Talk to me about babies and the unvaccinated.

[Modified]

Of course, anyone with a persistent cough needs to have a medical evaluation. It could be anything from a chronic heart or lung condition to a few rare infections (still unlikely if the cough has really been going on that long).

Silent acid reflux is also a common cause.

 

[Skeptic Ginger]

Not necessarily, since the validity of Shaken-Baby Syndrome diagnoses is now being questioned.

Here's a NT Times article, starting at the bottom of page 2 for the "con" discussion.

You are confusing two different things. There is no question, shaking an infant violently causes brain damage.

Diagnosing that brain damage and convicting parents of child abuse is a separate issue.

 

[Skeptic Ginger]

He was given Tdap a couple of years ago, along with his annual influenza vaccine. He has a severe heart condition that merits extra precaution.

Glad to hear you were not opposed to him getting the Tdap. Sorry he has a heart problem. Glad there is modern scientific evidence based medicine to provide the best prognosis for him.

 

[Chris Haynes]

Glad to hear you were not opposed to him getting the Tdap. Sorry he has a heart problem. Glad there is modern scientific evidence based medicine to provide the best prognosis for him.

I kept asking. The first time it was only for those between twelve and eighteen, so my younger kids got it and not him. I didn't have to ask the next year when he went in for his annual flu shot, the doctor told me that the age level had been raised.

For years he has been on the catagory of folks who had first priority for the flu vaccine. So I would take him in October, and then get mine a month or two later after the high priority folks got theirs.

Last fall I was able to get his, daughter's and mine all at the same time. Insurance covered his and mine, but not daughter's (because she was sixteen?).

 

[Skeptic Ginger]

I kept asking. The first time it was only for those between twelve and eighteen, so my younger kids got it and not him. I didn't have to ask the next year when he went in for his annual flu shot, the doctor told me that the age level had been raised.

For years he has been on the catagory of folks who had first priority for the flu vaccine. So I would take him in October, and then get mine a month or two later after the high priority folks got theirs.

Last fall I was able to get his, daughter's and mine all at the same time. Insurance covered his and mine, but not daughter's (because she was sixteen?).

You could complain if you had the motivation to bother. Here's the CDC recommendation from last flu season:

CDC recommends that everyone 6 months of age and older get a seasonal flu vaccine. This includes all children aged 6 months up to their 19th birthday. Vaccination is especially important for children younger than 5 years of age and children of any age with a long-term health condition like asthma, diabetes and heart disease. These children are at higher risk of serious flu complications if they get the flu.

Some kids had higher priority, but there was no vaccine shortage last year.

 

[EHocking]

You are confusing two different things.

Not at all, upon further reading the actual cause is being questioned, not just the diagnosis.

There is no question, shaking an infant violently causes brain damage.

Actually, yes there is.

BIOMECHANICAL ANALYSIS HAS PROVEN THAT SHAKING ALONE IS NOT SUFFICIENT TO CAUSE BRAIN INJURY IN INFANTS.

Diagnosing that brain damage and convicting parents of child abuse is a separate issue.

Not only is the diagnosis being challenged, the existence of the syndrome is being challenged. As the link alludes, it is being questioned whether violently shaking a baby can actually cause the trauma being diagnosed as SBS.

 

[Skeptic Ginger]

Not at all, upon further reading the actual cause is being questioned, not just the diagnosis.Actually, yes there is.

BIOMECHANICAL ANALYSIS HAS PROVEN THAT SHAKING ALONE IS NOT SUFFICIENT TO CAUSE BRAIN INJURY IN INFANTS.Not only is the diagnosis being challenged, the existence of the syndrome is being challenged. As the link alludes, it is being questioned whether violently shaking a baby can actually cause the trauma being diagnosed as SBS.

This is so typical of some person or group fighting what they perceive as a legal or other injustice. One researcher challenges the medical science and anyone interested in said legal injustice, (usually because they can't believe a person they know hurt their infant, or they are trying to prove they themselves did not do it), latches on to the fringe opinion as if it disproves years of science.

First, I am not arguing all people accused of injuring their infants are guilty. There are documented cases where the legal system falsely convicted parents of abuse.

