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Flu Vaccine Update for the 2009/2010 Season
With the threat of H1N1 flu, the government is recommending everyone begin their regular flu shots earlier this year, as in right now. The available brands are virtually identical to what they were last year (and the year before) as far as manufacturing and ingredients go (including mercury). Full details on how each flu vaccine is made, what the ingredients are, and the possible side effects are available in The Vaccine Book, although published in 2007, the flu vaccine info my book has changed very little, you can click here for any updates to The Vaccine Book.
The most important thing for infants, children, and pregnant women is to MAKE SURE YOU ARE GETTING A MERCURY-FREE FLU VACCINE. Here is a list of this year’s available flu vaccines with updated info on mercury content:
FLUZONE shot
This is the only brand approved for all age ranges, from young infants to adults. It comes in four different formulations:
Pre-filled syringe for infants 6 through 35 months (contains ½ dose) – NO mercury.
Pre-filled syringe for children 3 years and older and adults – NO mercury.
Single-dose vial for children 3 years and older and adults – NO mercury.
Multi-dose vial for infants 6 months and older, children and adults – contains the full dose of mercury (25 mcg of thimerosal). Infants 6 thru 35 months would get a ½ dose of this form, all others would get a full dose.
FLUZONE is the only brand of flu shot approved for young infants and toddlers. BEWARE – the multi-dose vial has the full dose of mercury. You have to make sure you are getting a single-dose pre-filled syringe or vial, NOT the multi-dose vial to avoid mercury.
FLUMIST nasal spray
An alternative to the flu SHOT for young children is the FLUMIST nasal spray. There is no mercury in this formulation. It is approved for children 2 years and older and adults through age 49.
FLUVIRIN shot
This shot is approved for children 4 years and older and adults. It comes in two formulations:
Pre-filled syringe – has a trace of mercury (see below)
Multi-dose vial – has the full dose of mercury
FLUARIX shot
This is only for adults 18 years and older. It only comes as a pre-filled syringe with NO mercury (this is new this year: in past years, there was a trace of mercury).
FLULAVAL shot
This is only for adults 18 years and older. It only comes as a multi-dose vial with the full dose of mercury.
AFLURIA shot
This is only for adults 18 years and older. It has two formulations:
Pre-filled syringe with no mercury
Multi-dose vial with the full dose of mercury
WHAT ABOUT THE H1N1 VACCINE THAT’S COMING OUT IN OCTOBER?
Click here to view my previous blog on this. I will be writing an updated H1N1 vaccine blog when the safety research is finished and I see what the vaccine ingredients are.
TIMING THE FLU VACCINE WITH OTHER VACCINES
Because the flu vaccine is so reactive (likely to cause fever and flu-like side effects), I prefer to avoid giving it with other reactive shots (like MMR, Hep B, Chickenpox, or the H1N1 vaccine). I recommend at least one month between the flu shot and any of these. I would place the priority on the flu shot over the MMR, Hep B or Chickenpox; delay any of those until it’s been at least a month after the flu shot. I do think it’s ok to get the flu shot with any other vaccine on the same day. The teenage vaccines (Tdap, Meningococcal, and HPV) are also fairly reactive, so it would be better to get any flu shots at least one month apart from any of those as well.
As for the H1N1 vaccine, I won’t be recommending that anyone get it at the same time as the regular flu vaccine. So, if you anticipate that you or your child will likely be getting an H1N1 vaccine in October or November, I would get the flu vaccine now (if you are going to get it). Another option, wait until November or December, 1 month after you’ve gotten the H1N1. The flu is unlikely to hit until that time anyway.
Keep in mind that infants and children 8 years or younger need 2 doses of the flu shot the first year they ever get it. So, if this is your child’s first year of flu shots, you need to plan ahead and not get any other reactive shots during those two months.
NASAL SPRAY VERSUS THE SHOT?
The nasal spray is a great alternative for anyone who wanted the shot, but can’t find a mercury-free version. It seems that the nasal spray works a little better, but causes flu-like side effects more often. It also shouldn’t be used in anyone with asthma or a history of wheezing. The shot seems to not quite work as well, but may cause fewer side effects. I have a slight preference for the nasal spray, because it’s a more natural form of vaccination (it is given nasally, which is how the flu is naturally contracted).
