Staggering Vaccinations?

[Clearlymisunderstood]

What's the benefit of it? My DD will be having all of her vaccinations but I've heard of people staggering then so was just wondering why basically and whether that is something I should consider? Apologies if I sound ignorant but googling has made my brain hurt!

Halvorsen started by offering single vaccinations to his NHS patients as an alternative to the standard schedule because he felt it was the right to offer a choice. This was obviously at no cost to his patients.

I know some people he has advised not to vaccinate at all, and others he has advised the standard schedule to be fine for so I think to suggest his motivation is purely money is a little disingenuous.

As I have already said on here the private GP I approached asking whether he could obtain singles said he appreciated my concerns and could see why I wanted them but was worried that the political fall out would adversely affect his business (he was concerned about ending up at the GMC).

Personally I would rather my doctors were able to make medical - rather than political decisions. Especially given that the choice here is for something that may actually work better than the combined option (although studies on efficacy do vary) I have given a couple of potential - I think - sensible reasons above for a preference for single jabs. if the aim was for the highest possible vaccination coverage for each disease - then making it easy to obtain other combinations of vaccination - even if on a paid for basis. Nothing will persuade me to give a pertussis jab. Currently that means whether I want them or not ds2 and ds3 cannot have diphtheria tetanus polio or hib either.

I'm not sure what's quite so controversial about people being able to choose

That's the point though, that isn't comparing like with like. It is one of the reasons I find the new 'inhalable' vaccines interesting because they enter the body by a more natural route. (I think you were on that thread) I'm still reading about them and it will be interesting to see what comes from them.

I think most people would agree that the balance on MN is very much swayed towards 'pro-vax'.

I'm not sure either, saintly.

BFG, the singles were still available on the NHS when the Lancet published the Wakefield paper. It would not have been suggesting that there was a danger with the jab to keep it that way until further research had been done. (both options had been available for some time) IMO it was a silly time to decide to take people's options away when concerns had been raised about the MMR.

An immune system battling a live virus and an immune system fighting a dead or attenuated virus is the same. Antibodies are generated and stored for later. The only difference is virulence. The full on virus is likely to make you ill. The wonder of vaccines is they give the immune system a chance to produce antibodies without getting very ill.

The point of the inhalable vaccine is they are easier to administer. The problem with jabs, as we all know, is they are sore. In my wisdom at 14yo I chose not to be vaccinated (think it was the BCG?) because of the needle. They got me the following year though

I think, jimjams, I explained the reasoning behind combining vaccines. Coverage is always better. As soon as you split, people don't complete the course. Why don't you tell bm about how the conclusions of Cochrane report?

From the Babyjab website:

Consultation with Dr Richard Halvorsen £150 (for 30 minutes)
Telephone consultation £160 (for 30 minutes).

He can easily afford to advise people not to vaccinate with his time being worth 300 quid an hour!!!!!

When ds2 was a baby one option my GP offered was to split/give some and not the others. My GP is no longer able to offer that. I believe the old system was better.

Where would you suggest that people go if they want advise on alternatives? I went to my GP ten years ago. 5 years ago my GP told me he wasn't allowed to advise anything other than the standard schedule.

Vaccination coverage is a population issue. And that is the big issue that I have with vaccinations. I am interested at an individual level.

If you made both options available presumably most would opt for the standard schedule. Ten years ago nearly everyone did - but for those that were unhappy with that there was another option. I'm not suggesting everone switches to singles - just that they're available on a paid for basis for those who wish to have them.

Although granted may not be the fault of the NHS. In 2001 the dept of health told me they were happy to licence single vaccinations but the pharmaceutical companies had not requested a renewal of their expired licences. Maybe that's why they're not available on the NHS.

Buggering iPod won't scroll - yep halvorsen charges a lot - although presumably going rate for a central London private docs appointment & if his interest was purely money he would be jabbing everyone (and after ten years of looking up private doc prices I hardly shuddered) - yea would be much better if this could be discussed with regular GP's. At the moment it cannot.

Sorry I meant available on a paid for basis if necessary (although ideally not).

As I said earlier, have a look at the role the mucous membranes play in the immune response.

Bumbley - I can't look ATM but there's been some recent research published about gut bacteria and immune system interactions - you migh find it interesting in a general sense.

