Vaccination issue, WWYD

[DrSally]

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[o_mom]

The anti-vax sources say the DTaP scream comes from encephalitis. I'm not saying that is it or anything, but that is what most will attribute it to. I think you can research that and see what you think of their sources.

Quite honestly, I would hold off at bit while you research it more. Of the components, the aP is the only one she is at risk for (diptheria being so rare here and tetanus a non-risk at this age). You will have to reasearch that and decide the risk/benefit of waiting on that. I also wouldn't discount it being any of the other vaccines either - Prevnar is very reactive.

You may want to consider slowing down to one at a time, spread out, to isolate which one is causing the reaction. Remember that the schedule is set by the CDC to get as many in before 2 years because that is when WBV compliance drops off, not so much from a risk perspective, so don't feel rushed just to stay on schedule.

[CAM7]

mothering.com has a few threads on "dtap scream". I'm not certain what causes it but there has been discussion there on this topic.

You may want to do a search in their vax forum on it...

[maestramommy]

This I remember clearly after Dora's first round of shots. Her ped had me give Tylenol before the shots, then about 6 hours after, she woke up from her nap very upset. When I tried to hold her, she got worse. That's when I noticed the bumps on her legs. So I gave her Tylenol again, and after a while she calmed down. Perfectly fine the next day. So from that point on until 12 months, I gave her Tylenol 4 hours after the first dose, and that was it for the day. With Arwyn this didn't happen, but she did have a very low grade fever the day after the shots.

[DrSally]

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[brittone2]

If it were me, I would hold off until I was certain whether I wanted to proceed and how. You can always catch up later, etc. if you feel it is necessary but you don't have to repeat anything by delaying the next one, kwim?

The DTaP scream has been reported by more than one parent.

You may also consider entering something in the VAERS database. A parent can file a report on their own, even if your physician will not. IMO, the reason many reactions are underreported is many peds brush off reactions or parents are told the two are unrelated. It doesn't have to be *confirmed* to have come from the DTaP for you to report it. You never know if it will help another parent down the road, kwim?

I would not act until I was sure, whether provax or non-vax or delaying for additional time. You can't take it back once you do it.

[brittone2]

This I remember clearly after Dora's first round of shots. Her ped had me give Tylenol before the shots, then about 6 hours after, she woke up from her nap very upset. When I tried to hold her, she got worse. That's when I noticed the bumps on her legs. So I gave her Tylenol again, and after a while she calmed down. Perfectly fine the next day. So from that point on until 12 months, I gave her Tylenol 4 hours after the first dose, and that was it for the day. With Arwyn this didn't happen, but she did have a very low grade fever the day after the shots.

I know many docs recommend this, but the problem for anyone worried about a possible previous reaction is that the Tylenol can potentially mask the symptoms of a reaction, and in some cases, it is better to know that there was a reaction. At least, that's what I've read. Everyone handles their own sitation individually, but if I were concerned about a possible reaction to I'd be hesitant to do something that might mask it next time around.

[firsttimemama]

I'm in favor of delayed/selective vaccination and/or not vaccinating. DS is 11 mo and has not received any shots yet.

I have read several books re: vaccines. If I were in your position I would hold off on any more shots, maybe read Dr. Sears vaccine book and possibly look at a couple of other vaccine books, and then make a decision.

I have not decided what we're doing with DS - possibly starting a selective schedule at age 2. If we do vaccinate, I'll be doing as much as I can to get 1 shot at a time so that I can identify anything he may react to.

[Radosti]

I always do tylenol an hour before shots and then throughout the day, as needed. He did worse after the 2 months shots than he did after the 4 months shots, so it doesn't always get worse.

[maestramommy]

I know many docs recommend this, but the problem for anyone worried about a possible previous reaction is that the Tylenol can potentially mask the symptoms of a reaction, and in some cases, it is better to know that there was a reaction. At least, that's what I've read. Everyone handles their own sitation individually, but if I were concerned about a possible reaction to I'd be hesitant to do something that might mask it next time around.

Well, in Dora's case at least I was pretty sure she was just sore in the leg, because of the way I was holding her. She wasn't screaming though, just crying and p'oed.

[mamicka]

I would definitely hold-off on all other shots until you've been able to research & think enough to become comfortable with a decision. FTR, I'm not anti-vax but I delay vax & have refused some & don't intend to ever consent to them. I've heard about the scream reaction & I think its frightening. Whatever you decide, you're right to not ignore it, IMO.