WHAT IS THE DIFFERENCE BETWEEN TRACE AND FULL-DOSE MERCURY?
In trace mercury vaccines, mercury is added to the manufacturing process as a preservative, but is then filtered out at the end before being put into single-dose syringes or vials. A full preservative isn’t needed because this vial or syringe is only opened and used once, then discarded. The amount of mercury in vaccines that are labeled “trace” is less than 1 microgram. I believe that this amount is completely harmless (as opposed to the full dose).
In full-dose mercury vaccines, the mercury is not filtered out. The preservative is needed for these large 10-dose vials because many doses are drawn out, and the solution needs to stay sterile during that process. The amount of thimerosal in these large vials is 25 micrograms per dose (any infants through age 3 getting a Fluzone shot from the multi-dose vial with mercury would only be getting a half dose, so each shot would be 12.5 micrograms).
WHY NOT JUST MAKE ALL FLU SHOTS WITHOUT MERCURY?
The challenge is space and money. The five different companies that make the flu shot have to scramble every year to make enough. It costs more money and takes up more manufacturing time and space to put single doses of the flu shot into syringes or single-dose vials, compared to putting 10 doses into larger vials. In order to accommodate the demand, manufacturers have to make most of their product “in bulk”. In the future I hope that more companies will change to mercury-free formulations, or the almost-as-good trace mercury formulations.
INFANTS AND PREGNANT WOMEN – JUST SAY NO TO MERCURY
The debate over whether or not mercury in the flu shot is enough to cause harm continues to rage on, with no clear resolution yet. I believe it is prudent in the mean time to avoid giving any full-dose mercury shots to children under 3 and to pregnant women. What should you do if all you can find is a full-dose version? Just say no, and tell your doctor why. Maybe if enough patients do this, doctors will order and demand more of the mercury-free version for next year. For kids 2 years and older, get the nasal spray instead (this can’t be given to pregnant women).
NEW FLU SHOT RECOMMENDATIONS FOR THIS YEAR?
The ACIP, AAP and CDC have decided that it would be beneficial for all children to get a flu shot every year until age 18. Previously the recommendation was for all children until age 5. They don’t know whether or not to push the new policy for THIS year, or wait until next year, because they don’t know if there will be enough flu vaccine to go around to immunize every child and teenager. They don’t want to make a new policy unless they have enough vaccine to cover it. But whether it goes into effect this year or next, it is now believed by medical experts that it’s best to get a flu vaccine for all children and teens every year.
FOR MORE INFORMATION ON DECIDING WHETHER OR NOT TO GET A FLU VACCINE, VISIT www.TheVaccineBook.com
YOU CAN VIEW THE PRODUCT INSERTS FOR THIS YEAR’S FLU VACCINES YOURSELF AT http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Post-MarketActivities/LotReleases/ucm162050.htm
Labels: Vaccines and their diseases
Swine Flu Outbreak – Is It Time to Panic?
No, it’s not. But people should be aware of what’s going on and how to lower their risk of catching or spreading this unusual strain of the flu.
Instead of writing my own details on the swine flu in this blog, I am simply going to refer everyone to the Centers for Disease Control and Prevention’s website on the swine flu. Because this information is changing on an almost daily basis, it doesn’t make much sense for me to try to write a new blog every few days.
The CDC’s website is www.CDC.gov/swineflu/ . There you can read all sorts of timely and useful information about what it is, where it is, how to prevent it, and how to seek care if you suspect it. In a nutshell, here are a few highlights:
• There is currently no vaccine for humans for the swine flu. There is one for pigs. • The current common flu vaccine used in humans does NOT protect against the swine flu. • There are anti-viral medications for anyone with a confirmed case available for children age 1 year and older, and adults. • The symptoms are the same as the regular flu. It isn’t clear why there have been more fatalities than expected in the Mexico outbreak. • This particular strain of the swine flu seems to be a naturally-occurring cross breed of the human flu, an avian flu, and 2 types of the swine flu.
