Friday, November 5, 2010

12 Month Vaccinations

Yesterday, Oliver went in for his 12-month vaccinations. I didn't feel comfortable with Oliver getting six injections (It's hard enough doing two! Three is my maximum per visit, I've decided), so we decided to split the visit into two. For this first visit, we got him the MMR (not the MMRV) vaccine, the hepatitis A vaccine, and, after much deliberation, the inactivated (and thimerosal-free) influenza vaccine.

I don't have a paranoia of vaccines in general like some people. I think a lot of anti-vaccine proponents use fear tactics to try to keep us from vaccinating our children. Vaccines save lives. Whooping cough (pertussis) is often fatal in infants, as it can close down their lungs. There were 17,000 cases of whooping cough last year. So, no, I'm not going to hesitate over the DTaP vaccine. One out of 1,000 kids who contract measles, mumps, or rubella die, and those are preventable with the MMR vaccine. That's a scary statistic. However, I also think the medical community is almost as guilty as the anti-vaccine people's fear tactics, because they often use fear tactics to force us to vaccinate our children for things that aren't likely to be life-threatening or -altering. I am a practical person, and I read up on the vaccines. Almost all the vaccines we use today have been used for decades. I have no fear of them, as they've been tested time and time again on many generations. I've had MMR, Andrew has MMR, almost everyone I know has had MMR. I've read about MMR and the removal of questionable preservatives and mercury, and I've read scientific studies, and I don't have any concern about it somehow causing autism. I'm glad I did the research, though, because I could confidently bring Oliver in for that vaccination, and I am now completely aware of checking his temperature regularly for the next 12 days. The side effect of MMR I'm worried about is not the unfounded fear of autism, but of a seizure caused by fever (which is listed as 1 out of 3,000 doses). Apparently, that side effect is typically seen 7-12 days after the injection. Good to know.

So, yes, Andrew and I decided we were comfortable with Oliver getting his 12-month old MMR vaccine. On his next visit, he'll get DTaP again as well as Hepatitis B and polio (which you couldn't pay me to forgo). It's the new vaccines that I'm most weary of. I don't want my child to be a guinea pig, and it seems that many of the rare side-effects take millions of doses to discover.

The newest vaccines that we are introducing to our kids are the influenza vaccines and the varicella (chickenpox) vaccine. At first, I was completely against the chickenpox vaccine. I mean, it's the chickenpox. It's not polio or measles or whooping cough. It's chickenpox. I joked to Andrew that I'm sure the CDC has extreme symptoms listed on their website to promote the chickenpox vaccine; One in ten million kids end up in a coma! or some crazy statement like that. In the end, it's the chickenpox, and I have no fear of Oliver contracting the chickenpox as a child. We checked their website, and, sure enough, they listed the potential for people to get their sores infected. Well, duh. Oliver also has the potential to get his mosquito bites or little cuts infected, but we're not medicating him for that potential side effect. How stupid!

Anyway, I read more about it, and I did more thinking, and, eventually, I came to the conclusion that I will give Oliver get the chickenpox vaccine one day, just not now. I really don't have any concern over him getting the chickenpox. In fact, like most parents, I want him to get the chickenpox because the symptoms are less severe for kids than they are for adults. The CDC website kind of mocked parents who want their kids to get the chickenpox "naturally" as opposed to the vaccine. It's not that I'm a huge naturalistic proponent or anything, but the chickenpox are just not a big deal to me.  The varicella vaccination has the worst side effects of all the vaccines we give children.  Even though the bad side effects are still very rare, they are most common in the chickenpox vaccine. People act so scared of vaccines like MMR when the worst vaccine that we use on kids in the United States, according to scientific studies, is varicella.  That baffles me.  Why is the riskiest vaccine for the most mild disease? Also, the side effects of the MMRV (MMR + varicella, or chickenpox) are more frequent and slightly more severe than the regular MMR. I'm of the opinion that the known increase in those side effects outweigh the very rare potential for him to get a serious infection from contracting the chickenpox, at least at this young age.

Because many other kids will be getting the chickenpox vaccine, I realize that Oliver is less likely to contract the virus as a kid than people of my generation and of older generations were. When I was a kid, everyone got the chickenpox. We had chickenpox parties (True story! When Julie had the chickenpox and missed a big softball game, we invited the neighborhood over--anyone who had the chickenpox already or wanted the chickenpox could come!). I've considered, though, that it's possible Oliver won't have the opportunity to be exposed the virus as a kid. So, I decided, if Oliver still hasn't had the chickenpox by the time he goes to school, we will get him vaccinated, as the state requires for school admission. Besides, even though I'd rather him get childhood chickenpox than the vaccine, I'd also rather him get the vaccine than get chickenpox as an adult. Chickenpox in adults is much more severe and can sometimes be fatal. At some point, then, I guess the risks of contracting the disease outweighs the risk of getting vaccinated. He's certainly not at that age yet, though, and so I'll wait until school time to get him vaccinated.