[Clarity]

My friend's son had the DTaP scream. Her father, a family physician told her it was probably the Pertussis component of the DTap that caused some encephalitis which led to the screaming. I'm sure it was heartbreaking to hear. Definitely let your pediatrician know and discuss how to move forward if you are going to continue to vax.

[JTsMom]

I agree with everyone who said to research more before you do any more shots, especially another DTaP. We all have our different comfort levels when it comes to vaccines, so of course nobody here can give you the "right" answer. The best advice I can give you is to look at hard numbers, and then see what you think. Look at VAERS, read a couple of books, find the numbers on D,T, and P- occurence, complications, deaths, treatments etc.

I think most of us will agree that there are risks to vaxing, and there are risks if you don't vax- you just have to decide which set of risks you are more comfortable with.

:hug: b/c I know how stressful it is to make these deciscions, and b/c I'm sure the reaction-whatever it was- was really scary.

[KBecks]

I would be reading a ton about the vaxes and vax reactions and probably delay until I could feel comfortable with each shot. I don't think I would want to risk a repeat of what happened to DD without at least trying to get an understanding of what happened last time.

[DrSally]

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[DrSally]

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[sariana]

My DS was 8 weeks early. We did all vax on the regular schedule; we did not correct by 2 months. (I was concerned about this, too.) DD was a month early, and we are following the regular schedule for her, too.

DS was 4 in July and received his 5 year shots. The only reaction he has ever had was at 18 months. He got 5 or 6 spots after receiving the chicken pox vaccine. It was a blessing in disguise, though. When I took him in for his ped to look at the spots, she found an ear infection, a throat infection, and a tooth infection. My little guy never complained or cried, so I never would have known!

I was not aware of the milk allergy issue. We are a family of cows and drink a lot of milk. I would definitely hesitate on any more shots if I knew about a contraindication such as this one.

[lisams]

DS reacted very similarly to his round of 2 month vaccines. He would not stop screaming and we were sooo close to heading to the ER. He ended up with one of his legs swollen, hot, tender and red for a few days. For the 4 month round we only did 2 vaccines and made note of which vaccine went in each leg so we'd know if there was a local reaction which vaccine was causing it. To this day I will not give him more than 2 vaccines at a time. He didn't have a problem with any others (he hasn't had the MMR and he never had the rotavirus) so I don't know if it was the combination of all 4 or if it was just a fluke.

[mytwosons]

ok, just doing some more reading, it seems that the DTaP is contradicted for those with milk allergy or a family hx of milk allergy. I was never told this for DS (milk allergy) or DD! I wonder if this would be enough to convince my ped not to give the aP to DD.

From some of the autism groups I belong to, I've seen postings that vax manufacturers are now (they may have in the past as well) recommending that kids with immune issues don't get vaxed. Since a lot of kids on the spectrum have allergies, this has raised the question of which came first, etc. Also, should they have been vaccinated in the first place or should there first be some allergy testing performed?

I'm sorry you had to experience that reaction; I'm sure it was terrifying. Personally, I would hold off on any other vaxes until you are absolutely positive it is something you want to give. You can always make up "late" shots, but there's no going back once you give them.

[megs4413]

DS had the DTaP scream. it was really scary because it was like he wasn't even conscious....he was just screaming, sort of like a night terror. we had already been following a delayed/selective vax schedule. we haven't had any more DTaP shots, so i can't speak to how a kid does on the shot after they've had the scream reaction. Probably not related at all, but DS had a seizure last spring and then another one this past week. He won't be able to receive a pertussis vaccination again at all because of the seizure risk.

I would just wait until you were comfortable. I don't think you'd be risking anything to do so. Also maybe see if you can get your hands on the shot separated out. Does your DD have a diagnosed milk allergy?

[Fairy]

Do you ever see the DTaP scream with the 4-year booster, or only the first shot? DS has his checkup tomorrow and will be betting his DTaP, Polio, and possibly flu and Hep-A if I choose to give those. I wanted to spread them out over four months, rather than get 4 sticks, but I know I will be met with opposition on that. And this is the first I've ehard of the DTaP scream, as DS didn't have that the first time. I've got some anxiety about the vaxes tomorrow, tho, due to the number of them. Now I'm curious if the scream has happened in the 4-year booster.

[sanja973]

I am in the midlle, not very provax and not comletlly against it. I read a lot abut it and I think some of vaxes are not as necesary but I am not a doctor to say that.
My DD was on schedule first six months( generally she was OK, but she wouldn't smile for a couple days) but when she got five shots at once it was to much for me to watch and we decided to split it, so now she gets no more than two at a time and there is much less or no fever/reaction. This way if she gets reaction we will know what to avoid or postpone next time...

