Tag: delaying vaccines

Vaccine Signs You Might See at Your Pediatricians Office

Does your pediatrician have any signs or posters up on the doors or walls?

If they do, it is probably just a sign alerting you that flu vaccines are available or a reminder to cover their cough when they are sick.

Or maybe they have some educational posters up to educate parents about the overuse of antibiotics, how to wash your hands, or when to call poison control.

Vaccine Signs You Might See at Your Pediatricians Office

Some pediatricians also have signs and posters about vaccines and vaccine preventable diseases:

Do your kids get a lollipop after their vaccines, or just protection against life-threatening diseases?
Do your kids get a lollipop after their vaccines, or just protection against life-threatening diseases?
Thank vaccines and herd immunity.
Thank vaccines and herd immunity.
Skipping some vaccines? Are you going to say sorry if your kids get a vaccine-preventable disease?
Skipping some vaccines? Are you going to say sorry if your kids get a vaccine-preventable disease?
Does your pediatrician have separate waiting rooms for unvaccinated kids?
Does your pediatrician have separate waiting rooms for unvaccinated kids?
There is no benefit, just extra risks, if you delay your child's vaccines.
There is no benefit, just extra risks, if you delay your child’s vaccines.
Vaccine preventable diseases are just a plane ride away.
Vaccine preventable diseases are just a plane ride away. Get vaccinated before you travel.
Parents of Earth, are your children fully immunized?
Long ago, everyone vaccinated their kids.
Unvaccinated children exposed to measles are quarantined for at least 21 days.
Hopefully you will never see a quarantine sign at your pediatrician’s office.

Got questions about vaccines?

Get your answers before your pediatrician puts up a sign that they are firing all unvaccinated kids.

More Vaccine Signs and Posters

Personal Stories About Vaccine-Preventable Diseases

Parents these days seem to get bombarded with vaccine injury stories and videos on Facebook.

Is that because vaccines cause so many bad reactions?

Of course not.

It’s because some folks think that everything that happens to their kids is a vaccine injury.

Personal Stories About Vaccine-Preventable Diseases

If you are going to watch those videos and listen to their stories, getting scared in the process, be sure to also listen to the stories of parents who’s kids have suffered through actually getting a vaccine-preventable disease.

While it’s great that these diseases are much less common because most people vaccinate and protect their kids, one side effect of that progress is that we don’t have many reminders of just how terrible these diseases are anymore.Have you ever seen a baby with congenital rubella syndrome?

Or a child with tetanus or diphtheria?

Have you ever even seen photos of these diseases?

Will you read these stories of parents who have lost a child to a vaccine-preventable disease.

“Kimberly Coffey was buried three days before her high school graduation in the prom dress she didn’t get to wear. She didn’t have the opportunity to be vaccinated against Meningitis B.”

Kim’s Meningitis Story

In Kimberly‘s case, the Men B vaccine wasn’t yet available, but in many other cases, parents have shared their stories of unvaccinated children who suffered with a disease that was vaccine preventable at the time.

“From 2010 to 2016, young children continued to be at the greatest risk for influenza-associated pediatric deaths. Children without preexisting medical conditions accounted for half of all deaths. Vaccination coverage was low among influenza-associated pediatric deaths.”

Shang et al. on Influenza-Associated Pediatric Deaths in the United States, 2010–2016

Tragically, there are also many flu stories.

But the flu isn’t the only vaccine-preventable disease that still harms children.

This family didn't have a choice about their son getting sick - he was too young to be vaccinated when he was exposed to an unvaccinated child with measles.
This family didn’t have a choice about their son getting sick – he was too young to be vaccinated when he was exposed to an unvaccinated child with measles

There are other diseases. Other stories.

Read these stories.

Listen to these parents.

Are the stories supposed to scare you into vaccinating your kids?

Of course not. Just like you shouldn’t let the myths and propaganda from the anti-vaccinate movement scare you away from vaccinating and protecting your kids.

Instead of being motivated by fear, you should make your decision because you understand that the many benefits of vaccines are far greater than their small risks.

What to Know About Vaccine-Preventable Disease Stories

Reading stories of vaccine-preventable diseases are a good reminder that these diseases are not so mild as some folks suggest, and they are instead life-threatening diseases that are best avoided by getting fully vaccinated.

