WWYD concerning four month vaccines and cruising

[globalwife]

Our baby girl is due for her next round of vaccines on Dec 21 (4 month vaccines). They won't do it earlier than that date. We plan to drive to port (11 hours away) on the 22nd and we board for a 7 night cruise on the 24th. We will spend a few extra days after the cruise along the coast and arrive back home around Jan. 3. So I am at a loss as to what to do. I'm scared to do her vaccines so close to leaving in case she has a bad reaction but at the same time the more she is vaccinated against by the time she boards, maybe the better??? WWYD- have her get her vaccines the day prior to departure (4 days prior to boarding) or wait till she is 4 and a half months for the next round after we get home? Of course I am going to ask her doctor but if he says it doesn't matter I am at a loss as to what to do.

[Keith1010]

Our baby girl is due for her next round of vaccines on Dec 21 (4 month vaccines). They won't do it earlier than that date. We plan to drive to port (11 hours away) on the 22nd and we board for a 7 night cruise on the 24th. We will spend a few extra days after the cruise along the coast and arrive back home around Jan. 3. So I am at a loss as to what to do. I'm scared to do her vaccines so close to leaving in case she has a bad reaction but at the same time the more she is vaccinated against by the time she boards, maybe the better??? WWYD- have her get her vaccines the day prior to departure (4 days prior to boarding) or wait till she is 4 and a half months for the next round after we get home? Of course I am going to ask her doctor but if he says it doesn't matter I am at a loss as to what to do.

 

You have the right approach and that is to consult with the doctor Do not rely on any recommendations from anyone else but the doctor.

 

Keith

[mikesteg]

I believe "WWYD" implies a request for an opinion.

 

I would delay based on:

(1) These are all booster shots on the CDC schedule (but verify if that is correct in your case)

(2) I'd be more worried about a reaction on day 2 or 3 when you're already at sea

(3) "4 months" is a convenient time to get a batch of vaccinations. There is nothing magic about the specific day. I suspect that you (and my wife :)) are in the minority that worry about getting vaccinations exactly on schedule.

 

I don't know much about Pullmantur: do they have a nursery that your child might be exposed to other, potentially unvaccinated, kids? Or will she be with you more or less 24x7?

 

Alternately, you may also want to ask why they will not give the vaccine a few days early. We ran into this with our 2Y Hep A booster, and my understanding is that some insurance companies will not pay for a booster given in advance of the date. If that's the case, you may be able to get an exception from the insurance company, or just pay cash. Not a great alternative, but perhaps the right answer for you personally.

[cruisincarly]

I believe "WWYD" implies a request for an opinion.

 

I would delay based on:

(1) These are all booster shots on the CDC schedule (but verify if that is correct in your case)

(2) I'd be more worried about a reaction on day 2 or 3 when you're already at sea

(3) "4 months" is a convenient time to get a batch of vaccinations. There is nothing magic about the specific day. I suspect that you (and my wife :)) are in the minority that worry about getting vaccinations exactly on schedule.

 

I don't know much about Pullmantur: do they have a nursery that your child might be exposed to other, potentially unvaccinated, kids? Or will she be with you more or less 24x7?

 

Alternately, you may also want to ask why they will not give the vaccine a few days early. We ran into this with our 2Y Hep A booster, and my understanding is that some insurance companies will not pay for a booster given in advance of the date. If that's the case, you may be able to get an exception from the insurance company, or just pay cash. Not a great alternative, but perhaps the right answer for you personally.

 

It could also be that an early vaccine won't "count" for school admissions and things. We ran into that with an MMR vaccine.

 

I'm with both of the previous posters: talk to your doctor, but also my suspicion is that he or she will say delay until after the cruise. Even if the child doesn't have a severe reaction, my son was always sluggish and grumpy for about 24 hours after his shots and I would not have wanted to travel with him!

[Mack2]

I would suggest consulting the pediatrician.

 

I agree with Mikesteg with his opinion that your child might get that post-injection temperature, but that's neither here nor there.

 

According to the CDC schedule:http://www.cdc.gov/vaccines/recs/schedules/downloads/child/0-6yrs-schedule-pr.pdf

This schedule includes recommendations in effect as of December 21, 2010. Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible.

 

You have to also remember that the recommendations are not static. For example, there's always the possibility that a child may be suffering from an infection on the scheduled day of a vaccine, in which case the pediatrician may opt to deliver the vaccine when the child is NOT sick. Such accommodations may be considered for the cruise vacation, but it's totally up to your pediatrician's recommendation.

 

There's always the risk that you come back from vacation, and the baby has a cold, that would delay the inoculations further.

 

Ask the doc.

 

edit: I'm a pharmacist, did the vaccine delivery training recently.

[Mom2B&Z]

I'm with both of the previous posters: talk to your doctor, but also my suspicion is that he or she will say delay until after the cruise. Even if the child doesn't have a severe reaction, my son was always sluggish and grumpy for about 24 hours after his shots and I would not have wanted to travel with him!