[o_mom]

Do you ever see the DTaP scream with the 4-year booster, or only the first shot? DS has his checkup tomorrow and will be betting his DTaP, Polio, and possibly flu and Hep-A if I choose to give those. I wanted to spread them out over four months, rather than get 4 sticks, but I know I will be met with opposition on that. And this is the first I've ehard of the DTaP scream, as DS didn't have that the first time. I've got some anxiety about the vaxes tomorrow, tho, due to the number of them. Now I'm curious if the scream has happened in the 4-year booster.

If you read the VIS, they say that some of the problems are more likely with later shots. Not the scream in particular, but swelling of the entire limb for up to a week happens in 1 in 30, for example.

[brittone2]

If you read the VIS, they say that some of the problems are more likely with later shots. Not the scream in particular, but swelling of the entire limb for up to a week happens in 1 in 30, for example.
ITA. I am not sure about the scream specifically (and I agree w/ the PPs, I've read that this may indicate encephalitis in some kids), but the risk of adverse reactions is thought to go up with each DTaP dose administered. I haven't checked for a while now, but I recall reading that when researching it with DS.

[happymomma]

I would really look into delay vaccination. I wish I had done that with my DS when he was younger. Starting around the time that he was 2, we've done delayed vaccination. Both DS and DD gets the shots they need but at a slower pace. We generally only give one shot at a time. So I would bring them in once every couple of months for a shot. It was a pain but I think it was better for them in terms of the side effects.

[Fairy]

It's been so long since I read the VIS's, I forgot they were there. Thanks for the reminder, and I read them all. DS has already had three of the four DTaP and Polio's, so I'll go ahead with them, but I think I'm going to spread them out rather than give 4 shots at once.

Would be interested on thoughts on Hep-A and the Flu shot for a 4yo. My thoughts are to give Flu and DTaP tomorrow, then Polio and Hep-A next month. I'm pro-vax but interested in your thoughts.

[o_mom]

I am not sold on the flu shot. There have been numerous articles in the last couple of years which show flu shots to have very little if any effect. Combine that with the fact that our ped doesn't get the mercury free shots, and we skip it.

Hep-A - Not routine here so I haven't researched it as much. I would do titer testing prior to giving it, though as most childhood infections are asymptomatic and a prior infection can give lifelong immunity. The same would go for the booster dose - 97% respond to the first dose, so you could skip the second one if the first one provides immunity.

[brittone2]

Even if I were pro-vax, I am very much not sold on the flu vax in particular. If you look at the list of side effects from the flu vax at the CDC's own page it lists:

Fever
Aches
Runny Nose
Muscle Aches
Wheezing

They insist that the flu vax does not cause influenza, but whenever I look at the side effects list, it makes me chuckle. Sounds pretty much like influenza to me.

There have been review studies out that show the flu vax is no more effective than a placebo in children under 2 (yet the recommendation is to vax every child over 6 months of age). Some new studies have come out questioning how effective the flu vax in the elderly as well. I have dug into it a bit with respect to asthma, and have found similar review studies questioning whether it really leads to decreased hospitalization/death in that population as well. Since those are the groups that are most at risk, it makes me question exactly how well it works. JMHO.

http://www.bmj.com/cgi/content/full/333/7574/912
http://www.ncbi.nlm.nih.gov/pubmed/15106150
old thread with several links to studies:
http://windsorpeak.com/vbulletin/showthread.php?t=238585

It can also still be somewhat difficult to find non thimerosal containing influenza vaccines. Here's the table of what is available from which manufacturers in the 08-09 season. For those who choose to do the influenza vax, I would strongly recommend cross checking what your doctor/clinic is administering, since it isn't uncommon for nurses, etc. to insist they are giving a "thimerosal free" shot when they are really not.
http://www.cdc.gov/flu/about/qa/vaxsupply.htm

[CAM7]

I was never told this for DS (milk allergy) or DD! I wonder if this would be enough to convince my ped not to give the aP to DD.

Remember you don't have to convince your Dr of anything! Just say "no, not today". And if they are super pushy find another Dr.

If you go to mothering.com for "Finding your Tribe" and look for your state... and then search threads (or post one) and find a good non-vax Dr in your area.

You can file an exemption in every state except WV and MS for school and preschool...also for daycare...