Second, I'm not arguing it is not possible for some established medical 'fact' to be wrong. In my own field the discovery of h-pylori not too long ago overturned long standing beliefs about the cause of gastric ulcers.

However, I am not impressed by a single researcher claiming some unique hypothesis or his particular research which is not presented as repeatable peer reviewed research is a reason to start claiming an established medical 'fact' has been refuted. And that a bunch of news reporters latch on to the claims is even less meaningful. This guy is likely getting paid as a very expensive defense witness in child abuse cases.

Look at "about" on that site. It's a web site with a cause.

Look at the "advocates" on the web site. It's a law firm which describes itself as: "Michigan Children’s Protective Services Defense Attorneys"


So, if you want to really show that shaken baby syndrome is a "wrong diagnosis" you need medical research from a peer reviewed publication, not some doctor for hire that claims to have evidence refuting an awful lot of valid science.

 

[samanthakayee]

I used to be an delay vaxxer till they are sent to school. My three kids made it till my husband was able to get me to remove my head from my butt. Hugs try not to stress yourself out to much. You can only really ever know if your kids have shots or not.
I never told anyone my kids was not up to date on shots. I did not want to have a debate and if you asked me if they have shots I say yep just to get the topic dropped.
My thing was not that I thought it would make my kid mentaly ill. I just got the mumps as a kid after getting some of my shots and wanted them to be older in case that happened to them also.

 

[Emet]

I used to be an delay vaxxer till they are sent to school. My three kids made it till my husband was able to get me to remove my head from my butt.

What technique did he use?

 

[samanthakayee]

What technique did he use?

LOL tons of KY.....

Really just showed me tons of info on the subject thats also how he got me to stop being LDS.

 

[AmandaM]

Okay, now I have a new but related question:

Doc's advice is to make sure all family members who will have contact with the newborn have the tdap booster.

Now Mother-In-Law explains that sister-in-law never had the whole pertussis vaccination series because she had such a "bad reaction" to it as an infant. So SIL will not get the tdap. MIL and FIL think the whole argument is silly, they don't NEED any vaccines, and that I'm being ridiculously over-paranoid.

I'm fuming over this, but still trying to figure out what "bad reaction" could have occurred, and why this would affect her ability to get the immunization NOW.

Again, I'm really trying to not be paranoid, but the hospital already has infant cases of pertussis. The hospital and my doc are taking this threat very seriously. This is starting to become an issue for me, because I think it's incredibly selfish of the family members to not take this threat into consideration. This is ONE specific disease that has already shown up in our community. I don't think I'm being unreasonable in asking that they take one simple step to help ensure a safe environment for the baby.

Thoughts? If I am being unreasonable, just tell me.

 

[Emet]

Okay, now I have a new but related question:

Doc's advice is to make sure all family members who will have contact with the newborn have the tdap booster.

Now Mother-In-Law explains that sister-in-law never had the whole pertussis vaccination series because she had such a "bad reaction" to it as an infant. So SIL will not get the tdap. MIL and FIL think the whole argument is silly, they don't NEED any vaccines, and that I'm being ridiculously over-paranoid.

I'm fuming over this, but still trying to figure out what "bad reaction" could have occurred, and why this would affect her ability to get the immunization NOW.

Please stop fuming.

How old is your SIL? People have very bad memories about their childhoods, and family lore gets lost in the translation and retelling.

Again, I'm really trying to not be paranoid, but the hospital already has infant cases of pertussis. The hospital and my doc are taking this threat very seriously. This is starting to become an issue for me, because I think it's incredibly selfish of the family members to not take this threat into consideration. This is ONE specific disease that has already shown up in our community. I don't think I'm being unreasonable in asking that they take one simple step to help ensure a safe environment for the baby.

Thoughts? If I am being unreasonable, just tell me.

Everything we do is risk/benefit. I personally would discuss the particulars of your SIL's case with your MD (her vaccine history, her potential as a carrier of pertussis to your newborn), and express your honest concerns and options. I don't expect he/she will tell you what to do per se, but with an additional exchange of info between your MD and yourself, you might be able to make a decision. (unless your MD already knows all of this, and you have discussed it--if so, please disregard my post )

What does the prospective father have to say about the issue?