EVERYONE NEEDS TO DO THEIR PART AND STAY HOME IF YOU ARE ILL WITH FLU-LIKE SYMPTOMS, COVER YOUR MOUTH IF YOU SNEEZE OR COUGH, WASH YOUR HANDS FREQUENTLY, AND CONTACT YOUR DOCTOR AND ASK ABOUT BEING TESTED FOR THE SWINE FLU IN THEIR OFFICE WITHOUT INFECTING EVERYONE ELSE THERE.
As of right now, only people who have knowingly been in contact with a swine flu-infected person, or people who are part of a large flu outbreak in a certain area, are recommended to get tested with a nasal swab. If you have flu symptoms, but haven’t been knowingly exposed and aren’t part of a large outbreak (such as your workplace, school, etc), then you probably just have the regular flu. The CDC website has up-to-date information.
If a vaccine becomes available and necessary, I will post the info on this blog.
Dr. Bob Labels: Vaccines and their diseases
Should Parents Continue to Give Their Infants the Pneumococcal Vaccine (Prevnar) in Light of Current Controversies Over it?
The NY Times published a very interesting article summarizing the challenges with the PC vaccine. http://www.nytimes.com/2008/10/14/health/14vacc.html?_r=1&em&oref=slogin
Since the vaccine came out in 2000/2001, the number of total cases of severe PC disease has declined dramatically (from about 100 cases for every 100,000 children under 5 years of age down to about 20 per 100,000). This occurred because the PC vaccine protected infants and children against the 7 most common PC strains. While these strains are still circulating among the general population, they are no longer causing many severe infections in young children since kids are now protected. Plus, kids aren’t spreading these strains to the elderly, another at-risk age group for severe PC disease. Almost everyone has a variety of strains of the PC bacteria living within their nose and throat. For the most part, the germs are harmless. But occasionally they invade into the body and cause severe internal infections like meningitis, pneumonia, bloodstream infections, and severe ear infections. This vaccine prevents those 7 strains from doing this anymore.
However, there are dozens of OTHER strains of PC bacteria that are not covered by the vaccine, and one particularly nasty strain is now jumping in and replacing some of the vanishing strains. It is called strain 19A. Since the PC vaccine’s use began, 19A has increased from about 3 cases per 100,000 children under 5 to about 11 cases per 100,000. Plus, some areas of the country are reporting that this strain in their area is resistant to most antibiotics (New York and Texas, for example). But in most areas, the strain is likely still susceptible to most antibiotics. Overall, the number of total cases of severe PC disease from all strains combined is much lower than it used to be.
The logical next step would be to update the current PC vaccine to include 19A and other emerging strains, and that’s exactly what vaccine makers Wyeth and Glaxo Smith Kline are doing. However, these vaccines are about 1 to 2 years away. Wyeth has developed one, but safety and efficacy approval testing is a long process. Wyeth hopes to apply to the FDA for review and approval some time next year. I don’t know how far along the GSK company is with their version.
There are now two main questions parents are asking: Should parents stop giving their kids the current PC vaccine since those strains aren’t causing as much severe disease? NO. My opinion is that since those strains ARE still around, living in older kids and adults, any unvaccinated child could catch it and come down with a severe case. I recommend that parents continue with the vaccine for now.
The other question is this: Does getting the current PC vaccine (and therefore preventing those 7 strains from living within that child) make that child more likely to have other strains of PC (namely the 19A strain) set up shop in their nose and throat and possibly cause a severe internal infection that may be antibiotic resistant? I don’t think so. Or rather, I hope not. We just don’t know yet. Someone will have to do the following research: compare the rates of severe PC disease in vaccinated versus unvaccinated kids (I think they’ll find it lower in vaxed kids). But IF the rates are higher in vaxed kids (which I don’t think they’ll find), what strains are they finding and are they antibiotic resistant? If they find that vaxed kids are catching more severe and antibiotic resistant PC diseases compared to unvaxed kids, then the current vaccine would NOT be a good idea. But I just don’t think that they will find that to be true in a research study.
I feel the benefits of the current PC vaccine are still valid and parents should continue to vaccinate with it until an updated version of the vaccine becomes available. Should parents skip the current one and wait for the new one? No – it is at least one, maybe two, years away.