[DrSally]

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[brittone2]

YEah, I know. I realized this as I was typing. I just hate getting grief. I'm really going to ask about the milk allergy issue (or family history of it). I kind of po'd that no one mentioned it to me with DS, who has multiple food allergies starting at 6 months. Does anyone have a specific link for info on this?
I'm having trouble finding a firm contraindication with respect to dairy allergy, but I did find this:

Daptacel (http://www.fda.gov/cber/label/dtapsan110806LB.pdf) (diphtheria, tetanus, acellular pertussis)
Pertussis:
Bordetella pertussis cultures grown in Stainer-Scholte medium, with added casamino acids and dimethyl-beta-cyclodextrin.
Toxin detoxified with glutaraldehyde.
Filamentous hemagglutinin is treated with formaldehyde.
Residual aldehydes are removed by ultrafiltration.
Individual antigens adsorbed separately onto aluminum phosphate.

- Diphtheria:
Corynebacterium diphtheriae cultures grown in modified Mueller’s growth medium.
Toxin purified by ammonium sulfate fractionation and detoxified with formaldehyde and diafiltered.
Toxoid is individually adsorbed onto aluminum phosphate

- Tetanus:
Clostridium tetan: cultures grown in modified Mueller-Miller casamino acid medium without beef heart infusion.
Toxin is detoxified with formaldehyde and purified by ammonium sulfate fractionation and diafiltration.
Toxoid individually adsorbed onto aluminum phosphate.

Defintion of casamino acid here:
http://www.biology-online.org/dictionary/Casamino_acid

The group of amino acids which results when casein, a protein found in milk, is broken down by enzymes. http://www.biology-online.org/i/1.gif

Pediarix (http://www.fda.gov/cber/label/dtapsmi121302LB.pdf) (diphtheria, tetanus, acellular pertussis)
Diphtheria:
Corynebacterium diphtheriae cultures grown in Fenton medium containing a bovine extract.

- Tetanus:
Clostridium tetani cultures grown in a modified Latham medium derived from bovine casein.
Detoxified with formaldehyde.
Purified by precipitation, dialysis, and sterile filtration

- Pertussis:
Bordetella pertussis cultures grown in modified Stainer-Scholte liquid medium.
Toxin detoxified with glutaraldehyde and formaldehyde.
Filamentous hemagglutinin and pertactin, two pertussis antigens, are treated with formaldehyde.

I'll keep looking and let you know if I find anything else. Apparently not all ingredients are listed all of the time.

You are the mom. If you are concerned, I'd tell the doctor no, at least until you have more time to investigate.

eta:
http://www.scribd.com/doc/5558114/Vaccine-Excipient-Media-Summary-2 (has the casamino acid listed here for Daptacel at least)

if you go to http://www.fda.gov/search.html you can plug in "dtap casein" and it mentions other DTaP formulations cultured in casein containing media.

edited again to say if you google "Latham medium DTaP" you'll get more info as well. It looks like several DTaP formulations contain cultures grown using this medium.

[CAM7]

DrSally... I was taking the kids to a pedi that was really nice...but she was pro-vax and it was so stressful taking the kids for their checkups... I was always having to give myself that 'pep talk' before we went in and I just HATED taking them for their appointments.

Last year I found a family dr (from mothering.com search) and the kids just love her! I took the kids in for their annual check up last week and the kids actually ENJOYED their check up! :-)

It's like night and day I tell ya...

Search for a new Dr! It's takes a bit of work but soooo worth it.

Also, I don't worry about the kids getting sick at all now... I have complete trust that my Dr will suggest natural remedies first and perscription med only if that doesn't work.

[DrSally]

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[brittone2]

So, I've done more poking around and found that the Dr. Sears website has a vaccination discussion forum. I described the issue and Bob Sears answered. His answers were very thorough and helpful.

#1 He said he didn't have a prob vaccinating a later premie, like DD, which made me feel better.

#2 He felt the reaction "wasn't good" and thought it was more due to a general overload of vaccines that day, rather than a specific vax. Unless I had followed his alternate vax schedule and only had her get rota and DtaP (which I didn't), in which case, he would finger the DtaP.

#3 He said that one brand of DtaP, Infanrix, prob would have casein since it is cultured in it, but not listed as a final ingred. He recommends Tripedia or Daptacel, which aren't cultured in casein, anyway b/c of lower aluminum content.

He is so knowledgable and on my wavelength in terms of not antivax, but not denying side effects and cautious about them. I'm going to get his book and follow the alternate vax schedule he suggests to reduce the loads she gets each time. I wish I would've done this with DS.

I'm glad you felt as though he had some good advice for you. :hug:

[mamicka]

Sounds like you got some great advice. Thanks for letting us know about the forum there - I could see myself using it in the future.

Hope your little one is back to normal.

[DrSally]

I'm glad you felt as though he had some good advice for you. :hug:

Thank you, and thank you for your support and help with info :)

[DrSally]

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