[SeaCliff]

no one has answered my original question. what's wrong with spacing out the three-in-one to three different shots? right or wrong, people have the belief that getting all 3 shots at once causes problems. is there any reduction in efficacy by spacing out the 3 shots?

I can hear you thinking, "What's the harm?" - but it's not that simple, unfortunately.

The answer is in a basic reality of medicine and pediatric practice: It's hard enough to get a child into the doctors office for one shot, nevermind 3. Kids simply would go unvaccinated - especially in the poorer communities.

Now onto the second reality, and another reason why it's not that simple to split it up: Even if you could get the kids back for more shots, the insurers wouldnt pay for the extra office visits anyway, since the available medical evidence doesnt support any increased risk from giving the M-M-R vaccine in one shot.

[BlueBerry]

SC, I took Ollie to HepA and Tet on Wednesday. They asked if I wanted N1H1. I'm not sure why but I thought it would be better to not give him 3 shots in one sitting. Especially because I honestly felt N1H1 was being marketed by a massive fear campaign. "Get your N1H1 now, we are running out.  Medical Professionals, Elderly and babies only".

The first Vaccine he got was terrible. He had a fever and runny poo. It was very hard to deal with. Glad the Doc gave us a heads up and prepared us to deal with it all.  If I have the opportunity to say, just 2 per visit, why not?

BTW He still has a scar on his right thigh from that first shot. I spoke to my Doc and they don't know why he reacted so badly to the shot. The scar is still there 16 months later.

That said he's dealt with all his other shots fine.

[SeaCliff]

SC, I took Ollie to HepA and Tet on Wednesday. They asked if I wanted N1H1. I'm not sure why but I thought it would be better to not give him 3 shots in one sitting. Especially because I honestly felt N1H1 was being marketed by a massive fear campaign. "Get your N1H1 now, we are running out.  Medical Professionals, Elderly and babies only".

The first Vaccine he got was terrible. He had a fever and runny poo. It was very hard to deal with. Glad the Doc gave us a heads up and prepared us to deal with it all.  If I have the opportunity to say, just 2 per visit, why not?

BTW He still has a scar on his right thigh from that first shot. I spoke to my Doc and they don't know why he reacted so badly to the shot. The scar is still there 16 months later.

That said he's dealt with all his other shots fine.

I have no problem splitting vaccinations - if it's feasable. As far as H1N1 - this was media hype to the worst degree right from the start....ughh. Don't even get me started - or better yet, just search the forums for my posts on the topic dating back to last summer. 

Glad he's doing fine - and hopefully the scar fades over time - hopefully to be happily replaced by non-serious scars that he'll earn over his lifetime pursuing a huge variety of sports and activities.

[BlueBerry]

Can't wait until Grom is his surf/wrestling coach. 


I remember reading some of your N1H1 post. I just thought it was being pushed harder then SUP'ing and that made me nervous.


 

[SeaCliff]

Can't wait until Grom is his surf/wrestling coach. 


I remember reading some of your N1H1 post. I just thought it was being pushed harder then SUP'ing and that made me nervous.
 

Hell, Dude - at this rate, Grom is going to need a good MMA coach - know anyone?? Seriously, he's having fun - wait til you see him, trimmed down, lean and ready to go - and he'll have a blast with Ollie. 

Back to H1N1 and the overhype: The sheer amount of vaccine that is about to be thrown away (much of it expires Feb 15th) has to be in the hundreds of millions of (our tax!!) dollars. In the absence of hard data, and only knowing what I've personally seen in the dozens of facilities and clinics I have visited,  I'm going to go out on a limb and say that well over half of the vaccine produced was never used because of distribution problems and growing public skepticism about the need, and yes, safety.

This is criminal, if you think about it - and not just because of the waste. Consider the fact that production of seasonal flu vaccine was halted to make way for H1N1 vaccine production - and MANY more people suffered and even died from seasonal flu than H1N1! It's impossible for me to imagine that some of these illnesses and deaths couldnt have been prevented if the seasonal flu vaccine was produced and distributed on schedule, instead of being delayed because of..well....again, don't get me started. 

[little_nasty]

H1N1 – case in point about poor public health policy sub-optimal for health of individual or society and why I don’t trust ‘em.

no one has answered my original question. what's wrong with spacing out the three-in-one to three different shots? right or wrong, people have the belief that getting all 3 shots at once causes problems. is there any reduction in efficacy by spacing out the 3 shots?