Dr. BobLabels: Vaccines and their diseases
Second Rotavirus Vaccine Now Available and the Timing of the Doses has been Expanded
Rotateq was the first rotavirus vaccine to come onto the market (2006). I provided full details on how this vaccine is made in The Vaccine Book. Now there is a competitor, Rotarix (GlaxoSmithKline), licensed in April 2008. At the time The Vaccine Book was written I wasn’t able to provide you with the precise details on how its manufacturing process may differ from Rotateq. Here’s how it is made:
The viruses used in this vaccine are a single strain that was originally taken from infected humans. They are grown in a culture of monkey kidney cells to allow the virus to multiply. Batches of the virus are removed from the kidney cells and mixed into a solution of amino acids, sugars, and minerals (see details in The Vaccine Book).
As for the ingredients, I provided most of these in The Vaccine Book, except I couldn’t give details on what was in the solution that the viruses are grown in, called DMEM (Dulbecco’s Medium). DMEM contains numerous vitamins, minerals, sugars, amino acids, and phenol red.
Here is how the new Rotarix differs from the Rotateq:
Single strain of the virus (the most common one that infects humans), so it may be less protective against all strains of the virus compared to Rotateq (which uses 5 strains).
Virus comes from humans and is not “cross-bred”. The 5 strains in Rotateq are a mix of human and cow strains, and the viruses are cross bred to increase their effectiveness in the vaccine.
The PI for Rotarix makes no mention of using fetal cow serum to nourish the viruses as it does in Rotateq.
Rotarix only has TWO DOSES, compared to the three doses of Rotateq.
So, which one is better?
I have no preference between the two brands right now. I’ve been using the 3-dose Rotateq, since that’s what came out first. Once Rotarix has been out for a year or more, and no problems are found with it, I may switch over since it’s only two doses.
The timing of when you can give Rotavirus vaccine has expanded.
When Rotateq first came out, it was advised to be given around 2, 4, and 6 months. It could be started are early as 6 weeks, but the first dose needed to be started by 12 weeks of age. The last dose couldn’t be given later than 32 weeks of age.
NOW, you can start the vaccine at the slightly older age of 14 weeks and 6 days. And the last dose needs to be completed by 8 months, 0 days. These guidelines apply to both the 2-dose and the 3-dose brands. You are NOT supposed to go back and forth between the two brands.
Labels: Vaccines and their diseases
Reported Side Effects of HPV Vaccine Has Parents, and Teens, Worried
The HPV was licensed in 2006, and since that time over 16 million doses have been distributed across the United States (although, it isn’t known how many of these have yet been administered to patients). There have been about 10,000 reports of adverse reactions to the vaccine. 6% of these reports (or 600) were considered serious, either causing an ER visit, a hospitalization, a fatality, or permanent disability. If all 16 million doses were given, that would mean about 1 in every 26,000 patients would have a severe reaction. If 12 million doses, about 1 in every 20,000.
What about the reported fatal reactions? So far there have been about 20 reported fatalities. This obviously has parents very concerned. But the question is, are these fatalities caused by the vaccine? I was able to review the VAERS reports on 17 of these cases. Here is what I found:
- 17 year old girl – sudden death due a suspected heart arrhythmia 2 days after the shot.
- 12 year old girl – a history of seizure disorder and prolonged QT syndrome (a type of heart arrhythmia), on seizure meds. After 2nd dose of the vaccine began having seizures again (hadn’t had any seizures for a couple years). She died 56 days after 2nd dose of the vaccine from a heart arrhythmia and complications of a seizure.
- 17 year old girl with a previously diagnosed seizure disorder died 15 days after the vaccine was given. No other details were provided.
- 15 year old obese girl – 2 days after the vaccine was found to have an enlarged heart and heart failure and died.
- 21 year old girl – 17 days after 2nd dose of the vaccine was found dead in dorm room. She died of unknown causes. There was a trace of alcohol in her bloodstream.
- 14 year old girl – developed a new seizure disorder after 2nd dose of the vaccine. Then, 2 weeks after the 3rd dose she was rushed to ER for unknown reasons. She died in the ambulance.
- 21 year old – developed viral myocarditis (a heart infection) after the 3rd dose of the vaccine and died. Details as to how many days after the vaccine weren’t provided.
- 12 year old - 6 days after a dose of the vaccine died suddenly of myocarditis.