FWIW, in another forum, this issue was discussed with slightly differing parties:

http://www.dcurbanmom.com/jforum/posts/list/125666.page

 

[Skeptic Ginger]

Okay, now I have a new but related question:

Doc's advice is to make sure all family members who will have contact with the newborn have the tdap booster.

Now Mother-In-Law explains that sister-in-law never had the whole pertussis vaccination series because she had such a "bad reaction" to it as an infant. So SIL will not get the tdap. MIL and FIL think the whole argument is silly, they don't NEED any vaccines, and that I'm being ridiculously over-paranoid.

I'm fuming over this, but still trying to figure out what "bad reaction" could have occurred, and why this would affect her ability to get the immunization NOW.

Again, I'm really trying to not be paranoid, but the hospital already has infant cases of pertussis. The hospital and my doc are taking this threat very seriously. This is starting to become an issue for me, because I think it's incredibly selfish of the family members to not take this threat into consideration. This is ONE specific disease that has already shown up in our community. I don't think I'm being unreasonable in asking that they take one simple step to help ensure a safe environment for the baby.

Thoughts? If I am being unreasonable, just tell me.

It's time for you to discuss this with your hubby if you have not already. It's his family, he needs to be involved lest the family relationship suffer.

What area are you in? Are there any local stats on pertussis cases that your in-laws can relate to a little more personally? The best way I have found to approach people who don't believe the medical recommendations I might make is to provide the CDC's or similar group's published materials. Have the recommendation come from the doctor, not from you. The Immunization Action Coalition provides a lot of reliable vaccine materials including handouts. Here's one on pertussis you can print if you have access to a printer.

Who should get this vaccine?
All people need protection against these three diseases—diphtheria, tetanus, and pertussis. Routine booster doses are also needed throughout life. Older children and adults without documentation of ever receiving the basic series of shots should receive a primary series of three doses, properly spaced. A single dose of Tdap is recommended for people ages 11 through 64 years in place of one of the Td doses, preferably the next one needed.

In October 2010, ACIP voted to recommend a onetime dose of Tdap for the following groups if they had not previously received a dose:
• Adults age 65 years and older who anticipate having close contact with an infant younger than age 12 months (e.g., grandparents, childcare providers, healthcare providers)
• Children ages 7 through 10 years who had not completed a full primary series of DTaP
They also recommended that other unvaccinated older adults (65 years or older) who did not anticipate having contact with an infant but wanted to be vaccinated with Tdap could be given a one-time dose.

It's possible your in-laws are due for their 10 yr tetanus boosters anyway.


As for Tdap in adults >65 yrs old, I wish people would realize recommendations change and if they are not in the loop to receive ACIP updates they should review current recommendations before offering advice:
Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine from the Advisory Committee on Immunization Practices, 2010

Guidance for use. ACIP recommends that adults aged 65 years and older (e.g., grandparents, child-care providers, and health-care practitioners) who have or who anticipate having close contact with an infant less than 12 months of age and who previously have not received Tdap should receive a single dose of Tdap to protect against pertussis and reduce the likelihood of transmission. For other adults aged 65 years and older, a single dose of Tdap vaccine may be given instead of Td vaccine, in persons who have not previously received Tdap. Tdap can be administered regardless of interval since the last tetanus- or diphtheria-toxoid containing vaccine. After receipt of Tdap, persons should continue to receive Td for routine booster immunization against tetanus and diphtheria, according to previously published guidelines (4). Either Tdap vaccine product may be used. Further recommendations on the use of both Tdap vaccines in adults aged 65 years and older will be forthcoming should one or more Tdap products be licensed for use in this age group.

For the SIL, Tdap is not contraindicated in most teens and adults who had reactions to their DPTs as young children. This came up in this thread already. See Chris Haynes' posts above. It's only if the person had a really serious reaction to a DPT like a coma or the entire leg became red and swollen (called an Arthrus reaction).