Another vote for talk to the doctor and follow your gut. You know your child best.

I would ask the doctor what effect (if any) doing the vaccines before you go would have on your daughter. I know other vaccines take several weeks before they are fully effective, so it may be a moot point.

[Woodmnky]

Talk with your doctor, but if the Dr saw no reason why to give them before I would wait until after. DS is a cranky monster for a day or two after his vaccines and I would not want to travel with him unless my Dr thought that it was better for him to get the shots before we left.

[cb at sea]

My kids both came down with fevers after vaccines....and once, my daughter actually came down with measles 3 days after her measles shot....go figure.

 

I'd wait until we were back, or do it a week ahead of the cruise.

[globalwife]

You all have made some great points that I hadn't thought about. This is exactly why I asked this question here. It gives me some things to discuss with her doctor. Thank you for sharing your thoughts on his one. If he leaves it up to me, I think we are going to wait till after the vacation.

[lrowe70]

Goodness, "4 month" doesn't mean exactly to the day. What if your child turns 4 months on a weekend? You'd do the shots later. Just get them done after the cruise. My kid had his 2 month shots done at 2 and a half months and won't get his 4 month until about 5 months. The reason for this is that his 4 month falls over the Christmas holiday and his doctor isn't even in town, nor do we want a cranky child at the holidays.

 

Almost all kids have a reaction of some sort to shots, it's to be expected. Do you really want to spend the first day of your trip tending to an uncomfortable child?

[kasil]

Where are you traveling? How many people, especially children, will be on the ship with you? Is there a chance of your child being exposed to whooping cough, polio or bacteria that cause blood and brain infections? I'd rather deal with a day or two of fussiness that a pain medication can help than the possiblilty of 6 to 8 weeks of coughing (whooping cough) and possible hospitalization or worse (all three). And don't forget rotavirus; nothing like changing 20 or more diapers in a day and dealing with a nasty diaper rash.

 

Definitely talk to your child's health care provider; most likely they won't give the vaccines any earlier because it's too close to the first set. While it does take time for the vaccines to cause immunity, the second dose of vaccines is not a booster dose - it is part of the primary series that is necessary to have full antibody production. The sooner your child gets them, the sooner they'll be fully protected.

 

Have a great vacation whatever you decide.

[Mack2]

Where are you traveling? How many people, especially children, will be on the ship with you? Is there a chance of your child being exposed to whooping cough, polio or bacteria that cause blood and brain infections? I'd rather deal with a day or two of fussiness that a pain medication can help than the possiblilty of 6 to 8 weeks of coughing (whooping cough) and possible hospitalization or worse (all three). And don't forget rotavirus; nothing like changing 20 or more diapers in a day and dealing with a nasty diaper rash.

 

Definitely talk to your child's health care provider; most likely they won't give the vaccines any earlier because it's too close to the first set. While it does take time for the vaccines to cause immunity, the second dose of vaccines is not a booster dose - it is part of the primary series that is necessary to have full antibody production. The sooner your child gets them, the sooner they'll be fully protected.

 

Have a great vacation whatever you decide.

 

 

Looks like the recommended vaccines @ 4 months are Rotavirus, Diptheria/Tetanus/Pertussis, H.Influenza (bacterial), Pneumococcal, and Polio.

 

http://www.cdc.gov/vaccines/recs/schedules/downloads/child/0-6yrs-schedule-pr.pdf

 

A few comments I can make about these vaccines is noted:

2. Rotavirus vaccine (RV). (Minimum age: 6 weeks)

• Administer the first dose at age 6 through 14 weeks (maximum age: 14

weeks 6 days). Vaccination should not be initiated for infants aged 15 weeks

0 days or older.

• The maximum age for the final dose in the series is 8 months 0 days

• If Rotarix is administered at ages 2 and 4 months, a dose at 6 months is

not indicated.

 

Secondly, the good thing about the Diptheria/Tetanus/Pertussis vaccine is that the CDC started recommending Tetanus/Pertussis boosters for routine vaccinations of adults.

 

This is because there HAS been an increase in cases of Whooping cough (Pertussis)

Td is a tetanus-diphtheria vaccine given to adolescents and adults as a booster shot every 10 years, or after an exposure to tetanus under some circumstances. Tdap is similar to Td but also containing protection against pertussis. Adolescents 11-18 years of age (preferably at age 11-12 years) and adults 19 through 64 years of age should receive a single dose of Tdap. For adults 65 and older who have close contact with an infant and have not previously received Tdap, one dose should be received. Tdap should also be given to 7-10 year olds who are not fully immunized against pertussis. Tdap can be given no matter when Td was last received. Updated Jan 2011

This was a decision made by the CDC recently to help combat whooping cough cases by trying to develop a "herd immunity" situation, where adults who are protected against Pertussis will be less likely to transmit it to children.

 

 

Lot's of interesting things about the CDC and vaccines I did not know about before the training... It really put the movie "Contagion" into perspective for me.