- 19 year old - Sudden death from a pulmonary embolism 14 days after first dose of the vaccine.
- 15 year old - Died of staphylococcus (a bacteria) bloodstream infection and the flu 2 months after the vaccine (not clear how many doses she received).
- 11 year old - 3 days after the 1st dose of the vaccine had a severe allergic reaction (anaphylaxis), cardiac arrest and died.
- 22 year old - 2 days after the vaccine suddenly died. No other data were given on this case.
- 17 year old with diabetes – 50 days after 2nd dose of the vaccine, died of complications of diabetes (life-threateningly high sugar and acid levels in the bloodstream).
- 18 year old - 5 months after getting the meningococcal vaccine and HPV vaccine, died of meningitis.
- 12 year old – 21 days after getting the vaccine, died in her sleep. No other details provided.
- 26 year old - between 1 and 21 days after the first dose of the vaccine, developed blood clots in her legs, which traveled to her heart and lungs. She was found dead in her car.
- 20 year old - 4 days after first dose, suddenly died. Autopsy was normal. No drugs were found in her system. Cause of death, unknown.
- I couldn’t find info on 3 of the deaths.
I count about 4 cases in which the death was sudden due to heart problems – arrhythmia, heart inflammation, heart failure, and severe allergic reaction and cardiac arrest. I count one case that was sudden and unexplained with a normal autopsy. There was one case in which a seizure problem may have been caused by the vaccine, then on the third dose a fatal seizure or heart complication was triggered. These six deaths were sudden, without any warning, in seemingly healthy young women, and could have conceivably been triggered by a cardiac or neurologic reaction to the vaccine.
The remaining deaths are less likely to be related to the vaccine. There were two cases with prior seizure problems who suddenly died, seemingly from complications of their seizures. There were two cases of sudden death, but no details are given to know if their deaths were mysterious (and maybe from the vaccine) or some natural explanation. Two developed blood clots that traveled to their heart and lungs, causing sudden death. A few died a long time after the vaccine, so it would be unlikely to be related. These deaths seem to be more related to a pre-existing medical condition or a known sudden condition that is known to happen (like blood clots).
Overall, it does seem like a few of these very tragic deaths could be caused by the vaccine, but certainly not all of them. If you consider that perhaps six of these deaths were due to the vaccine, out of approximately 12 million doses given, that would put the risk at about 1 in every 2 million doses.
Now what about other severe reactions that did NOT result in death, but were nevertheless very serious? I searched VAERS for all reactions that resulted in a hospitalization and were considered life-threatening. I came up with 59 results. Many of them seemed to occur too far away from the shot to have been related, or occurred in women with pre-existing medical problems that were probably responsible for their hospitalization, or were hospitalized for reasons probably unrelated to a vaccine reaction. However, some reactions occurred close to the vaccine and may have been related. 25 reactions occurred within 2 weeks of the vaccine in a perfectly healthy person who had no underlying reasons for suddenly becoming seriously ill. Such reactions included severe neurologic problems (nerve and muscle weakness, partial paralysis, and various nerve dysfunctions), severe bleeding disorders (sudden anemia or bleeding problems), blood clotting problems, sudden onset of diabetes within a few days after the shot, and a few serious allergic reactions.
WHAT SHOULD PARENTS DO WITH THIS INFORMATION?
Such reports of deaths and severe reactions would naturally scare any parent, and these events are very tragic for the families involved. But overall, the risk of a fatal reaction is very, very small. The risk of a severe reaction (not fatal) is also fairly small, but may give parents pause. I think that if a teen is going to be sexually active, the risk of HPV disease is very real, and getting the vaccine is worth the small risk. Any teens who are committed to abstinence may not need to take the small risk of the shot. Any teen who has a seizure disorder (or other neurologic disorder), a problem with blood clotting (or other hematologic disorder), or any heart problems (especially heart arrythmias) may be at a higher risk of suffering a severe reaction to the HPV vaccine. Labels: Vaccines and their diseases
New Flu Vaccine Recommendations for Older Children
The American Academy of Pediatric announced a new policy for the flu vaccine. They will now recommend a flu shot for every child age 6 months through 18 years of age at the start of flu season each year. For the past few years the flu vaccine had only been recommended for all kids 6 months to 5 years. Prior to that, the flu vaccine was only used for select children with certain chronic medical conditions that would make the flu more dangerous to them.
