Home > Parent Perspective, Preventable Diseases, Testimonials > From Avoiding Vaccines to Getting A Child Caught Up: Where To Start?

From Avoiding Vaccines to Getting A Child Caught Up: Where To Start?

people-217251_640We often receive personal inquiries about immunizations, especially on our Vaccinate Your Baby Facebook page.  While people realize that it’s best to seek the advice of a licensed medical professional, and we always encourage them to do so, many parents also appreciate hearing from others who may have some relevant insight.  It helps to know that our parental concerns are reasonable and that others have successfully overcome the same obstacles that we are facing.

In the case of one particular family, their immunization questions center around a major shift in their philosophy.  They once actively avoided vaccinations, but have now decided to get their two young children caught up on the recommended vaccines.  However, they are overwhelmed by all the considerations this will require.

While there is a catch-up schedule designed to bring unvaccinated children up to date, they wonder if their plan should consider the fact that there are disease outbreaks in various parts of the country and they also have a new baby on the way.  Until their doctor is able to provide more specific guidance, they’ve reached out to our immunization community for words of wisdom, understanding and encouragement.

Please note that they are not looking to be convinced whether they should, or shouldn’t, vaccinate.  Rather, they’re looking for intelligent insight into how they should best get their children caught up.

Their inquiry reads as follows:

Hello!! I need some advice, and I’ve been following your page.

My husband and I have two children (age 5 and 3), and a baby on the way (due in November). We’ve navigated the vaccine controversy for 5 years, surrounded by a great many anti-vaccine families, and have actively avoided vaccinations due to an intense fear of side effects, and through everything have tried to keep an open mind. We’ve come to the decision (finally) that we are going to vaccinate. Better late than never.

I know our oldest has passed the age where certain vaccinations would have been administered. Our son is still young enough to get on track to a normal schedule. When asking our Family Physician which vaccinations are most important, his response was “all of them”, which may be the case, however I need help understanding what I should start with. Coming off of our vaccination phobia, we would be most comfortable spacing out the shots. What would be the very best to begin with, knowing that we have a baby on the way? Chicken Pox? MMR?

You have some very knowledgeable readers, and if at ALL possible, please understand that this has been a difficult path for us, and I’m eager for intelligent comments, not judgment or nastiness. Thanks SO much!!

If you have something you would like to share about this mother’s concerns than please comment below.

If you have immunization related questions of your own that you would like us to consider sharing for discussion in future blog posts, please explain your concerns via email to shotofprevention@gmail.com.

  1. Mark Sawyer, MD
    June 5, 2014 at 11:40 am

    Prioritizing vaccines is always a challenge for physicians because we do think they are all important. Having said that, there is a spectrum of risk for exposure to the diseases we can prevent with vaccines so I’ll give my opinion about that. As you have probably heard measles and pertussis (whooping cough) are on a record breaking pace this year so I would consider those high priority now. Especially the pertussis vaccine given the new baby on the way. The diseases caused by Pneumococcus and Haemophilus can be very severe so the PCV13-Prevnar and HiB vaccines are always a top priority. Varicella (Chickenpox) is still around and is very contagious so that’s my next priority. I’m happy you’ve decided to vaccinate your children. Don’t wait too long in getting fully caught up!

    Like

  2. Lawrence
    June 5, 2014 at 12:02 pm

    My wife recently got here titers tested as part of her annual check-up & she discovered that she was not immune to Measles. With the recent rash of outbreaks (one is local to us), she felt it was important to get her MMR as quickly as possible.

    Even adults should be knowledgeable about their immunity status – so catching up isn’t just for kids – it behooves all of us to do our part to protect ourselves and others.

    Like

  3. June 5, 2014 at 12:38 pm

    Your child’s doctor honestly has your child’s best interests in mind, years of schooling, and tons of research behind his decision. Talk to him and get the shots on the schedule he recommends. Your child will face a stronger immunological threat from the lollypop they give him when he’s done (assuming your son is like mine, and the lolly will immediately be covered in dirt.)

    Like

  4. Mary
    June 5, 2014 at 12:42 pm

    I would find another doctor, perhaps a pediatrician, who can provide you more concrete advice. I would ask: can my 3 and 5 year olds receive all vaccinations (at least the 1st dose in those that have multiple doses…) right away? Basically what is the soonest you can “catch up.” I would also be aware of the vaccine rates in their daycare/playgroup/etc and take care to minimize exposure in the same way you will keep your unvaccinated newborn away from unnecessary risk. I don’t think you need to over-worry about this, you are on the right path. Just start and make sure you (and other adult family members) personally get your boosters too – whooping cough etc Basically I think your family physician should be more proactively helping you with this, so I would recommend to be direct with them and ask for more guidance ASAP, or find another doctor who is more responsive. Good luck 🙂

    Liked by 1 person

  5. June 5, 2014 at 12:45 pm

    Maybe I misunderstood your doctor’s advice – my advice is get all the shots as SOON as you CAN.