More Vaccine-Preventable Disease Stories

Avoiding the Most Common Vaccine Errors

Although it would be great if mistakes never ever happened, the best we can do is to understand that mistakes do sometimes happen and take steps to avoid them.

How can we avoid mistakes and errors about vaccines?

Avoiding Vaccine Errors

It can help to:

  • understand the 7 Rights of vaccine administration, including that you give the Right vaccine to the Right patient at the Right time by the Right route at the Right injection site and then follow it with the Right documentation
  • use a screening checklist to help avoid giving vaccines that are contraindicated
  • double check vaccines that look alike or have names that sound like, such as DTaP and Tdap
  • double check expiration dates
  • make sure you aren’t giving live vaccines within 28 days of each other, unless they are given at the same time
  • make sure you aren’t giving the wrong dosage amount for the patient’s age, as some vaccines have different formulations depending on the age of the patient, including flu shots, hepatitis A, and hepatitis B vaccines
  • be careful so that you don’t give a combination vaccine, such as Pediarix, Pentacel, Kinrix, Quadracel, or ProQuad, inappropriately

That we are have a 4-day grace period does help avoid the need to revaccinate some kids when vaccines are given a little too early.

“With the exception of rabies vaccine, ACIP allows a grace period of 4 days (i.e., vaccine doses administered up to 4 days before the recommended minimum interval or age can be counted as valid). However, if a dose was administered 5 or more days earlier than the recommended minimum interval between doses, it is not valid and must be repeated. The repeat dose should be spaced after the invalid dose by the recommended minimum interval.”

Ask the Experts About Scheduling Vaccines

In many cases, as long as vaccine doses were administered less than or equal to 4 days before the minimum interval or age, then they can still be counted and are considered valid.

Common Vaccine Errors

It’s easier than you think to prevent vaccine errors.

Especially if there are more than one child in the room getting vaccines, either the tray itself or the vaccines should be labeled with each child's name so that they don't get the wrong vaccines.
Especially if there is more than one child in the room getting vaccines, either the tray itself or the vaccines should be labeled with each child’s name so that they don’t get the wrong vaccines. Photo by Vincent Iannelli, MD

When are you most likely to make a vaccine error?

When you are doing something that isn’t routine, which most commonly happens when folks delay or skip some vaccines and are now playing catch-up.

In addition to the tips above, remember that:

  • the first dose of the rotavirus vaccines must be given by 15 weeks
  • the rotavirus vaccine series must be completed by 8 months (32 weeks)
  • ProQuad, the MMR and chicken pox combination vaccine, is not licensed for kids who are older than 12 years, although if a teen or adult did get ProQuad, it could be considered an off-label dose and could still count.
  • Kinrix and Quadracel, the DTaP and polio combination vaccines are only licensed for the 5th dose of DTaP and 4th dose of polio in children who are 4 to 6 years old, so wouldn’t be appropriate for an 18-month-old, even if he needs both (DTaP and polio) vaccines. Earlier doses can sometimes count as off-label doses though.
  • the combination vaccines Pediarix and Pentacel are only licensed up through age six years, but don’t necessarily need to be repeated if given to older kids.
  • children and adolescent’s get a pediatric dose (0.5ml) of the hepatitis A vaccine, while older teens, who are at least 19-years-old, get an adult (1.0ml) dose. Since most kids get vaccinated when they are younger, many pediatricians may not have the adult version of the hepatitis A or even realize that there is a different version.
  • children and adolescent’s get a pediatric dose (0.5ml) of the hepatitis B vaccine, while older teens, who are at least 20-years-old, get an adult (1.0ml) dose. Since most kids get vaccinated when they are younger, many pediatricians may not have the adult version of the hepatitis B vaccine or even realize that there is a different version.

Most importantly, even when giving vaccines on schedule, be sure to triple check everything. This is especially important if multiple kids in the same room are getting immunizations.

Also remember that vaccine errors should be reported to the ISMP National Vaccine Errors Reporting Program (VERP) or VAERS, with the correct dose repeated if necessary.

What to Know About Common Vaccine Errors

Although none of these vaccine errors are very common (hundreds of millions of doses of vaccines are given in the United States each year), understanding which ones occur the most often can help to make sure that they don’t happen in your office.

More on Common Vaccine Errors

Why Can’t My 9-Month-Old Get the Rotavirus Vaccine?

The rotavirus vaccines are typically given when infants are two to six months old.