The new policy is hoped to go into effect for this coming flu season (2008/2009), but officials aren’t sure if supplies of the flu vaccine will be adequate. It will definitely be in effect for the 2009/2010 flu season. Parents who have been giving their young children a flu shot every year will probably just continue this practice throughout childhood without putting much thought into it. However, parents with older children who aren’t used to this routine will now be faced with deciding whether or not to get the shot each year.
The flu shot has always been controversial because the disease has a very low fatality or complication rate for healthy children and young adults and the shot has a high rate of flu-like side effects. People wonder if they even need it. Each year there are about 100 fatalities in infants, children, and teens combined, and a few thousand fatalities in the elderly. So getting the flu shot certainly can help minimize these tragic deaths. The problem is, the flu shot doesn’t always work. Each year officials have to predict which strains to put into the vaccine for the next year. If they guess wrong and different flu strains circulate (as in 2007/2008), the flu shot doesn’t help much.
There’s really no right or wrong answer, in my opinion. You either get the shot or you don’t. The most critical part of this decision is to make sure you are getting a mercury-free version. As flu season approaches, I will post an update on how to tell which flu shots don’t contain mercury for this coming year. Labels: Vaccines and their diseases
New Study Suggests Delaying Vaccines May Lower Risk of Asthma
A new study to be published in the Journal of Allergy and Clinical Immunology by the University of Manitoba (Canada) looked at 14,000 infants given the DTP vaccine in 1995. The study found that of all the infants who started the vaccine series at the recommended age of 2 months, 14% of them later went on to develop childhood asthma. Babies who delayed the vaccine until age 4 months or older only had a 6% asthma rate. The DTP shot was given in the U.S. and Canada at 2, 4, and 6 months of age, with a booster at 18 months and 5 years, to protect against Diphtheria, Tetanus, and Pertussis (Whooping cough).
This is a very interesting study, but I would like to make several comments:
1. This MAY show that the early introduction of a vaccine can trigger a hyperactive immune response that later increases the risk of asthma. BUT everyone should realize that this study was done with an OLD VACCINE that was taken off the U.S. market in the late 90s. We no longer use this vaccine. So the question is, does this finding ONLY apply to that ONE vaccine, and is now irrelevant, or do we apply it to all vaccines? So far, this only shows a possible connection with the old DTP vaccine.
2. IF people delay all vaccines until 4 months based on this study, they leave their babies open to infection with Pertussis, Meningitis, and Rotavirus, all of which cause infant fatalities each year.
3. I'm not saying people can't or shouldn't make that choice to delay shots. Vaccine reactions DO happen, and everyone is looking for a way to decrease the risk of a reaction. I just like to point out there is disease risk as well.
4. Now, IF a baby has severe colic (linked to food sensitivities and an irritated nervous system) or develops early eczema (allergic rash) or allergic wheezing in the first 2 months of life, a parent could conceivably decide to delay shots so as not to exacerbate their baby's allergic condition. This would be a question of risk versus benefit of the vaccine.
Overall this study raises an interesting question, but doesn’t really help parents decide what to do with vaccines NOW since it applies to an old vaccine that is no longer used. What would be nice is if someone did this type of research on the entire vaccine series – Does delaying ALL vaccines until 4 months or later reduce the risk of asthma and other allergies? Now THAT would be an interesting study. The only problem is that we would be risking disease exposure in the delay-vaccine group. Any volunteers?
Labels: Vaccines and their diseases
Do Vaccine Brands Matter? How to make sure your baby is getting the brands with the lowest chemical contents
Most doctors don’t think much about what brand of a particular vaccine to use in their office. And up until now, parents never gave it a second thought either. But thanks to The Vaccine Book, parents and doctors are now becoming aware that not all vaccines are created equal. Now some vaccines only have one manufacturer, so doctors don’t even have a choice on what brand to use. These include pneumococcal vaccine, MMR, Chickenpox, polio, HPV (another brand is on its way), Rotavirus (another brand is coming), and meningococcal vaccine. But the other 5 vaccines have more than one maker, and parents and doctors should take the time to look at the various ingredients to determine which one may be the safest to use. The Hepatitis A and B vaccines are fairly similar when you compare the two makers. But the DTaP, HIB, and Flu vaccines have some striking differences: - DTaP – one brand has a high aluminum content and uses cow serum in manufacturing. Another brand uses the lowest amount of aluminum, but has a trace of mercury and also uses cow serum. A third brand has a moderate amount of aluminum, but does not use cow serum and has a lower amount of pertussis germ components than the others (it is thought that the pertussis germ components are responsible for many of the side effects). So which one should you use? Logic would dictate that either the one with the lowest aluminum, or the one with moderate aluminum but less pertussis and no cow serum would be the two best choices.