From the ACIP (remember the update supersedes these recommendations where applicable like on the age 65 and older)

2-A. Contraindications
• Tdap is contraindicated for persons with a history of serious allergic reaction (i.e., anaphylaxis) to any component of the vaccine. Because of the importance of tetanus vaccination, persons with a history of anaphylaxis to components included in any Tdap
or Td vaccines should be referred to an allergist to determine whether they have a specific allergy to tetanus toxoid and can safely receive tetanus toxoid (TT) vaccinations.
• Tdap is contraindicated for adults with a history of encephalopathy (e.g., coma or prolonged seizures) not attributable to an identifiable cause within 7 days of administration of a vaccine with pertussis components. This contraindication is for the pertussis components, and these persons should receive Td instead of Tdap

2-C. Not Contraindications or Precautions for Tdap
The following conditions are not contraindications or precautions for Tdap, and adults with these conditions may receive a dose of Tdap if otherwise indicated. The conditions in italics are precautions for pediatric DTP/DTaP but are not contraindications or precautions for Tdap vaccination in adults (1).
• Temperature >105°F (>40.5°C) within 48 hours after pediatric DTP/DTaP not attributable to another cause;
• Collapse or shock-like state (hypotonic hyporesponsive episode) within 48 hours after pediatric DTP/DTaP;
• Persistent crying lasting >3 hours, occurring within 48 hours after pediatric DTP/DTaP;
• Convulsions with or without fever, occurring within 3 days after pediatric DTP/DTaP;
• Stable neurologic disorder, including well-controlled seizures, a history of seizure disorder that has resolved, and cerebral palsy (See section, Safety Considerations for Adult Vaccination with Tdap);
• Brachial neuritis;
• Immunosuppression, including persons with human immunodeficiency virus (HIV). The immunogenicity of Tdap in persons with immunosuppression has not been studied and could be suboptimal;
• Breastfeeding;
• Intercurrent minor illness;
• Use of antimicrobials;
• History of an extensive limb swelling reaction following pediatric DTP/DTaP or Td that was not an Arthus hypersensitivity reaction (see Safety Considerations for Adult Vaccination with Td section for descriptions of ELS and Arthus reactions).

While there is a recommendation that adults who never had any tetanus vaccine get the 3 dose series with Tdap, there is no recommendation yet for adults who only had DT (and not DPT) to get more than one dose of Tdap.

 

[Skeptic Ginger]

Here's an example of stats from Colorado that show the ages people had documented cases.

States typically have public health department recommendations that are useful: Illinois Dept of Public Health "Health Beat"

Who is susceptible to contracting pertussis?

Despite the effectiveness of vaccination, pertussis continues to occur in the United States among all age groups. Anyone who has not had pertussis previously or who has not received the pertussis vaccine can get the disease. Immunity following disease or vaccination is not lifelong. Older children, adolescents and adults can become susceptible to pertussis five-to 10-years after their last dose of pertussis-containing vaccine. Older children and adults can carry the germ and spread it even though their cold-like symptoms may be so mild they might not seek medical care.

Since 2000, about a quarter of the cases reported have occurred in children younger than 1 year of age and this group has the highest rates for complications and death. Older children and adolescents have accounted for more than half the reported cases, and adults 20 years of age and older comprise the remaining 25 percent of reported cases.

It just makes it a little more real to people to see someone their age in their area got this infection.


Oh, BTW, Emet is right. Don't fume. Instead see these as solvable problems you just need to do more work on. Doing battle with resistent people is often best done more subtly.

 

[EHocking]

This is so typical of some person or group fighting what they perceive as a legal or other injustice. One researcher challenges the medical science and anyone interested in said legal injustice, (usually because they can't believe a person they know hurt their infant, or they are trying to prove they themselves did not do it), latches on to the fringe opinion as if it disproves years of science.

From the brief reading I have done, the years of science haven't actually tested the biomechanics of this since the initial research in the '70s(?).

And this is not a "single" researcher with a special interest as a professional expert witness.
Here are two more papers on the subject.

The shaken baby syndrome. A clinical, pathological, and biomechanical study.

... It was concluded that severe head injuries commonly diagnosed as shaking injuries require impact to occur and that shaking alone in an otherwise normal baby is unlikely to cause the shaken baby syndrome.

A response to the above 1987 paper, questions their conclusions and modelling;
Can shaking alone cause fatal brain injury? A biomechanical assessment of the Duhaime shaken baby syndrome model.

