Wednesday, October 18, 2006

Vaccines

I am really interested in your responses to this post. Gretta's 4 month check up is coming right up, and I have been doing some thinking about vaccines.

I had thought that I would just go along with the recommended vaccination schedule, but after seeing how hard it was on Gretta (no extreme reactions, just hard), I began rethinking the vaccination schedule.

I know that some people do all the vaccinations, but just at different times than those recommended or not all at once. I would love to know what you all do, and how you decided on which vaccinations to get and when.

I have found the Department of Health and Human Services' recommendation schedule and an interesting article on whether or not multiple vaccines overwhelm the infant's immune system. Here is also a link to get a personalized immunization schedule for your baby (free).

The above article seemed to be pretty convincing on why vaccines are good and okay at this point in Gretta's life.

The only question I still have is on whether or not it is good to get them all at the same time. This article was arguing that it was perfectly okay, but there was a comment in the article that gave me pause. And so I though perhaps I just didn't understand why they thought this was okay:

"Achieving similar immune responses by giving vaccines at the same time at different sites may be more easily accomplished than by combining vaccines in the same syringe. Challenges to giving many vaccines in a single injection are based partly on incompatibilities of agents used to buffer or stabalize individual vaccines."

So my question is: Why do they think that these agents that are used, that would be incompatible when put together, would not be incompatible when injected at the same time?

My doctor friend responded: "My guess is that because the vaccines are prepared differently that a solution used for one vaccine would inactivate another vaccine. This isn't a problem in the body because the vaccines injected at different sites will be locally taken up into the lymphatic system and wont have a chance to interact with the vaccines at other sites."

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I thought I would include some (particularly good) brief exerpts from the article:

On the infant's immune capacity:
"...then each infant would have the theoretical capacity to respond to about 10 000 vaccines at any one time (obtained by dividing 107 B cells per mL by 103 epitopes per vaccine).

"Of course, most vaccines contain far fewer than 100 antigens (for example, the hepatitis B, diphtheria, and tetanus vaccines each contain 1 antigen), so the estimated number of vaccines to which a child could respond is conservative. But using this estimate, we would predict that if 11 vaccines were given to infants at one time, then about 0.1% of the immune system would be 'used up.'"

On the number of vaccines given today:
"Although we now give children more vaccines, the actual number of antigens they receive has declined. Whereas previously 1 vaccine, smallpox, contained about 200 proteins, now the 11 routinely recommended vaccines contain fewer than 130 proteins in total."

On whether or not vaccines weaken the immune system:
"Vaccines may cause temporary suppression of delayed-type hypersensitivity skin reactions or alter certain lymphocyte function tests in vitro. However, the short-lived immunosuppression caused by certain vaccines does not result in an increased risk of infections with other pathogens soon after vaccination. Vaccinated children are not at greater risk of subsequent infections with other pathogens than unvaccinated children. On the contrary, in Germany, a study of 496 vaccinated and unvaccinated children found that children who received immunizations against diphtheria, pertussis, tetanus, Hib, and polio within the first 3 months of life had fewer infections with vaccine-related and -unrelated pathogens than the nonvaccinated group.

"Bacterial and viral infections, on the other hand, often predispose children and adults to severe, invasive infections with other pathogens. For example, patients with pneumococcal pneumonia are more likely to have had a recent influenza infection than matched controls. Similarly, varicella infection increases susceptibility to group A ß-hemolytic streptococcal infections such as necrotizing fasciitis, toxic shock syndrome, and bacteremia."

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