- HIB – one brand uses aluminum and the other brand doesn’t. As you have read in The Vaccine Book, it is prudent to give infants the lowest amount of aluminum possible. Doctors should consider this as they choose what brand to order for their office.
- Flu – all flu shots are made in a similar manner, except for the use of mercury. Some flu brands still contain a full dose of mercury. Some filter out the mercury, leaving only a tiny trace amount in the injection. Only one brand makes a completely mercury-free flu shot in single-dose small vials. BUT that same brand also makes a flu shot in a large 10-dose vial with the full dose of mercury. Logic would dictate that doctors would make sure they are providing mercury-free flu shot to infants, children, and pregnant women. If this is unavailable, then a brand with only a tiny trace of mercury is a good second choice.
- Large combination vaccines – there are two new vaccine formulations that just came on the market. These combine 3 vaccines all into 1 injection. While this may sound like a good thing, one of the brands has a fairly large dose of aluminum. I prefer to stay clear of the large combination vaccines.
You have noticed that I didn’t actually tell you which brands are the best choice for each of these three. I’m going to make you do you homework – this information is clearly spelled out in The Vaccine Book.
What can parents do if their doctor doesn’t offer a particular brand that you want to give your baby? Make an appointment with your doctor and explain to him or her the reasons you want a particular brand. Hopefully over the next several months more doctors will become award of this issue and provide parents with appropriate vaccine brand choices.
Labels: Vaccines and their diseases
Polio vaccine and disease: Herd immunity - Are parents who don't vaccinate their infants for polio taking advantage of the rest of you?
This is one of the timeless debates over vaccination, and it rings very true for the polio vaccine. This disease has been gone from the U.S. since 1985. Yet, we continue to vaccinate. Why? The answer is obvious - to keep the disease out. It still occurs in parts of Asia and Africa. If we all stop vaccinating before the disease is eradicated from the whole world (like Smallpox was almost 40 years ago), it could potentially make its way back into our country, and we'd have to start all over again. But some parents choose to skip the vaccine because they know their child is shielded by everyone else around them who are vaccinated ("herd immunity"). However, if too many sheep in the herd hear about this, and decide to skip the shot for themselves, what happens when a sheep from Asia (do they even have sheep in Asia? I guess they do. I always think of sheep being in Ireland, Israel, or Australia) wanders into our herd? If only one of our sheep isn't vaccinated, chances are the two will never come into contact. But what if 10 sheep aren't vaccinated? Or more? The result could be a resurgence of polio, sheep would become paralyzed, some would die, and we'd have less wool to make nice blankets for those cold winter nights. Put into human terms, we'd have a resurgence of paralytic polio. There are still some adults today who were affected by this decades ago and are still suffering from the effects. Admittedly, it is extremely unlikely that an unvaccinated child living in the U.S. and not traveling to Asia or Africa would catch polio. So I have to admit that parents who skip the vaccine aren't really putting their own individual child at risk. BUT they ARE putting our nation's overall public health endeavor to eliminate polio at risk. Until the entire world is polio-free, continued vaccination, even in our country, is fairly important. So, how do you make vaccine decisions for your own child? Do you base them on just your own child's risk? Or do you take into consideration the health of all the other kids in your neighborhood, your city, your country, your "herd". Are parents WRONG to put their own kid's health first and foremost? Don't all parents put their own kids first, before anyone else's? This is definitely one of those things that makes me go "hmmmmmm". Labels: Vaccines and their diseases
Pneumococcal vaccine and disease: Some vaccines are much more important than others.
