Tag: anxiety

Do Vaccines Cause PANDAS?

PANDAS, first described in 1998, is an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.

Kids with PANDAS can have tics and/or OCD that come on suddenly or get worse after they get a strep infection. Specifically, a group A streptococcal infection, like strep throat.

These kids might also be moody and irritable, develop problems at school, have trouble sleeping, and have anxiety, including separation anxiety.

What Causes PANDAS?

Like other post-strep complications, PANDAS is thought to be an auto-immune disorder that occurs when a child’s immune system targets the strep bacteria, but also cross-reacts with molecules that strep uses to hide in our body.

“However, the molecules on the strep bacteria are eventually recognized as foreign to the body and the child’s immune system reacts to them by producing antibodies. Because of the molecular mimicry by the bacteria, the immune system reacts not only to the strep molecules, but also to the human host molecules that were mimicked; antibodies system “attack” the mimicked molecules in the child’s own tissues.”

PANDAS—Questions and Answers

If antibodies to mimicked molecules target a child’s brain tissue, then you can get the neuropsychiatric symptoms of PANDAS, including tics and OCD.

Does it sound a little unbelievable?

Do you know what causes rheumatic fever, besides an untreated group A streptococcal infection? It is an auto-immune disorder that occurs when the antibodies that are produced after a strep infection attack your joints and heart, including the valves of your heart.

Similarly, if the antibodies attack your kidney, you can develop post-streptococcal glomerulonephritis.

Do Vaccines Cause PANDAS?

PANDAS is caused by a strep infection.

Vaccines do not cause strep infections and vaccines do not cause PANDAS.

The Advisory Commission on Childhood Vaccines recently voted against adding PANDAS as a vaccine table injury.
The Advisory Commission on Childhood Vaccines recently voted against adding PANDAS as a vaccine table injury.

Responding to a petition to add PANDAS and similar conditions as a vaccine table injury, the Advisory Commission on Childhood Vaccines voted 5 to 1 against, stating that:

  • No published study that examines anti‐neuronal antibodies including anti‐dopamine receptor 1 (DR1), anti‐dopamine receptor 2 (DR2), anti‐tubulin, anti‐lysoganglioside – GM1 or antibody‐mediated activation of calcium calmodulin dependent protein kinase II (CaMKII) in children suspected of PANS and/or PITAND following pertussis infection or following pertussis immunization was found.
  • No published case report of conjugate pneumococcal vaccines or pneumococcal infections and Hib vaccines or Hib infections causing or enabling the development of acute neuropsychiatric symptoms via a mechanism of blood‐brain barrier disruption with GAS antibody‐mediated CNS cross‐reaction in a susceptible child were found.
  • No published case report of PANS, PITAND and/or PANDAS following pertussis vaccination or during or following pertussis infection were found.
  • No published case report of PANS, PITAND and/or PANDAS following either pneumococcal conjugate or Haemophilus influenzae type b (Hib) vaccination or pneumococcal or Haemophilus influenzae type b infection were found.

There is no evidence that vaccines cause PANDAS.

“Children with PANS and PANDAS should receive standard childhood vaccines, following recommendations from the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the American Academy of Family Physicians (Centers for Disease Control and Prevention 2016a). The patient and all family members should receive annual influenza immunization as described under Influenza (described earlier).”

Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part III—Treatment and Prevention of Infections

What about PANS and PITANDS?

These are similar, although much more controversial than PANDAS.

What’s the difference?

With PANDAS, the trigger is a strep infection. What about if you have symptoms of PANDAS, but no evidence of a strep infection?

Then some folks stick with the diagnosis and simply label you as having PANS or PITANDS, blaming some other infection, even though there is little evidence that these are a real thing.

More on PANDAS

Kids Getting Shots – Are You Prepared?

Most kids have a favorite cartoon or show that they like to watch.

When I was a kid, it was Sesame Street and Mister Rogers’ Neighborhood.

Are You Prepared for Your Kids Getting Shots?

Although we often complain about kids overdoing it with screen time, there are some circumstances when a little screen time might be a good thing.

A little distraction helped Elmo get his shot.
A little distraction helped Elmo get his shot.

For example, if your kids are nervous about an upcoming visit to their pediatrician when they will get shots, having things explained by a well known character will almost certainly be helpful.

How else can you prepare your kids?

Remember to be honest. Don’t lie and say that they aren’t getting a shot or that it won’t hurt at all, only to have their pediatrician tell them that they need a vaccination during the visit.

Going to the Doctor.Books on going to the doctors can also be helpful. Many include a section or story on getting vaccines.

Going To The Doctor by T. Berry Brazelton, MD has always been a favorite of mine, but there are many others:

  • Leo Gets a Checkup
  • The Berenstain Bears Go to the Doctor
  • Corduroy Goes to the Doctor
  • Nicky Goes to the Doctor
  • Daniel Visits the Doctor
  • Froggy Goes to the Doctor
  • My Friend the Doctor
  • The Big Blue House Call

And have your kids play with a Doc McStuffins medical kit.

Vaccines are safe and necessary and you can help to make sure your kids are ready to get them at their next appointment.

More on Preparing Kids When Getting Shots

How to Breastfeed Your Child During Vaccinations

Can you breastfeed while your child is getting their vaccines?

Sure.

How to Breastfeed Your Child During Vaccinations

While the smallpox vaccine and yellow fever vaccine are contraindicated for moms who are breastfeeding, there are no contraindications on vaccinating kids while they are breastfeeding.

Why breastfeed while your kids are getting their vaccines?