    Like

  6. Anthony
    June 5, 2014 at 12:46 pm

    First of all, they need to get a new family physician.

    Like

  7. June 5, 2014 at 1:23 pm

    Dear Mom of 2+1, Congratulations on your pregnancy! Such an exciting time for you and your family. I know I speak for many other mothers and nurses when I say, Thank you for taking the first initial steps in protecting your children from vaccine preventable diseases. By getting your older children up-to-date, you’re also creating a safer environment for your newborn. I agree with the suggestions of Dr. Sawyer, especially in light of the recent outbreaks we are seeing here in the United States.
    I would also like to mention that there are vaccines you and your husband should consider in the near future that will help to further protect your newborn. With almost half of pertussis/whooping cough cases in newborns originating from the parents and caregivers, we as healthcare providers highly recommend the Tdap for new parents and grandparents, especially If you cannot remember the date of your most recent booster. The best time for pregnant mothers to get the Tdap is ideally in the third trimester-that allows time for your body to pass antibodies to your baby before birth and has shown to provide protection in newborns! I strongly recommend that you also advocate for any adults who will be helping and visiting to verify their vaccination status as well.
    I’d also like to note that your delivery will take place during the beginning of Flu season. Once again, like the whooping cough vaccine, science has shown that by vaccinating a pregnant mother against flu protects the infant post-delivery. Especially since a newborn cannot receive an influenza vaccine till 6 months of age, your baby will be dependant on those around them to protect from viruses. Please inquire about these vaccines at your next ob appointment to learn about your healthcare providers recommendations for your area.
    Good luck with your growing family and the best wishes!

    Melody, Pediatric RN

    Like

  8. June 5, 2014 at 1:37 pm

    This is an excellent question – the CDC does have a catch up schedule, here http://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html but since you are have a lot to catch up on you can triage the “most important” vaccines (with a baby in the house that is hib, pertussis and PCV for the younger child), you have 5 months until baby, so some time, no need to rush – there are catch up schedules that would get your kids up to date really fast, however, I was never a great 5 pokes a visit fan (did it once, for DD, she did great with that, mom not so much) – what I would do (with no more than 2 shots per visit – you can combine more if you want fewer visits!):

    for the 5 year old – several vaccines are NOT needed: rota, hib, PCV, you could do:
    now DTaP/IPV/hepB (Pediarix is the US 5 in 1 vaccine)
    in July: MMR in one arm, Varicella in the other
    in August: DTaP/IPV/hepB 2 (so Pediarix again)
    in September: get MMRV

    The 3 year old doesn’t need rota, but one each of hib and PCV, so you could do:
    now DTaP/IPV/hepB (Pediarix is the US 5 in 1 vaccine)
    in July: MMR in one arm, Varicella in the other
    in August: DTaP/IPV/hepB 2 (so Pediarix again)
    in September: Hib in one arm, PCV in the other

    Both should get a third DTaP/IPV/hepB next spring, and 5 years after that.

    See how you feel then, still missing for “full coverage” are Meningitis (1 shot) and HepA (2 shots, 6 months apart). You could get them these (Men and the first of hepA) before the baby is born, but because of age, they would not be at the top of my list. You could, for example, also get those shots at a baby shot visit – that might motivate the older kids. I should mention that my suggestion contains one less DTaP than recommended on the US schedule. However, this is what is recommended on some European schedules and protection after two DTaPs is reasonable for about half a year and after the third DTaP in Spring, your kids will be as protected as if they had four shots. If you don’t want to veer off schedule, then you could get a DTaP in October and the DTaP/IPV/hepB 6 months after that.

    Several things to watch out for: on days where your kids do NOT get the same shot, have a look at the vial/syringe, so the right kid gets the right shot. Make sure to keep your own records on which shots your kids got when, since they are not on a “traditional” schedule, you might need to refer back to this. Also: older kids have their own minds whether they want to be vaccinated – calculate bribes into your budget 😉

    Finally: consider a DTaP for yourself at around 32 weeks pregnant (you could get one with your kids), so you’ll give your new baby maternal immunity against pertussis.

    I hope this helps: congrats on your decision!