Thanks! PM me later if you find it. :)

I'm just reading about other alternative vaccines - oral and 'skin patches' they are apparently looking promising. Eliciting a better immune response (because they're closer to natural exposure) and using a smaller amount of the vaccine. I really do think we're going to see a move away from injectable vaccines. Our grandchildren will probably be saying - 'you used to do what?!' :)

Why the 'skin patch' vaccines are thought to be more effective:

"The skin, in contrast to the muscles, contains a rich network of antigen-presenting cells, which are immune signaling cells that are essential to initiating an immune response. The researchers found that microneedle skin immunization with inactivated influenza virus resulted in a local increase of cytokines important for recruitment of neutrophils, monocytes and dendritic cells at the site of immunization. All these cells play a role in activating a strong innate immune response against the virus."

I understand where I'm going astray. You, bm, said: I said they 'pretty much go directly in' in comparison to natural exposure via inhalation, ingestion etc - bypassing skin, mucus membranes, the GI tract - all of which can act as 'filters'. That is where membranes came in. In context, you said I think people have concerns about vaccines bypassing parts of the immune system... Saying 'babies come into contact with so many antigens on a daily basis' may not be that reassuring considering you aren't injecting all those antigens.. I got they idea you were saying viruses entering the body directly would lead to an overloading of the system.

Now you are saying the membranes stimulation make vaccines more effective. OK. I agree (but I still think the main motivation is ease of administration). I STILL can't understand why this is a concern. Membranes may well elicit a better immune response, but in no way would this mean people would chose not to vaccinate if jabs were their only option. Injecting into the body may be less effective, it's still not a reason to not vaccinate or to stagger jabs. So frankly I don't understand why membranes were brought up in the first place.

As jimjams is being reticent, the Cochrane report concluded that safety studies for the MMR were inadequate in most studies, but the 30 odd studies that were adequate and analysed for the report showed MMR to be safe.

Eh? Not being reticent at all, just cba to get into a discussion about the MMR again as it's not relevant to my argument on this topic. If you are arguing that the MMR doesn't trigger many autism cases then I agree with you. If you are suggesting it never does, then I would argue that question hasn't yet been properly examined (autism always treated as one thing blah blah blah - been done a million times before). But anyhow as I said I don't see it as particularly relevant to the removal of the option of single jabs.

WRT the MMR - I would probably at some stage like my children to have measles vaccination. I don't want them to have mumps or rubella vaccination. On the NHS the choice is all or none (so none then). Granted, it is relatively easy to pay to get a single jab and we are generally in a position to afford it. Also granted the lack of availability on the NHS may be due to pharmaceutical companies not requesting a licence rather than an official policy.

However, I would argue that having the option of singles for those that want them would be a better system. My wish for the children not to have a rubella or mumps jab but probably a measles jab has nothing to do with autism.

Yes, I have gone off on a bit of a tangent with these new vaccines. Sorry, for any confusion! I just find it interesting :)

It does actually highlight how other parts of the body are important in our body's immune response though. The new oral vaccines that are being developed also seem to be more effective because of the GI tract's involvement in immune response . Current injectable vaccines bypass these systems completely. That's why I have a problem with people saying things along the lines of 'babies come into contact with so many antigens everyday' well, yes but they are not all injected into them!

jimjams: I didn't bring the report up, bm misquoted it, as all posters from your side of the debate seem to do - odd that.

bm: I also find some of the research on evolution of virulence in viruses that jimjams posts interesting as well . But this is also completely irrelevant to this thread, isn't it?

bm: is your interest in more natural ways of getting vaccines into the body an admission that you don't like needles? Or perhaps you don't like vaccines because the aren't 'natural'? I frankly see no difference between inhalable vaccines and jabs. They still have additives. They are still priming the immune system. They still won't be proven 100% safe. They will still be administered en mass....

They're not misquoting. They're quoting the previous cochrane report into MMR.

The new one was published a few months ago.

HTH

They ARE misquoting the 2005 paper. The worry pointed out is there were many studies not included because of poor design. Cochrane rejects all but the very best research....and still finds MMR to be safe wrt autism, asthma, leukaemia, hay fever, type 1 diabetes, gait disturbance, Crohn's disease, demyelinating diseases, or bacterial or viral infections.

Plus, jimjams, you may be happy to pay a consultant or specialist 150 quid an appointment....but to say this is not too bad for a GP of all people. GPs are non-specialists!!!! To charge 150 quid for half an hour is outrageous. He can only justify these prices because he's handing over the goods he's touted in the press - the single jabs. Haven't I seen threads on here refering to shortfalls in supplies of mumps vaccines at Babyjab? So he 'advises' separate jabs and then can't come up with the goods. Were the patients informed during the 150 quid appointment that they might not receive all the jabs? How is this ethical? As I said...he's a crank.