While some moms just breastfeed immediately afterwards,  others understand that breastfeeding at the same time as the shots are being given can help decrease any pain associated with getting those vaccines even more.

“If you are breastfeeding, feed your baby before, during and after immunization. The physical closeness and familiar taste of breast milk will calm your baby. Breastfeeding during immunization is safe for babies, even newborns. There is no evidence that babies will choke or associate their mothers with pain.”

Tips For Parents For A Positive Immunization Experience

Will it make it harder for health professionals to hold your child while the shots are being given? Not usually, especially if you help hold your child.

But how can infants get the oral Rotavirus vaccine if they are breastfeeding?

In general, infants should get the least painful vaccine first. And oral vaccines are typically given before shots. So they can get their Rotavirus vaccine before you begin breastfeeding and get prepared for the rest of their vaccines.

The Be Sweet to Babies videos can help you see the benefits of breastfeeding while your kids get their vaccines.
The Be Sweet to Babies videos can help you see the benefits of breastfeeding while your kids get their vaccines.

And while it might depend on the age and size of your child, in general, to breastfeed your child while they are getting their vaccinations, once everything is prepared and ready, you should:

  • hold your child on your lap, understanding that until age three years, most shots will be given in your child’s thighs, although toddlers can sometimes get them in their arms
  • once you have your child well positioned, have a good latch and have started nursing, make sure your child’s arm or leg remains exposed (wherever the shot will be going) and help hold your child securely so that they don’t move while getting their vaccines. For example, you might hold an arm or leg with your free hand and anchor their legs between your thighs or your other hand if possible
  • continue nursing after your child has gotten their vaccines, keeping in mind that you may have to switch positions if they are getting multiple shots

Also understand that it might not always be a good idea to nurse while getting vaccines. Is your baby a distracted eater? Is it going to be hard to hold your child while they are nursing and getting their shots? Does your health care provider not have experience giving vaccines to a child while they are breastfeeding? Does your health care provider have a lot of experience giving vaccines, and they think that giving them while you are nursing will just make the whole process take a lot longer?

“Breastfeeding moms may wish to breastfeed baby during vaccination or immediately after to lessen pain and stress.”

AAP on How can I comfort my baby during vaccinations?

In general though, especially as it is recommended by the WHO and the AAP, consider breastfeeding your child while they are getting their vaccines.

More On Breastfeeding Your Child During Vaccinations

Are You Too Scared to Vaccinate Your Kids?

These days, if a parent suggests to their pediatrician that they might want to skip or delay their child’s vaccines, it is typically not because they are afraid of any association with autism, or because they have been influenced by Jenny McCarthy or Andrew Wakefield, or even because they have done a lot of research.

It is mostly because they are scared.

Are You Too Scared to Vaccinate Your Kids?

What are they scared of specifically?

“In today’s world, smallpox has been eradicated due to a successful vaccination program and vaccines have effectively controlled many other significant causes of morbidity and mortality. Consequently, fear has shifted from many vaccine-preventable diseases to fear of the vaccines.”

Marian Siddiqui et al on the Epidemiology of vaccine hesitancy in the United States

Surprisingly, there often isn’t anything specific that they are scared of. That’s unfortunate, as it makes it harder to offer reassurance when they don’t have specific questions or concerns.

Still, something is scaring these parents, sometimes to the point that they have panic attacks if they even think about vaccinating their kids.

“…many parents are inundated with horror stories of vaccine dangers, all designed to eat away at them emotionally while the medical and scientific communities have mounted their characteristic response by sharing the facts, the data, and all of the reliable peer-reviewed and well-cited research to show that vaccines are safe and effective.”

Federman on Understanding Vaccines: A Public Imperative

What has them so scared?

Could it be:

Whatever it is, it builds up to the point to where these parents fear the risks of vaccines more than they fear the risks and complications of vaccine-preventable diseases.

As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks.
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

That’s not surprising.

After all, why fear polio, measles, diphtheria, or tetanus, etc., if you have never had or known anyone that has had one of these now vaccine-preventable diseases? Why fear them, if you have never known anyone who has died with one of these now vaccine-preventable diseases?

And why trust that you should vaccinate your kids when you are likely inundated with messages about vaccines being poison, a Big Pharma conspiracy, or that you can just heal your child with some garlic and essential oils if they get sick?

Reducing Anxiety from Vaccinations

Have any ideas on how to get over your anxiety about vaccinations?

To start, learn that vaccines are safe, necessary, and they work to protect your kids and that all of the messages you are hearing about vaccines that have been scaring you aren’t true. You have probably already realized that on some level, but there are cognitive biases, heuristics, and logical fallacies that work together to change our perception of risk, keep us believing things aren’t true, and in this case, can keep you from vaccinating and protecting your kids.

It can also help to learn to think critically and be more skeptical about the things you see and read about vaccines, especially if you aren’t sure about the source of the information.

“The Internet has been identified as an important source for parents to seek and share vaccine information. There are concerns that parental fears or hesitancy on childhood immunizations are increasing due to the popularity of social media and exposure to online antivaccination sentiment.”

Tustin et al on Internet Exposure Associated With Canadian Parents’ Perception of Risk on Childhood Immunization: Cross-Sectional Study

Don’t let a small, yet vocal anti-vaccine minority scare you into a poor decision about your child’s vaccines.

What to Know About Being Too Scared to Vaccinate Your Kids

Parents who are inundated with anti-vaccine messages and misinformation sometimes get too scared to vaccinate their kids, fearing vaccines more than they fear the diseases they prevent.

More on Being Too Scared to Vaccinate Your Kids