This bad bug is still fairly common. It's the most common cause of infant meningitis. Continue vaccination is quite important. That's why I start this vaccine very early in my Alternative Vaccine Schedule. I know some parents choose not to vaccinate their kids, and some choose to delay vaccines until their kids are older. After reading all the available negative literature on vaccines myself, I'm not surprised that some parents make this choice. However, some anti-vaccine literature states that ALL vaccine-preventable diseases aren't that serious or common, and parents shouldn't worry about them. This simply isn't true. Some diseases ARE serious, and some ARE still common. While pneumococcal disease isn't the MOST common or serious, it certainly is high up on the list. Parents who decline vaccines, or who wish to delay them, may find Chapter 18 in The Vaccine Book of particular interest. It highlights which diseases are the most common and serious ones. Parents should be aware of how these diseases are contracted and how they can be prevented. Parents should also consider Selectively Vaccinating their kids against these diseases. Labels: Vaccines and their diseases
Rotavirus vaccine and disease: Do you want your baby to be among the first to try a new vaccine?
This is a dilemma faced by all parents every time a new vaccine hits the market. And parents are once again faced with a new vaccine - Rotavirus. There's no question that this disease is a real pain in the diaper area. It is extremely common and can be very severe for infants. But since the vaccine is fairly new, some parents are leery. No one wants their own baby to be among the first to try out a new vaccine, but someone has to! You want your baby protected from this bad disease, but you'd rather wait until the vaccine has been given to hundreds of thousands of other babies first. Since this vaccine went into widespread use in 2006, nothing really bad has shown up yet. That's why I've put it first on my Alternative Vaccine Schedule. But this debate will come around again the next time a new vaccine comes out. Labels: Vaccines and their diseases
Hepatitis B vaccine and disease: Do newborns need a vaccine for a sexually transmitted disease?
Whose idea was it to begin vaccinating ALL NEWBORNS for a sexually transmitted disease? I had an interesting discussion with a doctor who used to work for the public health department. She told me that when her whole staff heard about this decision during the 1990s, they were dumbfounded. They saw no sense in it at all. But, they had no choice. The "powers that be" had made the decision, and they had to follow orders. But given the fact that this disease is virtually unheard of during infancy or childhood (unless an infected mother passes it along to her newborn baby during the birth process, a situation that is preventable with proper screening and treatment), and also given the fact that the vaccine can cause fever, lethargy, poor feeding, and irritability in infants (according to the vaccine's product insert), making them appear to have caught a severe bacterial infection that requires IV antibiotics and invasive testing (when all it really is is a vaccine reaction), again I must ask, WHY? I cannot tell you why. But I can tell you that by delaying this vaccine until your child is a few years old (according to my Alternative Vaccine Schedule), you avoid risking a severe reaction in your newborn that will put him in the hospital. Labels: Vaccines and their diseases
HIB vaccine and disease: How important is it to vaccinate for a disease that is very severe, but extremely rare?
There's no doubt that HIB disease is severe. But now that this particular form of meningitis is extremely rare, how important is the vaccine for infants today? On the one hand, continued vaccination helps keep the disease out of our population, and helps protect each infant individually. But on the other hand, since the disease is so rare, can parents safely skip this vaccine in their babies? There's really no right or wrong answer to this question. Most parents choose the vaccine, but some don't. The ultimate choice is up to you! Labels: Vaccines and their diseases
DTaP vaccine and diphtheria, tetanus and pertussis: Raise your hand if you want a plain pertussis-only vaccine?
Although the D and the T diseases are virtually unheard of in infants and young children in the United States, the P disease, pertussis, is still very common and can be very serious for infants. This makes this vaccine very important, and I place it first on my Alternative Vaccine Schedule. But wouldn't it be nice if you could just give your baby a pertussis vaccine, and delay the D and the T components until later in childhood? According to the vaccine product insert, it may be the Tetanus component of the vaccine that is responsible for the neurologic reactions (see The Vaccine Book). Unfortunately, an individual pertussis vaccine isn't available. Interestingly, however, P component of this vaccine is manufactured separately from the D and T parts, then combined at the end of the process. So it seems plausible that a separate pertussis vaccine could be done. It's quite the dilemma. Labels: Vaccines and their diseases
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