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  Topic Review (Newest First)
04-19-2014 07:39 AM
ss834

The CDC started recommending annual flu shots for everyone over 6 mos in 2010.

However, they still have a list of high-risk persons who should definitely get the shot, and these people are priority when there are shortages. I have heard of docs or pharmacists refusing shots to people outside of the high-risk categories because of shortages (either in the office or in the general supply).

04-19-2014 07:27 AM
prosciencemum It'd be interesting to discuss the difference in flu shot recommendations in different countries.

The UK seems to follow Cochrane recommendations mostly on the flu shots. Eg. Flumist for the very young, and no routine annual shot for otherwise healthy children and adults.
04-19-2014 06:16 AM
ss834

These are my state's recommendations, based on the CDC (US).

 

Birth -- HBV
2 Months -- §DTaP, Hib, IPV, HBV, PCV7◊, Rota
4 Months--- DTaP, Hib, IPV,PCV7, Rota
6 Months --- DTaP, Hib, IPV, HBV, PCV7, Flu, Rota
12-15 Months -- DTaP, Hib, MMR, Var, PCV7, HAV
18-23 Months -- HAV
4 Years Of Age -- DTaP, IPV, MMR, Var
Or Prior To
School Entry
11-12 Years -- Tdap, MCV4, HPV ∞(VAR, MMR, HBV If needed)
 
 
In Louisiana, flu and Hep A are not required for school entry and in my experience, school entry requirements seem to dictate whether or not pediatricians offer or insist on certain vaccines.
09-18-2013 08:11 PM
erigeron

Kind of apples and oranges, Dinah. There's a fairly big difference between everyone being recommended to get a certain vaccine, and everyone having the government all up in their uterus all the time. Like I said, if people want to opt out because they think the general recommendation doesn't make sense for them for some reason, that's their decision, but I don't think that's a reason for the general recommendation not to exist. 

09-18-2013 04:04 PM
dinahx I agree that in daycare settings, HepB makes more sense. The last Vax I got was a HepB after a public health nurse came to talk to my employer about how long it survives outside the body.

Generally speaking, folks don't like to be treated as populations. For example women really revolt against 'population control' historically, but welcome reproductive options for themselves.
09-18-2013 01:49 PM
erigeron

Now that DD is starting day care I feel more glad that she had the Hep B vaccine. If some kid bites her that's one less thing to worry about. 
 

As for the public health perspective, that's very true. I feel sometimes that some people get this very negative knee-jerk reaction to parts of the vaccine schedule (or other preventative health measures) that are done from more of this public health perspective. It doesn't make sense to pitch the entire vaccine schedule in the trash because you hate that the CDC includes the birth dose of Hep B. Or to conclude that the CDC is a hotbed of conspiracy theories. If you decide a particular recommendation doesn't apply to your family, don't follow it, but how about a little credit for the many fine educated minds that have worked on these recommendations throughout the years?

09-18-2013 10:54 AM
cwill
Quote:
Originally Posted by teacozy View Post


The statistic from that picture was pretty alarming if true. That before the vaccine about half of babies with hep B contracted it from casual contact with someone other than their mother.

 

I've seen that blood contact with other children is a significant risk factor for Hep B after maternal transmission, but I don't know where it falls on the spectrum of risk or if that is what the poster is referring to.  I'll see if I can track down the reference today - I think it might have been a Hep B manual, but I'll see if there's anything online.

 

 

 

09-18-2013 10:17 AM
teacozy
Quote:
Originally Posted by cwill View Post

It seems like the US has a tendency to adopt universal protocols more readily than other countries.  And from a public health perspective, I agree with it.  People lie.  Isn't that what House taught us?  orngtongue.gif   And even if they don't lie, they don't remember, or they don't have a medical history, or they don't receive adequate care - even people that you wouldn't expect.  In order to protect the most children possible, it makes sense to get them all as soon as possible.  Now how that applies to my children, is another story, right?  It's a huge downside to universal policies. 

That said, I will also do at-birth for Hep B because I see no reason to wait.

The statistic from that picture was pretty alarming if true. That before the vaccine about half of babies with hep B contracted it from casual contact with someone other than their mother.
09-18-2013 10:06 AM
cwill
Quote:
Originally Posted by pepperedmoth View Post
 

Yeah, the hep B thing always puzzled me. 

 

I think it makes sense as a childhood vaccine, because you never know (kids, blood, vomit, it gets everywhere), but still don't understand why an infant needs it if born to immune parents. 

 

I mean, my kid'll receive it, because I don't see a reason for them NOT to get it (it being perfectly safe IMO), and I also think I might forget to catch them up if I delayed it, but I DO wonder about the rationale behind that particular choice. 