    Like

  9. Mary Beth Koslap-Petraco DNP, PNP-BC, CPNP, FAANP
    June 5, 2014 at 1:50 pm

    First of all I am so happy that you have decided to protect your children against vaccine preventable disease! I know this has been a long and difficult decision for you and your family. I have 2 infant grandsons myself so I know how much thought you and your family have put into your decision. I have done a lot of research on how to vaccinate and what is the best way to do it so that I can offer the very best possible advice to families like yours. The schedules we use are based on the best available science to give individuals the optimum response to the vaccines so the vaccines provide the greatest amount of protection.

    Let’s start with your 5 year old. If he was my grandson I would suggest to my children that they do follow the ACIP schedule because there is no evidence that spacing out the vaccines decreases any chance for side effects. And the longer it takes to vaccinate the longer my grand babies would go without protection. For a reasonable first visit for your 5 year old I would suggest DTaP, IPV, Hep b, MMR and Varicella vaccines. That might sound like a lot but your son’s immune system is very capable of setting up an immune response provided by all of the vaccines. In fact one cold exposes your child to more antigens than all of the vaccines we give put together! I would suggest you request that your provider use the combination vaccines. If combinations are used then your child will only receive 2 shots on the first visit. The combinations he would receive are DTaP-IPV-Hep b vaccine and MMR/V vaccine. There is a chance your child could develop a fever following the vaccines but the fever does not usually last long and fevers of 101 degrees or higher can be controlled with acetomenophen or ibuprophen. You can also expect some redness and swelling at the site of the injections. If that happens cool water on a wash cloth applied to the injection sites usually helps. Yes you are correct that your 5 year old is too old for some vaccines and those are Hib, PCV13, and Rotavirus vaccine. Your 5 year old should return in 1 month for DTaP, IPV, Hep b, and MMR vaccine. Again he should get the combination DTaP-IPV-Hep b and MMR. He has to wait 3 months after the first dose to get the second VAR (varicella) vaccine. One month after the second set of shots your 5 year old would return for another DTaP-IPV-Hep b. This combination would give him an extra dose of Hep b which is perfectly fine for him and he would only need one needle rather than 2 if the DTaP and IPV were given seperately. Then he would wait 6 months after the 3rd DTaP-IPV-Hep b to get a booster dose of DTaP and IPV. While he could get a 4th dose of Hep b 2 months after the 3rd dose it could be given with the booster doses of DTaP and IPV. After those 6 month booster doses your 5 year old would be caught up with his immunizations. If it is influenza season then you would want to get the Flu vaccine. I prefer the inhaled flu mist vaccine over the shot for healthy children for 2 reasons. It is not a needle and it works better than the shot in children. Of course you can discuss this with your provider. I would also suggest that your children receive all of their shots in their legs. As a Nurse Practitioner comfort measures are very important to me and the data showes that children up through 5 years of age develop less redness and swelling when they get their vaccines in their legs rather than their arms. The reason for this is that the muscles in the legs are much larger than arms and walking helps the vaccines to be absorbed better. Another comfort measure is letting your child blow bubbles while he is receiveing the vaccines.

    Now for your 3 year old. Again what I am suggesting is exactly what I would suggest for my grandchildren. I would also ask for some combination vaccines for your 3 year old. On the first visit I would advise DTaP, IPV, Hep b, Hib, PCV13, MMR, and VAR. There are 2 different combinations among DTaP, IPV, Heb b, Hib, that could be used for your 3 year old as well as the combination MMR/V. There is a higher chance of developing a fever if your 3 year old receives the MMR/V and with that higher chance of fever a higher chance of developing febrile seizures. While children usually outgrow febrile seizures and they are not harmful to the child but they can be frightening for parents. The 3 year old would receive 4-5 shots at this visit depending on which combinations are used. For your 3 year olds’s second visit one month later DTaP, IPV, and Hep b would be needed and that can be given in one combination shot. For the third visit one month after the second you would have the same option as for your 5 year old. A seperate DTaP and IPV or the combination DTaP-IPV-Hep b where he will receive an extra Hep b. The next visit would be the same as for your 5 year old DTaP, IPV, and Hep B six months after the 3rd set of vaccines. Your 3 year old would then be caugh up. Influenza vaccine would also be needed if it is flu season. You should also consider adding Hep a vaccine at some point for both children.

    The latest recommendations from ACIP also recommends that you recieve a Tdap vaccine in your 3rd trimester to protect your new baby from whopping cough. The optimal time to give the Tdap vaccine is at this time because it gives the baby the best antibody protection. ACIP recommends a Tdap vaccine in the 3rd trimester with every subsequent pregnancy. I would also suggest your husband and other family members who will have contact with the new baby recieve a Tdap vaccine at least 2 weeks before the baby is born because it takes 2 weeks for the vaccine to work.