...There must now be sufficient doubt in the reliability of the Duhaime et al. (1987) biomechanical study to warrant the exclusion of such testimony in cases of suspected shaken baby syndrome.
​

Although, they are not that sure;

At this present stage the authors conclude that it cannot be categorically stated, from a biomechanical perspective, that pure shaking cannot cause fatal head injuries in an infant. Parameters identified in this study require further investigation to assess the accuracy of simulation and increase the biofidelity of the models before further conclusions can be drawn.
​

First, I am not arguing all people accused of injuring their infants are guilty. There are documented cases where the legal system falsely convicted parents of abuse.

Second, I'm not arguing it is not possible for some established medical 'fact' to be wrong. In my own field the discovery of h-pylori not too long ago overturned long standing beliefs about the cause of gastric ulcers.

However, I am not impressed by a single researcher claiming some unique hypothesis or his particular research which is not presented as repeatable peer reviewed research is a reason to start claiming an established medical 'fact' has been refuted. And that a bunch of news reporters latch on to the claims is even less meaningful.

Well, as I said, some disagree and this particular researcher is not alone in questioning the historical "common knowledge" on the subject.

This guy is likely getting paid as a very expensive defense witness in child abuse cases.

Talk about poisoning the well.
Are you saying, now, that because someone has appeared as a professional expert witness that their clinical expertise and research is invalid and their professional reputation should be questioned?
A pretty remarkable ad hom.

His CV doesn't indicate that any of his research is compromised.
But, as his interests are not noted in the particular report, I can't say that categorically.

Look at "about" on that site. It's a web site with a cause.

Look at the "advocates" on the web site. It's a law firm which describes itself as: "Michigan Children’s Protective Services Defense Attorneys"

Again, poisoning the well. There is no link that I can see between the author of that paper and the website that links to his webpage and paper.

Alternatively, you could look at his site and assess his peer-reviewed work, amongst them being;

Nelson A, Gross C & Lloyd JD. 1997. Preventing musculoskeletal injuries in nurses: directions for future research. SCI Nursing 14(2):45-51.

Nelson A, Tiesman T and Lloyd JD. 2000. Get a handle on safe patient transfer and activity. Journal of Nursing Management; 31(12): 47.


Baptiste, A., Tiesman, H., Nelson, A, & Lloyd JD. 2002. Technology to Reduce Nurses’ Back Injuries. Rehabilitation Nursing, 27 (2).

Smith LC, Weinel D, Doloresco L, Lloyd JD. 2002. A clinical evaluation of ceiling lifts: lifting and transfer technology for the future. SCI Nursing 19(2):75-7.

Nelson A, Owen B, Lloyd JD, Fragala G, Matz M, Amato M, Bowers J, Moss-Cureton S, Ramsey G, Lentz K. 2003. Safe Patient Handling and Movement. American Journal of Nursing. 103 (3): 32-43.

Nelson, A., Lloyd JD., Gross, C. & Menzel, N. (2003) Preventing Nursing Back Injuries. AAOHN Journal. 51 (3): 126-134.
​

Definitely someone with a financial agenda to his work. Everyone knows that nurses never hurt their backs and the monetary grants he has received to do the above studies obviously influences his conclusions.

So, if you want to really show that shaken baby syndrome is a "wrong diagnosis" you need medical research from a peer reviewed publication, not some doctor for hire that claims to have evidence refuting an awful lot of valid science.

See above.
All I pointed out is, that there is some dissention.

 

[Skeptic Ginger]

Shaken baby is off topic. Why don't you start a new thread?

 

[EHocking]

Shaken baby is off topic.

Not in the context of post/prenatal hospital procedures, which is how it came up.
i.e.,

Originally Posted by dirtywick
But now that I think about it I'm assuming it's probably not that way at every hospital.

We had to watch a video about shaken baby syndrome. For our second child, we had to sign a form saying we'd seen the video and remembered most of the important parts.

Why don't you start a new thread?

Because it is still on the topic regarding what is "standard" practice in hospitals.

 

[Skeptic Ginger]

Shaken babies has nothing to do with vaccinations or pertussis.

 

[EHocking]

Shaken babies has nothing to do with vaccinations or pertussis.

Perhaps you should have noted this point back at your post #47 instead of prolonging the OT discussion.

 

[Skeptic Ginger]

What's with your sour grapes, EH? All I said was start a new thread.