The first dose can be given as early as 6 weeks or as late as 15 weeks though.

The rotavirus vaccines are given between 6 weeks to 32 weeks.

And the final dose can be given as late 8 months (32 weeks).

Why Can’t My 9-Month-Old Get the Rotavirus Vaccine?

What happens if your child didn’t get their rotavirus vaccine on time?

While these vaccines are usually given on either a two and four month (Rotarix) or two, four, and six month (RotaTeq) schedule, as you can see above, there is some flexibility in that timing.

Still, the first dose of the rotavirus vaccine can’t be given any later than 15 weeks and the final dose can’t be given any later than 8 months though, so there is no way that a nine-month-old would be able to get vaccinated.

What would happen if your child did?

“Vaccination should not be initiated for infants aged 15 weeks and 0 days or older because of insufficient data on safety of dose 1 of rotavirus vaccine in older infants. The minimum interval between doses of rotavirus vaccine is 4 weeks; no maximum interval is set. All doses should be administered by age 8 months and 0 days.”

Prevention of Rotavirus Gastroenteritis Among Infants and Children Recommendations of the Advisory Committee on Immunization Practices

The rotavirus vaccines are only licensed at these specific ages, so were not studied in older infants and toddlers. If your 9-month-old did receive a rotavirus vaccine, it would be considered a vaccination error and should be reported.

So why not study them in older kids?

Since severe rotavirus infections mostly occur in younger children between the ages of 4 and 23 months, it doesn’t make any sense to wait until they are older to get them vaccinated.

“To minimize potential risk of intussusception, the World Health Organization (WHO) recommends that rotavirus immunization should be initiated by age 15 weeks and completed before age 32 weeks.”

Age restrictions for rotavirus vaccination: evidence-based analysis of rotavirus mortality reduction versus risk of fatal intussusception by mortality stratum

Also, although the risk is low, a small risk of intussusception after getting the rotavirus vaccine is thought to increase with increasing age of the first dose.

What does all of this mean?

It means that you should follow the immunization schedule and get your kids vaccinated and protected on time.

What to Know About Rotavirus Vaccine Timing

Don’t delay getting your child’s rotavirus vaccine or you may not be able to get it at all, as unlike most other vaccines, these vaccines have strict upper limits for when they can be given.

More on Rotavirus Vaccine Timing

Vaccinated vs Unvaccinated – Smallpox Edition

Anti-vaccine folks really like comparing vaccinated and unvaccinated kids.

Why?

They think that unvaccinated kids are healthier, even though we know that they aren’t, they simply get more vaccine-preventable diseases.

Vaccinated vs Unvaccinated – Smallpox Edition

And we have known it for a long time. In Leicester, for example, it was known that folks weren’t vaccinated were much more likely to die of smallpox than those who were. In fact, the fatality rate in Leicester in the late 19th century and early 20th century was 1 to 2% for those who were vaccinated. What was it for folks who were unvaccinated? It was 8 to 12%!

And like many other diseases, if they did get sick, those who were vaccinated against smallpox often got a very mild case, especially as compared to those who were unvaccinated. We can see that even now thanks to photographs taken by Dr. Allan Warner, the Resident Medical Officer to the Isolation Hospital in Leicester.

Vaccinated vs unvaccinated with smallpox.

Dr. Warner’s photos have been published time and again, but they can originally be found in the New Sydenham Society’s Atlas of 1904.

Vaccinated vs unvaccinated sisters with smallpox.

There are many photos and many stories from the time that were testament to the fact that vaccines work.

“A boy, aged 14 years, unvaccinated, sickened with small pox on April 14th. He was removed to hospital on April 18th, where he had a severe confluent attack. The father consented to his wife and three children being vaccinated, stating that personally he would not be vaccinated, but would be a “test,” to see if there was anything in it.

Ten days later his daughter, aged three years, developed a small-pox eruption she had less than one hundred spots and never appeared ill. No other person in the house suffered from small-pox except the father, vaccinated in infancy, his eruption appearing fourteen days after the son had been removed to hospital. A photograph of the father and daughter, taken on the twelfth day of the father’s eruption, may be seen in Plate VI. [see below] and requires no comment.”

This father was the only one in the family who skipped getting vaccinated, and he got smallpox.
This father was the only one in the family who skipped getting vaccinated, and he got smallpox.