    I have reviewed what I would do for your family following the ACIP guidelines but of course you should discuss your children’s immunization schedules with your provider. I wish you the very best for your family and a beautiful healthy baby and an easy labor. And thank you again for making such an important decision to protect your family and community from vaccine preventable diseases.

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  10. Ohio Pediatrician
    June 5, 2014 at 2:14 pm

    Congratulations on your new addition and on making the decision to vaccinate your children! As a pediatrician, I have run across almost this exact situation with some of my patients. I can tell you that as medical providers we are very excited to be able to provide the life-saving protection of vaccinations for previously unvaccinated children. While your children have aged out of some of the recommended vaccinations, they are eligible for the majority of them, although they may not receive as many doses due to their age.
    For the families I’ve worked with, I usually ask first if there are any restrictions on what vaccinations and the number of vaccinations that they are willing to receive and why; while I would prefer to provide complete catch up as fast as possible and healthy children are capable of tolerating and responding well to far more vaccines than I would probably give in one sitting (I have an arbitrary and personal 6 shot limit just from a kindness standpoint), I am willing to work with parents’ requests (I’d prefer your children to be vaccinated against something rather than nothing). I address any concerns they have regarding specific vaccines. From there, I tend to prioritize the most fatal and contagious diseases first. Given the current measles and pertussis outbreaks, I would make these the among the first that are provided, especially with a pregnant woman in the household and a newborn on the way. If the number of shots is the concern, there are many combination vaccines that reduce the number of injections your children receive, while still providing a very comprehensive update – you can ask your pediatrician what is available at the office. If spacing is desired, vaccinations can usually be updated monthly until catch up is complete, although this will vary with the type of vaccines. Be aware that this can be more distressing for your child than receiving shots at the same time.
    Ideally I would at the very least start with DTaP, PCV -13, Hib, and MMR. Thankfully, these are available in combinations that would also provide protection against varicella, Hepatitis B, and polio and I would certainly argue in favor of giving those combination vaccinations. Also of paramount importance, I would recommend that all family members get their seasonal flu vaccine this fall and that all adult caregivers (including mom) get their Tdap. It is safe and recommended for pregnant women to be vaccinated with flu vaccine at any point in the pregnancy (the killed injection, not the live intranasal) and the Tdap in their 3rd trimester, which has the added benefit of providing some passed down protection to baby.
    Again, my congratulations on your new baby and my commendations on your decision to vaccinate your children! Your doctor should be willing to discuss your concerns and to answer your questions about vaccinations. For additional reliable information you can consult the resources at http://www.immunize.org/catg.d/p4012.pdf.

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  11. June 5, 2014 at 2:33 pm

    I concur that you should get a new family physician. You need a physician you can trust and believe in, not one who is going to give you snark. First of all, is this the same physician who accepted your decision to not vaccinate your children for five years? Then I wouldn’t trust that doctor’s judgment and commitment to an appropriate vaccination schedule. The only downside of catching up is the time and expense of multiple doctor visits until all the shots are received. That is the reason combination shots exist. And that is one reason the shots are all administered in the first two years, Wellbaby visits are convenient. Once the children are older and reach school age when many mothers return to the workforce, it is harder to take time off from work and school for doctors appointments. That is why it is not really a conspiracy to over-vaccinate. It is just more convenient for everyone involved.

    Good luck and thank you for helping the herd. People with underdeveloped or compromised immune systems such as infants, those with allergies to vaccines, the elderly, and the medically fragile all thank you.

    Like

  12. Rich
    June 5, 2014 at 6:39 pm

    Just a quick note regarding Catherina’s recommendations…No “Meningitis” vaccine for kids of this age and the last line should be recommending a Tdap not a DTaP for a pregnant Mom.

    Like

  13. Alet RN
    June 5, 2014 at 10:35 pm

    Congratulations on your new baby! And on your decision to protect your newborn, as well as your older children. A good pediatrician will certainly be your most important start on this journey. I have nothing more to add to the excellent advice of the pediatricians on this thread. Good luck on your journey and enjoy your new baby!

    Like

  14. June 6, 2014 at 4:08 am

    Congratulations on all accounts! I’m sure that your family has not taken this decision lightly and it truly is gratifying on our end to see.

    My 2 cents: tetanus is very important as there is no herd immunity and it’s often fatal. There is no natural immunity to tetanus because the amount needed to kill is less than a nanogram. Even a wasp sting carries a risk, so get that one done.

    Agree with above that measles, pertussis and varicella are very important and timely to protect this new baby!