 

It seems like the US has a tendency to adopt universal protocols more readily than other countries.  And from a public health perspective, I agree with it.  People lie.  Isn't that what House taught us?  :p  And even if they don't lie, they don't remember, or they don't have a medical history, or they don't receive adequate care - even people that you wouldn't expect.  In order to protect the most children possible, it makes sense to get them all as soon as possible.  Now how that applies to my children, is another story, right?  It's a huge downside to universal policies. 

 

That said, I will also do at-birth for Hep B because I see no reason to wait.

09-17-2013 05:42 PM
nia82

http://www.euvac.net/graphics/euvac/vaccination/vaccination.html

 

All the European ones. From extremely many vaccines like in Germany to a more selective approach in Iceland, and everything in between. I want to add that since I know about Germany, it's not mandatory at all to vaccinate and most parents pick and choose (most will do childhood shots, but leave out stuff like varicella, opt for 5in1 instead of 6in1 - there was a link in German but that'll take me weeks to find it - essentially most parents go ahead with stuff like DTaP, polio, measles, but are more cautious about chickenpox, rota, hpv)...

 

Germany:

This is actually outdated - on there is also rotavirus and FSME for high risk areas (many in Germany; FSME is a viral encephalitis that is tickborne). Also, HepA is on the schedule similar to the US.

 

  DTaP IPV Hib HepB PCV MenC MMR Var dTap HPV
At birth       Yes1+3            
2 month Yes1 Yes1 Yes1 Yes1 Yes          
3 months Yes1 Yes1+2 Yes1+2 Yes1+2 Yes          
4 months Yes1 Yes1 Yes1 Yes1 Yes          
11-14 months Yes1 Yes1 Yes1 Yes1 Yes   Yes6 Yes    
11-23 months           Yes5        
15-23 months             Yes6 Yes6    
5-6 years                 Yes  
9-17 years   Yes   Yes4       Yes7 Yes  
12-17 years                   Yes8
1 Given at least 4 weeks apart with a required minimum of six months between final (11-14 months dose) and penultimate dose.
2 Given only if administered as a combination vaccine containing a pertussis component (aP), otherwise the second dose is recommended at the age of 4 months.
3 Recommended for newborns of HbsAg positive mothers or to mothers with unknown HbsAg status.
4 Primary HepB vaccination for previously unvaccinated persons and completion of the course is recommended in those incompletely vaccinated.
5 One dose in the 2nd year of life; should not be administered simultaneously with MMR + monovalent Varicella vaccine or MMRV vaccine.
6 Minimum interval of 4-6 weeks required between doses.
7 Recommended for those not previously vaccinated against or ill with varicella.
8 Recommended for females and given as a three dose regime at a 0-2-6 month schedule.
09-17-2013 12:39 PM
prosciencemum

Great idea for a thread. It was researching the difference in schedules when we moved from the US to UK which first got me interested in this topic much more than just having a general view that vaccinations were a good thing and do much more good than harm. 

 

Here's the UK schedule: http://www.nhs.uk/Conditions/vaccinations/Pages/vaccination-schedule-age-checklist.aspx

 

Summary

 

2 months: 5in1 DTaP/IPV/Hib, Pneumococcal (PCV) and Rotavirus (this is new since my son was born)

3 months: 5in1 second dose, Men C (which I think isn't on US schedule?), and Rotavirus 2nd.

4 months: 5in1 third dose, PCV second dose

12-13 months: Hib/Men C booster, MMR, PCV 3rd dose

2-3 years: annual flu shot (this is a new one since my son was this age too!)

3yrs 4mths: MMR second dose, DTaP/IPV pre-school booster

12-13 yrs: HPV (girls only) - 3 shots within 6 months

13-18 yrs: Td/IPV teenage booster (diptheria, tetanus, polio)

13-15 yrs: Men C booster (starts Sept 2013)

65+yrs: Flu annually, pneumoccoal (PPV)

70 yrs: shingles (from Sept 2013)

 

So a lot of changes lately actually - and I think the introduction of shingles for 70 yr olds might be the first step before adding a childhood varicella.... we'll see. UK recommends flu annually only for 2-3 yr olds and 65+ yrs (unless there are health issues which suggest it). Note we do have a vaccine not on the US schedule - Men C. Hep B is only recommended for certain groups (follow the link to see). 

 

Anyway, like in Canada, it's not much once they're past 4 months, and nothing between 3yrs4mths and 12-13 yrs for most children, then nothing for adults until 65 yrs if they're healthy. 