And there are also stories of folks skipping vaccines already. Remember, the anti-vaccine movement is even older than the first vaccines. It started with variolation. By the time these photos were taken, anti-vaccine folks had already marched on Leicester. A march that didn’t turn folks away from getting vaccinated.

The Vaccination of Contacts part of the Leicester Method is usually left out by anti-vaccination folks.
Folks were still getting vaccinated using the Leicester Method in Leicester.

For those who think getting smallpox was all about poor nutrition and hygiene, how do you explain these photos? Why such different outcomes for people in the same family, if it wasn’t their vaccine?

The smallpox vaccine clearly worked.
It was the vaccine, as this report on an outbreak of smallpox in 1903 clearly showed.

And that’s why the anti-vaccine movement “slowly faded from view” in the early 20th century.

Too bad we let them come back…

What to Know About Vaccinated vs Unvaccinated with Smallpox

It should be clear that in the era of smallpox, like with other vaccine-preventable diseases, you clearly wanted to be vaccinated.

More on Vaccinated vs Unvaccinated with Smallpox

Learn the Risks of Following Bad Advice

Who do you turn to for health advice?

Even if it’s your pediatrician, with the rise of holistic pediatricians, that doesn’t mean that you are getting good advice.

In general, if the advice you are getting lacks evidence that it is safe and effective, relies on anecdotes and testimonials, and is labeled as ‘alternative,’ then it is a safe bet that it is bad advice.

Learn the Risks of Following Bad Advice

Some folks seem to be drawn to this type of advice though.

Kat Von D has decided that she will be raising a vegan child, without vaccinations.
Kat Von D has decided that she will be raising a vegan child, without vaccinations.

As long as they think it is natural, holistic, and is the opposite of what mainstream health experts say to do, some parents will jump at the chance of trying the latest fad, even if it has no benefits and lots of extra risks.

Take giving your kids raw milk for example. Health experts have been warning about the dangers of drinking raw milk for years and even work to keep selling it outlawed in most communities, but some parents still give it to their young children. This is despite the fact that it has no health benefits and isn’t even fortified with vitamin D!

Would you give your kids raw milk if you knew it could make them critically ill?
Would you give your kids raw milk if you knew it could make them critically ill?

What’s worse than giving your kids raw milk? How about skipping your baby’s vitamin K shot? Although it has no major risks, parents of many anti-vaccine and holistic type Facebook groups on the internet are often encouraged to skip this shot.

The article, translated from Polish, describes anti-vaccine parents and their baby (Maluszek), who died of vitamin K deficiency bleeding.
The article, translated from Polish, describes anti-vaccine parents and their baby (Maluszek), who died of vitamin K deficiency bleeding because they skipped his vitamin K shot.

How come they never warn folks that their baby might die in agony if they skip the shot? After all, there is a very good reason that we started to give all babies vitamin K shots – to stop vitamin K deficiency bleeding.

Just like there is a reason that we started to pasteurize milk – to keep us all from getting critically ill from contaminated milk.

And why we take antibiotics for severe infections, and not essential oils.

“If one gets a cancer diagnosis, they need to detox the toxins that have accumulated in the body, minimize further exposure and boost the immune system to fight the cancer. This is done NATURALLY. Traditional medical approaches (drugs, chemo, radiation) only FURTHER damage the body and immune system.”

Brandy Vaughan for Learn the Risk

And why we take chemotherapy for cancer, and not coffee enemas.

Mud wraps don't cure liver cancer.
Mud wraps don’t cure liver cancer.

And why most of us don’t think to try chiropractic, acupuncture, Ayurveda, homeopathy, Reiki, reflexology, or other non-evidenced based therapies when our kids are sick.

Could someone search for advice on Google on treating a bite from a rabid animal and come away thinking their child doesn't need rabies shots from an anti-vaccine website?
Could someone search for advice on Google on treating a bite from a rabid animal and come away thinking their child doesn’t need rabies shots from an anti-vaccine website?
Can an unvaccinated child really get tetanus after a toe nail injury?
Can an unvaccinated child really get tetanus after a toe nail injury? Photo by Petrus Rudolf de Jong (CC BY 3.0)

Why don’t people get rabies very often any more? It’s not because folks are no longer at risk, although the risk is less because dogs and cats are now vaccinated. It is because the vast majority of people get treated if they are exposed to an animal that might have rabies.

Remember when the six-year-old boy in Florida didn’t after touching a rabid bat? He died.