Snaggle, to answer your question, it depends on the series.  Usually a series will have an efficacy and duration that increases with the 2^nd and 3^rd shot.  They “should” be spaced a certain amount apart, but I gotta be honest, it looks to me like the data is pretty sparse on that front.  Bottom line, is that I don’t think people really know the answer as far as ideal spacing.

But – I assume you know this, but the 3 in 1 is 3 different shots of different series.  So 3 shots turns into 9 shots which although spaced apart – it’s just tough to do that to the kid.  Anyway, that’s more to your question.

You bring up a couple of very interesting and difficult realities - one of which is this:

When a new drug is broght to the market, it must prove to the FDA, through clinical trials, that it is both safe and effective for it's indication for use. Now let's take the case of Vioxx - which was launched in 1999 as a safer alternative for the treatment of pain than traditional ibuprofen. The drug was so good in the minds of the medical community and the patients that took it, that along with it's cousin Celebrex, the two actually became the number 1 and 2 selling drugs in the world - until the world came crashing down - Vioxx was withdrawn from the market in 2004 due to potentially fatal side effects.

So how did Vioxx get approved as safe and effective if it could kill people? Why didnt the FDA know this up front??

Here's a summary of the data that presented to the FDA that led to Vioxx's approval for treatment of the most common form of arthritis, osteoarthris, abrreviated OA:

"Vioxx was evaluated in placebo- and active-controlled trials for the treatment of osteoarthritis (OA) of the knee and hip. The trials enrolled approximately 3,900 OA subjects and were six to 86 weeks in duration. Treatment with Vioxx 12.5 mg and 25 mg once daily produced improvement in patient and physician global assessments and in the WOMAC (Western Ontario and McMaster Universities) osteoarthritis questionnaire. In all OA clinical studies, once-daily treatment in the morning with Vioxx 12.5 mg and 25 mg was associated with a significant reduction in joint stiffness upon first awakening in the morning. Additionally, Vioxx (at 12.5 mg and 25 mg doses) was shown to be comparable to ibuprofen 800 mg TID and diclofenac 50 mg TID in the treatment of the signs and symptoms of OA."

I highlighted the unfortunate flaw in our system - a flaw to which there is no solution (I'll explain.) The drug was tested in 3,900 individuals - which sounds like a lot - until you consider that the drug was prescribed for perhaps 10 times that many in the first hours or even minutes of it's availability on the market, and in the year 2000, there were over 40 MILLION prescriptions written for Vioxx. All based on studies involving less than 4000 people.

Clearly what this means is that we learn FAR more in postmarketing surveillance of drugs and drug side effects/adverse effects than we EVER could in premarketing studies  - even a study of 4000 people is complex and wildly expensive to do. And while these studies are absolutely necessary and useful in preventing the launch of obviously flawed products, they obviously can't possibly serve to identify every side effect that might emerge when the drug is launched into broad use nationally and internationally.

Bottom line? It's the old adage that i can still hear my family physician telling me when I first entered Pharmacy school. I'll paraphrase..he said, "Son, let me tell you something about medicines. Don't be the first to use 'em, and don't be the last." He was a wise old physician. I never forgot his words.

All that said, it' important to put this in context and make sure that we draw a distinction between a newly developed chemical entity such as Vioxx and what's happening here in with vaccines:

There is hardly ANYTHING more widely studied and more closely scrutinized than vaccines and the vaccine industry. The postmarketing surveillance of vaccines is beyond extraordinary - it's simply tremendous. I still would not rush to use a newly developed vaccine for a less common illness - I might wait a cycle before vaccinating unless a major public health crisis was erupting - but with the hundreds of millions of dollars that have been spent studying and analyzing the data, and all of the post marketing surveillance and testing and major studies done, countless of which have been funded by independent organizations that have then been submitted and peer reviewed by the best scientific organizations we have, I have no fear whatsoever of the standard vaccines for Measles, Mumps, Rubella, Polio, Chicken Pox, Tetanus, and Influenza.

SeaCliff – you hit the ball outta the park with this reply.  This is exactly what I was trying to say in simple terms.  “Bottom line? It's the old adage that i can still hear my family physician telling me when I first entered Pharmacy school. I'll paraphrase..he said, "Son, let me tell you something about medicines. Don't be the first to use 'em, and don't be the last." He was a wise old physician. I never forgot his words.”