The next vaccine I had concerns over was the influenza vaccine. Unlike the chickenpox, severe side effects of the flu aren't completely out of the realm of possibility. I read that, each year, an average of 20,000 kids ages 0-5 years are hospitalized from the flu. Approximately 2/3 of those children have pre-existing conditions (like asthma), but that means nearly 7,000 otherwise healthy toddlers are hospitalized from the flu. I, personally, felt that that number wasn't very high (Oliver is healthy, so my opinion is based on the fact he doesn't have a pre-existing condition that makes him more susceptible), considering there are tens of millions of young children in our country. And, after all, a 1 in 3,000 chance of Oliver getting a seizure from the MMR vaccine didn't prevent me from getting that vaccine for him. Why are those odds acceptable for the MMR vaccine, but they're not OK for contracting influenza virus? Also, as I stated before, the influenza vaccine is relatively new. Because it's new every year, I worry about the unknown risks. That sounds paranoid, but toddlers in Australia suffered seizures from one brand of influenza vaccine. It wasn't a rare side effect: one out of 100 young children suffered seizures from it.  They didn't realize it was too potent for young children until it was administered to large numbers of young children. I decided the risks, to me, of Oliver getting severe side effects from the flu were not worth dealing with the vaccine (which he'd need two doses of).

Family members, however, disagreed with that decision.  I'm not a doctor.  I'm not a medical professional.  However, I'm fortunate to have medical professionals and health specialists in my family whom I can talk to.  This incluces a family member who is a PA and another family member who has a PhD (and actually went through a post-doc) in health sciences. The first is a strong proponent of the flu vaccine every year; the second is specifically a strong proponent of it this year and last year because of H1N1.  H1N1 has been hitting the younger population much harder than the seasonal flu. My husband and I decided to read more on the influenza vaccine. Most of what we read said the influenza vaccine had not been adequately studied in toddlers, and that it is, at most, 66% effective in children under 5. Sixty-six percent effective? Hmm.

Andrew, however, said that the 66% effectiveness was worth it to him. Family members pointed out that the CDC and AAP all support the flu vaccine. On the population level, the vaccine makes sense. I pointed out to Andrew that, last year, Oliver was not old enough for the flu vaccine. They recommended Andrew get one, and he decided not to. I thought it silly that he didn't want the flu vaccine for himself, but he wanted it for Oliver. To show me it was safe, Andrew went out and got the flu shot that day (he didn't even feel under the weather from it).

In the end, I decided that Andrew is half of this parenting duo, and if the flu vaccine meant a lot to him, then I'd agree to get it for Oliver. There were definite arguments in favor of the vaccine, and the odds of Oliver getting side effects from it seemed to be small (in spite of the fact I feel they still outweigh the chances of him contracting a serious case of the flu). So, I gave in, and we got Oliver the influenza vaccine.

Immediately after the influenza vaccine, Oliver came down with a severe case of diarrhea (we're talking multiple blow-outs), and then he started vomiting. Projectile vomiting. He had no fever at all, and he wasn't acting sick, so it didn't seem to be a virus. However, flipping through my vaccination sheets on what he was given (MMR, hepatitis A, and influenza), vomiting and diarrhea were not listed as potential side effects. Vomiting and diarrhea are potential side effects of the live influenza vaccine (that comes in the form of the nasal spray), but they're not listed as possible for the vaccine we got for him (which was the injectable, thimerosal-free combo). Most likely, Oliver is sick from a virus, but I can't help but think of those influenza-vaccine side effects that occurred a few months ago in Australia, and how they didn't know about the side effects until so many little kids started seizing...


sravanthi said...

hi, i liked reading your post a lot!! the best about it is that you have thoroughly educated yourself about the vaccinations and it is such a relief to make decisions based on that knowledge.
My son is up for his 12 month vaccinations and i am scared and very reluctant as i have heard horror stories about the 12 month vaccinations, and i have been searching fr good source of info but cant seem to find any, would you be able to suggest some good sources.
thank you.

whirledpeas1129 said...

Sravanthi, I am so sorry that I didn't see this comment until now. I know how hard it is to be bombarded by so much information and misinformation out there.

My favorite sources are directly from the CDC. They keep everything very factual, they list every risk to every vaccine, and they will even tell you how common each side effect is.

Here is information on the DTaP vaccine, which your child has probably already had before. They list the risk of the actual disease, and then they list the potential mild, moderate, and severe side effects:

Here is information on the HIB vaccine, which your son has probably already had before, too. With the exception of rare allergic reactions, the only side effects to this vaccine are mild:

Here is information on the MMR vaccine. Remember that the severe side effects are less than one in a million doses:

Here is information on the varicella/chickenpox vaccine. They no longer bundle this vaccine with MMR (for a while, it was a combined vaccine called MMRV):

Here is information on the PCV vaccine:

And here is the one on Hepatitis A:

I really hope those help you! We finally got the varicella vaccine for Oliver this past fall, after he turned 3. He had no side effects.