It’s just like the reason kids don’t get stuck by lightning very often. It’s not because lightning doesn’t happen anymore. It’s because we get a lot of warnings about thunderstorms and we know to go inside at the first sign of lightning in the area. Lightning strikes are rare because we take steps to reduce our risk of getting hit.

Why don’t folks get tetanus that much anymore? Again, most people are vaccinated, and they get boosters if they have wounds that puts them at extra risk. While we know what happens when unvaccinated kids are exposed to tetanus and don’t get treated, that isn’t a risk that you will read about on anti-vaccine websites or Facebook groups.

They also don’t tell you that kids in the US still die of diseases like Hib and rotavirus. And there are still measles deaths in the US.

That’s why the great majority of us get vaccinated, because we understand that vaccines are safe and necessary, and that skipping or delaying any vaccines simply puts our kids at risk to catch one of the diseases the vaccines are designed to prevent.

What to Know About the Risks of Following Bad Advice

You might get lucky and have a good outcome when you follow bad advice, but you should at least understand the risks of what might go wrong if you truly think you are making an informed decision.

More on the Risks of Following Bad Advice

How To Counter Vaccine Hesitancy

There is nothing wrong with having questions about vaccines. And there is certainly nothing wrong with doing a little, or even a lot of research about vaccines.

“We are not against vaccines. Just because we have hesitancies and valid concerns about injecting our baby with specific chemicals and toxins does not mean we are anti anything…

As a soon-to-be-parent [and especially as a first-time-mom] I do feel it my responsibility to have questions, and to listen to my motherly instinct to question things, and do my research.”

Kat Von D

The problem comes when the answers folks get come from misinformation, and it leads them to skip or delay their child’s vaccines, leaving them unprotected.

What is Vaccine Hesitancy?

To counter vaccine hesitancy, you likely first need to understand what it means.

“Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite availability of vaccination services. Vaccine hesitancy is complex and context specific varying across time, place and vaccines. It includes factors such as complacency, convenience and confidence.”

SAGE Vaccine Hesitancy Working Group

So it means someone who is anti-vaccine, right?

Not exactly.

“Although many may characterize all individuals who eschew vaccines as “anti-vaccine” or “vaccine deniers,” in reality there is a broad spectrum of individuals who choose not to have themselves or their children vaccinated.”

Tara C Smith on Vaccine Rejection and Hesitancy: A Review and Call to Action

Many of the folks who are vaccine hesitant aren’t truly anti-vaccine. They are likely being misled by anti-vaccine myths and propaganda, but at least they aren’t the ones spreading it across Facebook or on their own blogs and anti-vaccine websites.

How To Counter Vaccine Hesitancy

How do you counter vaccine hesitancy?

“It’s unfair for anyone to expect me [or any parent] to take the word of the pharmaceutical companies who have much to gain from and industry worth billions without question – and then have to dismiss any concerns of my own.”

Kat Von D

You learn to answer all of the questions and concerns that these parents might have about vaccines and vaccine-preventable diseases, including the risks and benefits of vaccines and the risks of being unvaccinated.

“Well, if you’re going to inform yourself about vaccines, I think anybody who’s truly informed will realize that getting a vaccine is much better than not getting one. If you’re choosing not to vaccinate your child, it’s because you’re getting, frankly, bad information about vaccines.”

Paul Offit, MD

You also make sure that parents, teachers, nurses, doctors, pharmacists, reporters, and everyone else gets good information about vaccines.

And you call out the misinformation and out-right lies of the anti-vaccine movement, especially when they say that vaccines never work, are always dangerous and full of toxins, or aren’t necessary.

You don’t let parents get manipulated by the anti-vaccine industry, which has gotten very good at selling fear – literally.

Like the card trick in My Cousin Vinny, anti-vaccine talking points are easy to explain because they are all an illusion.
Like the card trick in My Cousin Vinny, anti-vaccine talking points are easy to explain away, because they are all an illusion.

Remember, there is not one anti-vaccine argument or talking point that ever holds water.

Why not?

Because unless you go cherry picking, the evidence overwhelmingly shows that vaccines work, vaccines are safe, and vaccines are necessary.

What to Know About Countering Vaccine Hesitancy

If you are on the fence or scared to vaccinate your kids, let us help you learn why vaccines are safe and necessary and arguments against vaccines never hold water.

More on Countering Vaccine Hesitancy