4, 6, months etc. They may have underlying health issues that haven't surfaced yet, but let's still vaccinate them anyway because "that's the thing to do."eyesroll.gif   To go by the one-size-fits-all criteria is absurd.  I don't care how healthy the child "appears."

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Originally Posted by stik View Post

I disagree.  Like snowflakes, every child is unique, but also like snowflakes, they all have a lot in common.  From an immunological perspective, the really special ones tend to stand out.  

 

In the vast majority of children, a careful, individualized analysis would lead doctors to recommend administering the typical vaccines on the typical schedule. Carrying out millions of individualized risk/benefit analyses on healthy children every year would dramatically reduce the time that physicians have available to spend on patient care with no measurable benefit, because adverse reactions to vaccines are rare and unpredictable.  

 

As with any situation in which you receive a service, if you want something special, you have to ask.  


A lot in common? Sure. But some of their differences matter in a major way. Do you truly believe a child who is breastfed is at equal risk for complications from Hib or rotavirus as one who is formula fed? Especially if the child stays home? That requires very little time to determine, and could easily result in a risk/benefit analysis in favor of not giving those vaccines.

 

You will never convince me that potential risk factors in a newborn stand out. Nor a 2-month old, or a 4 or 6-month old. It's seriously not even worth your time to try.

 

My exact point is, custom medical care for children (or adults) should not be special. It should be standard.

 

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Quote:
Originally Posted by SilverMoon010 View Post

Quote:

Originally Posted by stik View Post

I disagree.  Like snowflakes, every child is unique, but also like snowflakes, they all have a lot in common.  From an immunological perspective, the really special ones tend to stand out.  

 

In the vast majority of children, a careful, individualized analysis would lead doctors to recommend administering the typical vaccines on the typical schedule. Carrying out millions of individualized risk/benefit analyses on healthy children every year would dramatically reduce the time that physicians have available to spend on patient care with no measurable benefit, because adverse reactions to vaccines are rare and unpredictable.  

 

As with any situation in which you receive a service, if you want something special, you have to ask.  

 

We're not talking about doctors administering one vaccine here or there. We're talking about 6 to 8 vaccines at one visit! That certainly calls for some heavy-duty risk/benefit analysis IMO.  Forget the doctor's precious time, although you're right, doctors don't take the time to look at each child individually and I think that is sad.  They just inject and wash their hands of it.

 

You can't tell what underlying health issues a child has when they are first born, even at 2, 4, 6, months etc. They may have underlying health issues that haven't surfaced yet, but let's still vaccinate them anyway because "that's the thing to do."eyesroll.gif   To go by the one-size-fits-all criteria is absurd.  I don't care how healthy the child "appears."

 

No, we're not talking about one vaccine here or there.  Yes, there can be a lot in one visit (though not 6-8 unless you've fallen behind on the schedule).  That certainly does call for heavy-duty risk/benefit analysis.  In aggregate, that analysis has been done.  No, you can't tell what underlying health issues a child will have at a young age.  However, very few underlying health issues are contraindications for vaccination.  And yes, if you are trying to serve the public health goal of vaccinations, which is to limit outbreaks of disease in a population, vaccination and hand-washing are "the thing to do."  

 

Most docs take a family history in which they check for things like food allergies, chronic illnesses, medical conditions suspected of having a genetic component, and a bunch of other stuff, when they first meet a patient.  Beyond that, how healthy a child appears is a generally sound criteria for identifying a healthy child.  In fact, that is the long-standing diagnostic standard for spotting healthy children.  

 

If you think your particular children are unique in a way that merits more thorough analysis, you should tell your doctor.  
 

 

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If you think your particular children are unique in a way that merits more thorough analysis, you should tell your doctor.  
 

 


Thanks for the suggestion but I actually was speaking of all children in general, not my own in particular.  I see all children as very special and deserving of time from doctors when it comes to their health and future.


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That's some intensive post-modern analysis of my statement there.  Let me assure you that the Poling family was very, very far from my thoughts when I wrote that.  

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Quote:
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Most docs take a family history in which they check for things like food allergies, chronic illnesses, medical conditions suspected of having a genetic component, and a bunch of other stuff, when they first meet a patient.  Beyond that, how healthy a child appears is a generally sound criteria for identifying a healthy child.  In fact, that is the long-standing diagnostic standard for spotting healthy children.  

 

 



And this is all obvious and apparent in a 2-month old?