Most pre-marketing studies I see are borderline irresponsible imho.  Yes, the post-market surveillance i.e. guinea pig testing is much much more robust.  So yea.  My point about the vaccine with a 2007-vintage study is that I will almost never ever have my girl vaccinated with something that hasn’t had many many years under its belt with LONG-TERM studies/results to uncover all the negative crap that inevitably escapes 98% of clinical trials.  And I don’t feel great about standing on that side of this classic free-rider problem.  But like I said, I don’t have enough faith or trust to take one for the team – too many bad examples.  And that credibility gap is real damage caused by previous idiots to our healthcare system and society.

Besides, it’s not me I’m deciding for, it’s my daughter.  And that’s a whole different story.

I never said the decision should be taken out of the hands of the parents.  I do think, however, that parents who do not vaccinate their children are irresponsible and are putting my children at risk.  Laugh off "two days of diarrhea" if you want to, but two days of diarrhea nearly killed me as an infant.  Seriously.  Like, dead. 

Anyway, I read the stories about vaccines, asked my pediatrician and my sister-in-law (M.D./PHd, infectious disease, Johns Hopkins University), read the science (thankfully, not in the Lancet) and decided that my concerns were based not on fact but on alarmist speculation in the media.  Both my children have had all their vaccinations because I think its better for them to have them. 

Bubba, I was not at all “laughing off” diarrhea.  I am well aware of the danger in infants and children (though I might rather focus on modern rehydration therapy).  If you read what I said, I was talking about weighing the risks.  So if the chances that my daughter gets a serious hospitalization case is 0.28% (high since actual deaths are less than 50/yr for what I was talking about), and the effective immunity from the vaccine reduces that chance to 0.06% but comes with a 10% chance of actually acquiring the virus, a 20% chance of a fever,  xx% chance of reaction and scarring like Ollie (yes, that’s often listed as a possibility with associated % incidence), and xx% of the unknown – which do you choose?  To me it’s a no-brainer, but informed, intelligent minds can disagree.

Finally I’d add that the risks are different based on where you are.  Manhattan, though densely populated, is still not sub-saharan Africa.  Nor is it 1976.  I’m just saying.

And thorium man, please point out where I’m wrong.  My conscience would love to have my position challenged factually, argumentatively, or morally.

[SeaCliff]

...and in the news this morning?
 
A mumps outbreak in Rockland County.


http://www.google.com/hostednews/canadianpress/article/ALeqM5jJASM2l2fTQhk-avl9SkFlGaskxw


MONSEY, N.Y. — More than 300 people have been diagnosed with the mumps in suburban New York as America's largest outbreak of the disease in years spreads. Almost all the cases are among Orthodox Jews.

A health official says 303 people in the Rockland County towns of Monsey and New Square have been diagnosed with the highly infectious disease.


Investigators say the outbreak started in August 2009 at a Jewish summer camp in Sullivan County with an 11-year-old boy who brought the disease from England.


It has since spread to Jewish communities in Brooklyn, New Jersey and Orange County in upstate New York.
Mumps is spread by coughing and sneezing with the most common symptoms being fever, headache and swollen salivary glands under the jaw.

[HydroGlide]

interesting stuff here.  I agree with the old family doc - we had the kids get the full standard vaccination schedule (the stuff that has been tried and tested on millions before over many years) but passed on the H1N1 and the cervical cancer vaccine offer (which was more like pressure than an offer) becasue we either didn't lke what we read or felt there was just not enough good info available yet.  Big pharma being out to make money is no revelation - drugs are business they are not magically created by the herbal forest pixies and i believe that the vast majority of doctors are really only out to try to make us better (not worse) - but a doctor, beyond test results and vitals, really doesn't know you from a hole in the wall - its up to you to self monitor and self advocate - so every once in a while you have to be like Nancy (but not her kids) and Just Say NO to your doctor's prescription drug offers - unless its Abilify - I hear that stuff makes you happier than 2 qualudes, a half ounce of hydroponic gold and a bottle of jack.

[Northstreet]

I'm almost 38, and I STILL have a scar/divot on my right leg from my baby shots....
 
 
 
I can't wait to see the Ambien lawsuits....that stuff is crazy!