    Also, consider that some vaccines can only be given after a certain delay if other vaccines have already been administered. For example, after you get the varicella shot, you must wait 4 weeks to give the measles shot. Ditto influenza. So you might want to give those together and schedule a few others a week or two later and then you’re clear for influenza season this Fall.

    I know it’s going to seem like a lot of poking in a short period of time but hang in there!

    Like

  15. katie
    June 6, 2014 at 10:43 am

    First of all, congrats on your pregnancy!!! And for coming to terms with vaccinations. This makes my heart smile.
    As you get you children up to date, dont forget to update yourself and your husband!!!!! To protect that new baby, youll want a recent Tdap booster for the both of you, plus anyone who plans to be your new baby!!!!!!! Just something to check into as you venture,into the wonderful workd of vaccines!!!!

    Like

  16. Georges Peter, M.D.
    June 8, 2014 at 6:01 pm

    We hope you are not overwhelmed by the volume of responses! They do emphasize that you and your husband, after considerable review and thought, have made a very important decision for the benefit of your children. We hope others will see the light and follow your lead. Those who don’t have their children vaccinated create a risk to other children, even those who are vaccinated because vaccines while highly effective are not 100% effective.

    By the way, the ACIP schedules are also approved each year by the Am. Academy of Pediatrics and the Am.Acad. of Family Physicians. Your doctor is probably a member of the latter. So the schedules reflect broad consensus among doctors.

    Like

  17. michelle
    June 10, 2014 at 6:40 pm

    I can’t tell you what is most important but the least important is Polio. The pediatric doctor I worked for always said that was the last one to catch up on.

    Like

  18. Lawrence
    June 10, 2014 at 6:52 pm

    @michelle – granted, I would also believe that is correct. There hasn’t been a Polio case here in a while…but I’m sure the anti-vax crowd would like nothing better than a return of “polio summers.”

    Like

  19. Gabs
    January 12, 2017 at 6:35 pm

    Why would you do this to your child. Getting him caugh up with not only traumatize him but could also be super dangerous. what made your change your mind? MMR vaccines is the worst

    Like

  20. Lawrence
    January 12, 2017 at 7:27 pm

    Why are you commenting on an article from three years ago?

    Like

  21. Chris
    January 13, 2017 at 12:39 am

    Gabs: “MMR vaccines is the worst”

    Why should we care about what you say, necromancer?

    Like

  22. Leila
    February 12, 2017 at 6:04 pm

    My daughter is 17 and missing 69 vaccines. Where to start? She has natural immunity to pertussis and mumps. She has never been on antibiotics, has no allergies, and has never been sick except for pertussis and mumps. She had a few days worth of tylenol once for a sinus headache. No one will believe this, but it is the story of every unvaccinated child we know. Wake up to true, unmanufactured health. Say goodbye to chronic conditions. Don’t bow to pharmaceutical profits.

    Like

  23. Lawrence
    February 12, 2017 at 7:48 pm

    I bet Pertussis was fun….could have killed her.

    And natural immunity doesn’t last either.

    Like

  24. Chris
    February 12, 2017 at 11:16 pm

    “Natural immunity” doesn’t last for mumps either. I had it twice as a kid.

    Also, there is absolutely no “natural immunity” for tetanus, diphtheria, strep, rotavirus and a few other diseases.

    “No one will believe this, but it is the story of every unvaccinated child we know.”

    And we are supposed to believe you, a random anonymous person commenting on a three year old article? Gather up the data of those children, then a thousand more… then with their permission get their full verified medical records. Compile them, do some statistics and write it up in a paper. Submit it to a peer reviewed journal, and then you might have something worth our consideration.

    Like

  25. B buckman
    September 25, 2017 at 5:45 pm

    How crazy. Even your meds say that if you miss dose do not double up. What the hell is wrong with your logic

    Vaccine store all the toxins In your child’s body. They do not go away

    Once you fill them up with aluminum mercury and the other toxic chemicals animal DNA and the rest. They go to work destroying their health.
    Have any of you actually real how much of this crap stays in there bodies and is responsible for hundreds of health problems and autism. How stupid can you be.
    Children are not at risk for diseases they are at risk for being piosonsed.
    Parents are brain dead

    Like

  26. Lawrence
    September 26, 2017 at 7:00 am

    #1 – vaccines don’t “store” anything in the human body.

    #2 – Thimerosal isn’t contained in a single US Pediatric Vaccine anymore (hasn’t been for more than 15 years).

    #3 – Care to provide any real citations for your little rant?

    Like

  1. August 28, 2017 at 5:32 pm

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