Splitting the 12 months vaccines?

[Mumchatting]

Hello, I'm looking for advise whether it's a good idea to split the 12 months vaccines? There is so many vaccines given all at once (as I understand 4 jabs at 1 appointment!) during the 12 months vaccination so I'm wondering if I split these over 2 appointments, would that be better? How did you split yours and how did you find it?
I'm really uncomfortable giving all 4 jabs at once. Has anyone tried to split it on NHS? What's your experience please?

I split them
We did Hib/Men C & PCV first
Then Men B & MMR

With my older kids the vax were at 12 mths and then 13 mths

Oh, Ok, I see. I guess that was much better when these jabs used to be at 12 and 13 months rather than all at once.

no medical reason to split - if you're comfortable taking up double the appointment times for no reason then go ahead. they are still officially 12 and 13 months but usually given together as much nicer for the child.

Is it not better to just get it over and done with? What's the benefit of splitting?

Why split?

Delaying any of them obviously delays being protected from the illnesses, and my belief is that this is more risky than having the vaccinations together and ASAP.

There's no need to split from a medical perspective. Their bodies are able to deal with all 4 at once.

From a personal point of view, I prefer to get it over and done with. It's never a pleasant experience for us or them so I feel it's better just to have it all in one hit. Mine was back to normal within 12 hours

Practice nurse here. No problem in giving four vaccines at once and certainly no benefit to the child in splitting. They have four vaccines at eight weeks after all. I've done it Separartely at parents insistence twice, and both times the parent said with hindsight they'd just got it over with in one go, as splitting had resulted in two unsettling episodes for all concerned rather than one.
Separating as a matter of course led to many DC being incompletely immunised - parents forget to complete, children become ill and postpone, people go on holidays, appointments are cancelled etc etc, all leading to increased risk.

www.gov.uk/government/publications/vaccinations-at-12-and-13-months-of-age

Here is the background to when they decided to combine them into one appointment

Dragging it out seems counter productive

I wouldn't out of choice but ended up having to delay the MMR (live) until DH had finished Chemo... took me and a trainee nurse to hold angry biting 1 year old while jabs went in - then we had to do it again not long after... so just getting her in the room was fun...

I used to think that splitting them could be a good idea, even for the combined shots. I changed my mind reading this (It's comprehensive but well written).

thescientificparent.org/vaccines-101-too-much-too-soon/

I also agree that minimizing the number of "traumatic events" for the little ones is an advantage. We went through a six months period of multiple immunisations recently before moving abroad. By the time DD was due for the last ones we had to be several persons to hold her safely still... She always had minimal reactions, if at all btw.

I am truly relieved her next one is in over 2 years time, at which point (5 1/2 years old) she should be able to keep still on her own...

Going against the grain a bit here, I’m in favour of spreading out vaccines.

I agree that there is no point in splitting the multivalent vaccines OldMummy, for the inactive ones anyway. That article misses the point though (at least as far as my concerns go) - it’s not multiple antigens in one go I object to, it’s multiple adjuvants from several simultaneous injections as these are what provoke the immune response (as that article actually acknowledges). If we could get them all over with in one injection with one adjuvant dose I’d be very happy! As it is though, my experience (backed up by data from the vaccine manufacturers) is that although spreading the injections out means more visits, there are hardly any side effects, sometimes none at all, vs fewer visits but high fevers and inconsolable crying for a couple of days. In that sense I definitely believe it’s kinder to spread them out - the number of jags is the same either way and a quick pin prick is quickly forgotten about, especially if there’s only one per visit.

That article is also somewhat misleading on aluminium for a UK audience: by their own standards the FDA recommends a maximum of 850-1250 micro grams of aluminium in one sitting for vaccines (although this calculation is itself a bit controversial and is a lot lower in other contexts). However, in the U.K. at 8 weeks we have Bexsero (which the US doesn’t have), and have recently changed from the 5 in 1 to the 6 in 1, which has 60% more aluminium than the 5 in 1. Tot this all up with Prevar13 and you get 1445 micro grams of aluminium at 8 weeks.

www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=610.15
www.medicines.org.uk/emc/product/5168/pil
www.medicines.org.uk/emc/product/453/pil
www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000296/WC500032505.pdf

Aluminium takes a long time to detox following intramuscular injection (months), and there is emerging evidence linking aluminium adjuvants to autoimmune disorders and neuropathies (see Pubmed for papers). This evidence is still pretty new, but I think more study is needed rather than the assumption that you can use as much as you want and it will be fine, which seems to be the approach of the authorities.

Don't disagree with any of the science. But in the long run, experience tells me that staggering would likely still result in far more incompletely immunised children. Our babies are already immunised later than ideal in some cases due to insufficient appointments/nurse availability, plus other reasons mentioned.

Those are problems CPtart and I don’t have all the answers. It seems likely that to achieve good coverage (and vaccine uptake is generally very high in the U.K.) in a ‘cost effective’ way we are putting babies at an increased risk of other problems down the line. The logistical argument is a bit short sighted though. The cost of extra clinics must surely be offset at least in part by a reduction in GP and hospital appointments if the side effects are less extreme. At the very least I think parents should be aware of other options, instead of being told that there is clear evidence that giving all the jags together is fine when there isn’t. Some are even under the impression that the jags come as a set and so they have to have them all or none - this in itself probably leads to missed doses if parents refuse any further vaccines after a bad experience with one (or more likely one set).

I wish the JCVI would consider these wider issues more strongly in their decision making too. I think they can be a bit too focussed on reducing levels of infectious disease (obviously an important aim) but miss the wider picture, especially beyond the short term.

Medicine is increasingly practiced in a 'cost effective' way though, rightly or wrongly. And what about the cost of treating DC who contract any of these illnesses due to incomplete immunisation? In twenty years of immunising I have very rarely come across parents who have actually abandoned completion deliberately due to side effects, although I'm sure it happens. Far far more commonly, regularly even, immunisations are missed due to parents 'forgetting', patients relocating, apathy, illness, appointment cancellation (staff shortages), etc. We barely have the GP's and nurses now to run safe clinics, let alone trying to put on extra. No easy answer as you say.

I agree with you cannot. I don’t believe our current vaccination schedule is sensible. Cost and convenience overtakes any discussions about any risks.

Not appreciating the ‘advice’ given here. Instead of being negative/abusive, try giving advice. Quite clearly this mum is concerned. My advice would be speak to your health visitor/doctor. I agree, our system of all-in-one vaccination is daunting if you don’t know the facts

"Not appreciating the ‘advice’ given here. Instead of being negative/abusive, try giving advice. Quite clearly this mum is concerned. My advice would be speak to your health visitor/doctor. I agree, our system of all-in-one vaccination is daunting if you don’t know the facts" Agree with all this, but note that the "health visitor/doctor" will be little more than a rehash of whatever the NHS policy is.