This is a genuine question, jimjams. I've been thinking about what you said about staggering jabs. Your DS1 had some kind of immune reaction to a virus leading to autism. So, of course, you have concerns of similar immune problems with the other two. Hence you are cautious about vaccinating (correct me if I'm misremebering). I understand fully why you might decide not to vaccinate at all. I don't understand, however, the benefit of staggering as your DC are presumably not immunocompromised. If DC react to the first vaccine, then you wouldn't continue with the rest. If they react to the last vaccine, they have had all the previous ones. If they react to none, then great. Why not just have them all at once? Perhaps you intend one DC to have the course first, but if s/he reacts to the first, who's to say s/he would not have reacted to the next ones? I'm trying to understand the benefit of staggering.

But you think it's ethical to not make singles available so forcing people to choose between all or none? How is that ethical? I don't think Halvorsen can be blamed for lack of single mumps vaccine

His prices are in line with other private GP's offering this service (clinics with no advice ate cheaper). I agree it's hugely expensive - which is one reason why I think it's shocking that my NHS GP isn't even allowed to discuss alternatives to the standard schedule with me anymore. How is that medicine and not politics? Especially as my GP of ten years ago was allowed to advise.

The 2005 conclusions said that the safety studies were 'largely inadequate'. You can use that to argue that safety studies should have longer follow up periods etc (iirc that was one criticism) or you can argue that as nothing specific has been linked then it's fine. Depends how you want your safety studies run I guess :shrugs:

anyhow - ds1 at respite today so I have to work. And I have no wish to get bogged down in an argument about whether the sodding MMR is safe or not again.

My argument remains - people may have valid reasons to want to vaccinate singly, for the baby jabs this is currently very difficult, this to me seems very wrong. To not even be able to discuss it with a GP is shocking. The system of ten years ago was better (and 15 years ago even better). Get politics out of vaccination decisions and allow doctors some leeway to give medical advice in this area. If you disagree fine.

Can you give me a good reason to vaccinate separately? I'm trying hard to think of a good reason. I'm not exclusively thinking of the MMR - the 5-in-1 for example.

Not wanting perussis vaccination?

I don't want either ds3 or ds3 to have pertussis for various reasons (not least ds3's tendency towards seizures - not worth the risk for a jab that doesn't seem to be working particularly well against current strains - and so requiring future boosters. DS2 has had it, so don't want him to take the risk - however small - for a jab he doesn't need).

Can't get any of the others without pertussis. Not until age 10+ anyway.

And whether you think that is a good enough reason or not is irrelevant really. You don't know our family history, and you haven't lived with a severe regression, you're not in position to decide whether our reason is medically valid or not (and anyway - no-one currently knows - the research into regression is ongoing). My point is that not wanting pertussis vaccination makes it impossible to have any of the other on offer (at least on the NHS).

Can't you have the pneumococcus and hep b separately?

Your problems aren't my problems, as you say. I'm only interested as much as I'm interested as to why people want to stagger or split vaccines. I can only think of staggering in cases with immunocompetency. But splitting is a bit beyond me. Why on earth wouldn't you want the whooping cough vaccine? Have you seen the thread on chat today? Makes for pretty scary reading. After reading that, I'm terribly glad to have vaccinated my DS.

Whether you like it or not, I will reiterate, vaccinations schedules are frequently not completed when separate vaccinations are offered. This puts the lives of those very children at risk (I'm not refering to coverage or population issues). Perhaps this is why they are no longer available on the NHS?

Well hep b isn't given here and I don't particularly see a need for pneumonococcus in our case as my kids were out of the risk age by the time it was introduced. But yes if I wanted them to have those I suppose I could. I could give flu jabs as well but as they're not in the risk group so it's not something I'd choose.

I have plenty of reasons for not wanting pertussis vaccination. Is there any reason you would see as a good enough reason for not having pertussis? DS3 is in a higher risk group for damage from a pertussis vaccination and ds2 has had the disease. There are a bunch of other reasons as well. And before you go on about herd immunity even the hpa recognises the problem of waning pertussis immunity (further complicated by evolution of new strains that the aP is not effective against).

If your child happened to be vaccine damaged do you believe that would be a) recognised by the State and b) that they would be adequately cared for by the State?

Actually in more general terms:

ds1 it appears, may very well have an undiagnosed underlying immune dysfuntion. This is considered likely but cannot be tested His siblings may or may not share this. It is currently poorly understood. If they do have this their risk from vaccination may be increased compared to the average child. This is also poorly understood. If the risks from vaccination are potentially higher than typical it makes sense to assess the risk from each disease. This is not the same for every vaccination that is given together. I would prefer to choose which vaccinations were covering a specific risk and to avoid the ones that were unlikely to confer much benefit.

Again it just comes back to treating vaccination as an individual, rather than population intervention.