Tuesday, December 15, 2009

Genevieve's 2nd dose of H1N1 vaccine

Vivi and I are going to stand in line again on Thursday afternoon to get her second H1N1 vaccine dose. I wanted to do a follow-up to my post about the vaccine debate, as I did not spend much time on my background and feelings about immunization of my daughter. When I was pregnant, I was finishing up my master's in public health, and much of my time was spent learning about infectious diseases and vaccines. I began researching what vaccines would be required for her, and I was astounded at the number and frequency of the schedule, particularly when she was under 1 year old. 2 months, then 4 months, then 6 months, then 9 months, then 1 year. Really??? After reading several books (among them, The Vaccine Book by Dr. Robert Sears), I made the personal decision to slow that schedule down and give her only the vaccines our pediatrician said were the MOST important in her first year of life. I did so because the sheer number of vaccines given to children has increased tremendously since I received my own vaccinations beginning in 1979, and I didn't see a lot of discussion about this jump in professional health sources of information besides "vaccines are safe." Our pediatrician was not happy with me and gave me several eye-rolls and disapproving pursed lips (among the many reasons we recently switched pediatricians), but I stuck to my guns despite this thinly veiled criticism.

You may not be as interested in the specifics of my vaccination schedule with Genevieve, but I'm adding the info for moms who might care. Between 0 and 6 months, I allowed Vivi to have the non-injection rotateq (for rotavirus, a serious diarrheal illness), and the 2 most important "stabs," as they say in Britain:
1) Hib, or Haemophilus Influenzae type b, the most frequent cause of bacterial meningitis, and
2) PCV, or pneumococcal congugate vaccine, the cause of pneumonia (incidentally, I got a serious case of pneumonia as an infant and had to be hospitalized for several days--very scary for my parents, who were originally told by their pediatrician that I had a minor cold).

Much to my dismay, I soon learned that my slowed schedule would be thrown out the window if I wanted to start a full-time job. In order to put Vivi in day care at 6 months old, she was required to have the exact schedule given by the state, and there was no variation allowed except for religious beliefs. I reluctantly agreed to the new schedule, with one caveat: I would take Vivi back more times to the pediatrician rather than allow them to give her multiple vaccines on the same day. I did this through her first birthday but eventually gave in when I realized she got a high fever nearly every time she got a shot, so it seemed like a wiser decision to get them over with at once rather than subject her to multiple fevers. From then until now, she has gotten DTAP (diptheria, tetanus, and pertussis), inactivated poliovirus, hepatitis A & B, influenza, MMR (measles, mumps, and rubella), and varicella (chickenpox). You can view the entire schedule on the CDC website.

So knowing my initial reluctance to follow the vaccine schedule exactly as outlaid, you might ask why I would voluntarily give her H1N1, an additional, not state-required vaccine. With the exception of a high fever, Vivi has never had another negative reaction to any vaccine. Because of my current position at work, I know the complications she could get if she contracted H1N1, among them pneumonia, coma, and death. When I weigh these terrible health issues with a temporary fever and no known long-term side effects, I must push aside my own reservations as a parent and take the lesser of two evils, so to speak.

Like I said in my previous message, I will not jump on the "vaccines cause autism" bandwagon. I received an anonymous comment to my last message to read the Fourteen Studies website. This group seeks to ask what they call "the right questions" about vaccines, namely whether they cause autism. There are various reasons given why the 14 existing studies that do not show a connection between the two are insufficient. After reading their reasons, I am still as skeptical as I was previously about the connection. They blame public health professionals and CDC for the push to keep the current vaccination schedule and for the lack of studies. However, they then go on to show that some of the 14 existing studies were funded by CDC, which is no small contradiction. As a public health professional who works with the CDC, I can report that they are very focused and dedicated to quantitative evaluation and evidence-based results. I do agree with one aspect of the 14 studies' point of view, which is that testing should continue to be done on the number of vaccines given and whether these vaccines have any long-term adverse reactions, not just specifically autism.

Here's one last thought for you. Imagine you are a college student about to plan a study-abroad trip to Africa, and you have been told by the nurse in the student travel office that you should receive vaccines such as yellow fever, typhoid, tetanus, hepatitis B,and varicella, among others, as well as take malaria pills while you were there. What would you do? If I were a betting girl, I would say you would get the vaccines. Almost 10 years ago, I was such a girl going to Kenya, and you can be sure I got all of mine. My point here is this: In our daily lives, we put ourselves in a certain amount of danger that we push aside or take for granted. This is a normal part of life, and there are psychological reasons for doing so. Anyone more afraid of flying than driving or more afraid of public speaking than death knows what I am talking about. So might we be putting our children more at risk by denying them the vaccines than by allowing them? I think so. I hope this look into my own psyche will help you see that even as a health professional I have personal reservations. However, I try not to let my emotional reaction overtake the logical one. In the end, I will say a prayer when I get in my car more often than when I get on an airplane.

Tuesday, December 01, 2009

Yay holidays!

Vivi turned 19 months old yesterday, and I know it's cliche, but I can't believe how fast she's growing. One of the best things about parenthood is definitely starting new traditions. We are teaching her about Christmas, which makes me realize how strange some of our traditions are when you are explaining it to someone who is not only hearing it for the first time but is a toddler. We've been telling her about a lot of different things, like Jesus and Christmas trees and snowmen and Santa; after all of that, I have to say probably what we tell her the most is "no Vivi, don't touch it, just look at it." Poor thing, it must be so confusing! One of the most fun new traditions I started with her is setting up the nativity scene. As a child, my aunt Marcia would let us help her set up the manger (which belonged to my great-grandma), and then on Christmas Eve she would read to us from the Bible about Jesus' birth and we would put baby Jesus in the manger. This year she passed along the nativity scene to us!

I am so excited about coming home for Christmas so we can see family and friends and she can play with her cousins. It gets harder every year to live away from everyone. But the good news is that I love my new job and am looking forward to the months to come. I am going on many site visits at the beginning of the year at local health departments around the country, which will be my first time actually visiting the places I work with from DC.


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