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All what is apparent in a 2-month old?   

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All what is apparent in a 2-month old?   



" food allergies, chronic illnesses, medical conditions suspected of having a genetic component"

"how healthy a child appears is a generally sound criteria for identifying a healthy child"


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Thanks for the suggestion but I actually was speaking of all children in general, not my own in particular.  I see all children as very special and deserving of time from doctors when it comes to their health and future.

 

I agree in re. children being special and deserving time from doctors.  My point is that for most children, individual risk-benefit analysis of the vaccination schedule is neither merited nor beneficial.  Their doctors should focus on their actual needs.  
 

 

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" food allergies, chronic illnesses, medical conditions suspected of having a genetic component"

"how healthy a child appears is a generally sound criteria for identifying a healthy child"


What my post said was that most doctors would take a family history regarding those issues.  This means they would interview the adult who brought the child to the doctors' office about whether those issues had occurred in the child's genetic relatives.  This does create difficulties for some families who may not have access to information on some or all of the child's genetic relatives, but in most families, family history is known and can be shared.  So yes, the family history can usually be made apparent.

 

And then, the doctor assesses how the child looks and sounds, and asks about eating, sleeping, elimination, and parent concerns.  If the kid looks healthy, in my experience, the kid is declared healthy.  I have never had a doctor say, "Well, everything looks great and your family history and reports of the child's behavior don't raise any cause for concern, but just to be certain that this kid ACTUALLY IS as healthy as we all think, lets run a chest x-ray, a spinal tap, and a panel of blood tests before administering routine prophylaxis for VPDs."  

 

But then, YMMV.  

 

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I agree in re. children being special and deserving time from doctors.  My point is that for most children, individual risk-benefit analysis of the vaccination schedule is neither merited nor beneficial.  Their doctors should focus on their actual needs.  
 

 


By this, when you say actual needs, you are referring to vaccines I assume.  The thing is not all children need all of the vaccines that are on the schedule.   If I would have listened to our doctor (and practically all doctors out there) I would have vaccinated our son for several diseases he never even became exposed to.  He is out of the so-called danger zone now for a few diseases, so no, those vaccines weren't his actual needs and I'm glad I didn't get them.


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Actually, I'm not referring to vaccines.  As you might have guessed, I vaccinate, but I don't think vaccines are the alpha and omega of pediatric care.  

 

 

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Actually, I'm not referring to vaccines.  As you might have guessed, I vaccinate, but I don't think vaccines are the alpha and omega of pediatric care.  

 

 


Ok, I'm sorry.   I thought that's what you were saying. My mistake.


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Originally Posted by stik View Post Yes, there can be a lot in one visit (though not 6-8 unless you've fallen behind on the schedule).

 

 



You don't have to be behind schedule to have 6-8 at a time.  The very first visit at 2 month has 7 different illness vaccinated against according to the Alberta schedule which is where I am from.  This doesn't even include Hep B which is on most schedules elsewhere.  Our schedule only has it at Grade 5.

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To my knowledge, 2+4 months of age are 7 vaxes  (Hib, Pc, DTaP, Rotavirus and Polio), or 8 at 2 months if HepB vax isn't given at 5 weeks or so,  plus Flu at 6 months of age.  12 and 18 months are 5 and 6.  And Fast forward to 5 years where a child may get 8 in one visit (DTaP, Polio, MMR, Chickenpox) plus maybe the Flu.   


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My bad - I was counting shots, not vaccines.  Even for the larger number of vaccines, the aggregate risk/benefit analysis has been done.  

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Even for the larger number of vaccines, the aggregate risk/benefit analysis has been done.  


It has? When? There are no studies supporting the safety of giving several vaccines at one time. Vaccines are administered simultaneously for convenience, not safety, because there are so many vaccines on the schedule that the number of visits to a healthcare provider for each of these shots individually would be a hindrance to everyone involved.  Therefore, the outcome is administering them all at one visit. 

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I agree in re. children being special and deserving time from doctors.  My point is that for most children, individual risk-benefit analysis of the vaccination schedule is neither merited nor beneficial.  Their doctors should focus on their actual needs.  
 

 

 

How would a doctor focus on actual needs without getting to know the personal history and risks of children without taking time to go over the many details that may affect their needs? Many of the same questions can be asked that affect individual risks for VADs, feeding needs, sleep needs, overall health and development, etc.
 

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