[JerseyJen]

no one has answered my original question. what's wrong with spacing out the three-in-one to three different shots? right or wrong, people have the belief that getting all 3 shots at once causes problems. is there any reduction in efficacy by spacing out the 3 shots?

It's actually very difficult to find all three components separately.
I am unaware of any doctors that stock them.

In the interest of full disclosure, we're doing a spaced/delayed vax schedule with Nat.
My husband and I wanted to break up MMR. Our doctor was happy to write us a prescription for the components but her other patients were reporting back that only one pharmacy in the surrounding few counties carried the individual components and they presently did not have all three. The one pharma-company that makes the separate components  available has ceased doing so for the time being and only does batches every few years.

When my husband and I went around for interviews with pediatricians before our son was born, most of them preferred sticking to a set schedule for vaccines (some the CDC schedule, some a modification of that). The doctors we spoke to cited paperwork/record keeping and convenience  as a justification for this.


Addressing the discussion of the flu vax above, NJ had made included it in the mandatory list for kids attending public school/daycares. This was repealed with this seasons shortage, and I believe Christie is not planning on reinstating it.

[theusername]

anybody see the article in the nytimes today reporting a possible link between parental age (of both the mother and father) and an increase in the incidence of autism?

http://www.nytimes.com/2010/02/09/health/09autism.html?ref=health

[the Kook]

Back to H1N1 and the overhype: The sheer amount of vaccine that is about to be thrown away (much of it expires Feb 15th) has to be in the hundreds of millions of (our tax!!) dollars. In the absence of hard data, and only knowing what I've personally seen in the dozens of facilities and clinics I have visited,  I'm going to go out on a limb and say that well over half of the vaccine produced was never used because of distribution problems and growing public skepticism about the need, and yes, safety.

This is criminal, if you think about it - and not just because of the waste. Consider the fact that production of seasonal flu vaccine was halted to make way for H1N1 vaccine production - and MANY more people suffered and even died from seasonal flu than H1N1! It's impossible for me to imagine that some of these illnesses and deaths couldnt have been prevented if the seasonal flu vaccine was produced and distributed on schedule, instead of being delayed because of..well....again, don't get me started. 

And some want the government RUNNING just about every aspect of health-care, because? ? ? ? ? ? ? ? ? ? ? ? ? ?

This exactly why I don't want the Feds involved in my health-care/insurance/decisions.

[JerseyJen]

...and in the news this morning?
 
A mumps outbreak in Rockland County.


http://www.google.com/hostednews/canadianpress/article/ALeqM5jJASM2l2fTQhk-avl9SkFlGaskxw[/]


MONSEY, N.Y. — More than 300 people have been diagnosed with the mumps in suburban New York as America's largest outbreak of the disease in years spreads. Almost all the cases are among Orthodox Jews.

A health official says 303 people in the Rockland County towns of Monsey and New Square have been diagnosed with the highly infectious disease.


Investigators say the outbreak started in August 2009 at a Jewish summer camp in Sullivan County with an 11-year-old boy who brought the disease from England.


It has since spread to Jewish communities in Brooklyn, New Jersey and Orange County in upstate New York.
Mumps is spread by coughing and sneezing with the most common symptoms being fever, headache and swollen salivary glands under the jaw.

Getting away from the Autism link...

http://www.cnn.com/2010/HEALTH/02/08/mumps.outbreak.northeast/index.html

"He was completely vaccinated," Pirutinsky said. "So it was a surprise to us he came down with mumps."

Anyone fully vaccinated from mumps receives two doses of the vaccine, according to the CDC. Of the New Jersey cases, 77 percent were vaccinated, Terjesen said.

[BOB]

And some want the government RUNNING just about every aspect of health-care, because? ? ? ? ? ? ? ? ? ? ? ? ? ?

This exactly why I don't want the Feds involved in my health-care/insurance/decisions.

solution: move to Haiti where the Feds won't be able to touch you and you can get your healthcare on the open market - the way Jesus and Rush Limbraugh intended for you to to be able to. I will contribute $100 towards your ticket

[the Kook]

I will gladly accept the $100 and I swear that it will go towards a ticket.  BTW Rush Limbaugh has nothing what so ever to do with my feeling about this subject.  What has the Federal government ever run efficiently?  Please feel free to respond with a cogent discussion, otherwise use my $100 towards a ticket for yourself.