09-17-2013 10:50 AM
pepperedmoth

Oh, of course I looked at the photo AFTER I wrote that. Here it is embedded:

 

 

I didn't realize it was so easily transmissible to infants. That makes sense then --- easier to vaccinate the kid than draw titers on the mother.

 

I didn't go out and try to confirm the facts here by checking them up in journals or anything, but I did look at the website of the organization and they seem pretty legit.  

09-17-2013 10:26 AM
pepperedmoth

Yeah, the hep B thing always puzzled me. 

 

I think it makes sense as a childhood vaccine, because you never know (kids, blood, vomit, it gets everywhere), but still don't understand why an infant needs it if born to immune parents. 

 

I mean, my kid'll receive it, because I don't see a reason for them NOT to get it (it being perfectly safe IMO), and I also think I might forget to catch them up if I delayed it, but I DO wonder about the rationale behind that particular choice. 

 

And totally off topic: erigeron, I've always wanted to mention that in your profile pic, your very cute child also has on a simply ADORABLE hat. Did you knit it? Can I have the pattern? She looks like a little gnome! Soooooo precious. (The cute Brian Froud gnomes, not the gnarly unpleasant kind)

09-16-2013 02:39 PM
dinahx

Lurking! Great topic.

09-16-2013 10:43 AM
erigeron

Well, it is possible for little kids to be exposed to Hep B (it's transmitted by blood/body fluids, but more readily than most STDs, so it can be caught from stuff like sharing nail clippers with an infected person) AND if they do get it, it's much more likely to progress to chronic liver disease than in an adult. So I do see a case for vaccinating little kids, and then if you get them then, you don't have to get them as teens/young adults. A catchup schedule for a teenager or adult would include Hep B if they hadn't already had it, so it isn't like "oh well, let's just wait until she pops out a baby and then vaccinate it right away". 

 

That said, I wasn't too fussed and would have delayed Hep B until she was older, on the grounds that it's still not really that likely, but my husband felt strongly about getting it while she was still young. He seems to think that she's going to want to play "blood sisters" with someone. I don't think that's a thing anymore, but whatever, I guess. 

09-16-2013 10:34 AM
teacozy I saw this the other day and was wondering if anyone can confirm the info on this photo? Also, if someone could embed the photo that would be helpful smile.gif haven't figured out how to do it on my phone yet.

https://m.facebook.com/photo.php?fbid=159150227617417&id=125879120944528&set=pb.125879120944528.-2207520000.1379352617.&refid=17
09-16-2013 10:29 AM
mom0810

This is interesting, as I've recently been looking at the tetanus vaccine schedule for different countries.  In the U.S., you are expected to get a booster every ten years.  This is even after the initial childhood series of three vaccines and two boosters.  

 

In the U.K., the initial series plus two boosters is thought to confer lifetime immunity, and no boosters are given in adulthood.  In Sweden, they do not recommend boosters except every 30 years.  In Australia, boosters are not given to adults until age 50.  

 

I found a study that showed that tetanus vaccine was effective for at least 30 years past booster shots.  This was an American study.  Why are we still recommending tetanus boosters every 10 years here, when the rest of the world has stopped doing so?  

09-16-2013 08:51 AM
MichelleZB

This came up in our roll call thread. We have many countries represented here. What are the different schedules?

 

Here is the link to the Canadian schedule.

 

In sum

 

2 months: Dtap-IPV-Hib; Pneu; Roto

4 months: Dtap-IPV-Hib; Pneu; Roto

6 months: Dtap-IPV-Hib

12 months: Pneu; MenC; MMR

15 months: Varicella

18 months: Dtap-IPV-Hib

4-6 years: Dtap; MMRV

Grade 7: MenC; HepB

Grade 8 females: HPV

14-16 years: Tdap

Every year: Flu

 

I have a few comments. One is that there aren't that many vaccines! My son is 21 months now, and we're done until he's 4. He won't remember getting any of his vaccines, basically.

 

Another is that, as you can see, they give HepB to children in Grade 7 in Canada. I know that in the US, they give it at birth. That is a fairly large difference in approach. In Canada, they consider it to be a sexually transmitted disease, and give it to teenagers before they reproduce. It's prophylactic. In the US, they assume that teenagers haven't had the vaccine (which is a good assumption, because of health care problems), have then contracted HepB, and are protecting babies from their mothers' assumed HepB. Hmmmm. Many people think of getting the shot at birth as getting it "early", but really it's the other way around--giving it to teenagers pre-birth is really thinking earlier of the babies to come.

 

Also, as you can see, HPV is only on the schedule for girls. It is likely that it will be required by both sexes by the time my son is a teenager; if not, we'll get that one for him as an extra.

 

So... post your schedules and comments!


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