Late Vaccination - this thread is for all those who have vax late or for med professionals who know something about it....

[lisalisa]

For various reasons my dd3 aged 5 was unvaccinated. She then suffered a fall and had to have tetanus vax. As this was offered only with full dose of dip and polio vax she had the full first dose vax.

I would like to continue with the vax schedule for her and asked my GP to book the 2nd vax in line for her. I recall that babies are initially given the DTP in 3 stages so presumed the same would be necessary for dd.

My GP seemed to think one dose only would be sufficient for a 5 yr old but this doesn't make sense to me as:

1 If a small baby needs 3 doses why would a larger child need less?

2 Presumably the vax is given in 3 doses to build up immunity slowly but surely. My dd being given one dose ( which wasn't adjusted for her age - just straight out of the vax box) would then not have the full immunity>

Can anyone who has vax late please advise on what their child had late or any med professionals or others in the know please advise?>

thanks

bump

Not an expert but I was under the impression that babies had to be given 3 doses because the maternal antibodies can interfere with the baby's own immune response.

it takes a while for vaccinations to "take" in young babies, which is why it is important to have boosters, because the immunity provided by the initial vaccines wears off quite quickly. That's why they do them again at ~1yo; and why the MMR is done again at whatever pre-school age it is. In fact, there is some suggestion that the immunity from the MMR "runs out" before they hit teenage in some children, so there is a risk of teens getting mumps, not a good thing for boys.

In an older child, the vaccine is more likely to "take" first time, but will still need boosters after 5 years.

thumbwitch can you explain more about the vaccinations and why they take a while to "take" in babies. Who told you this? Do you have anymore info? Doesn't make any sense to me. I believe the reason the boosters were introduced was to catch all the children from which the previous vaccines had not created immunity - therefore they were unsucessful! Should be no reason why vaccinating at 5 yrs whould be any different. Maybe I'm wrong. Would love to know more

I'm confused by the suggestion that vaccines take time to take

they either work and your body produces antibodies or not

boosters are done because for some vax after 1 dose only 80% are immune (example figure)

This is from the DoH "Green Book" - immunisation book. I think she should have another 2 doses at 1 month intervals to complete her promary course.

Primary immunisation
Infants and children under ten years of age
The primary course of tetanus vaccination consists of three doses of a tetanuscontaining
vaccine with an interval of one month between each dose.
DTaP/IPV/Hib is recommended to be given at two, three and four months of
age but can be given at any stage from two months up to ten years of age. If
the primary course is interrupted it should be resumed but not repeated,
allowing an interval of one month between the remaining doses.

sorry, am not avoiding answering your qu but have not time to do it just now - will get back to you later tonight.

I think I wasn't clear enough when I said it takes time for the vaccine to "take" - what I meant was it doesn't usually "take" with the first inoculation, hence more than one is required with neonates, partly because any maternal antibodies might interfere with the vaccine's efficacy and partly because the immature immune system may not respond the first (or even second) time it is exposed to the antigen in the vaccine. It does depend on individuals - but the schedule is designed to catch nearly all children.

Another instance - I worked in hospital labs and we were given a triple course of Hep B vaccine (2nd one 1m after the first and 3rd one 3m after that) and then checked after another (I think) 3m for antibodies - quite a few people had no antibodies or less than safe levels so had to be boosted at that point.

I was told by my GP practice nurse about the "wearing off" aspect of the vaccines - I wasn't aware that different vaccines had different in vivo shelf-lives, as it were.

Your GP may not have been thinking straight - as a protection against the fall, one dose of the DTP would have been fine; but if you want to give your DD longterm immunity then she should have two more doses, at one month intervals. This would then give her sufficient protection for another 3-5 years (I would think 5 at her age; they suggest 3 for the gap between neonate jabs and the next one but then the immune system is less-well developed at the younger age - but best to check with someone who deals with this at your surgery and who is a bit more clued up than the GP you spoke to)

have a read of this info on tetanus jabs

hope I've clarified my initial post and helped a bit.

Thank you for all your helpful posts.

Thumbwitch - do you have any evidence for saying that dd needs 2 further doses in order to protect her? I can only find info onbabies and adults vax not young kids . As someone previously opposed to vax I am treading very nervously and carefully here and particularly do not want to give her too much vax by way of unnecessary doses. ( I did read your hlepful link on tetanus jabs btw but didn't mention late vax in kids - only adutls.)

it is an extrapolation from both sets of info - for longterm immunity she will need 3 jabs; a single jab will only work for a short period of time (I don't know how long, I would be guessing at about 6-12m). It is common to several vaccines, including (as I mentioned) the Hep B vaccine, the Hep A vaccine (in which a single jab gives immunity for 1 year, but with a booster you get 10 years immunity) and others.

Despite having a qualification in Immunology I don't actually understand how the timescales work - but someone has obviously done the research to work out the different vaccine schedules for each one.

Your DD will be safe from tetanus for a short while but if she should have another accident, they will have to jab her again to be on the safe side, if you choose not to have the set of 3 now.

HTH

Thanks - much appreciated.

Lots of the vaccines require more doses if given as a baby and less with older children. I postponed several jabs with the dcs so that they would only have to have one or two instead of three or four.

jabberwocky - your advice is different then to thumbwitch. Where did you find your info?

If you look here you will see that several have the phrase "No further doses needed if administered after x years of age"

or "?For children who received an all-IPV or all-oral poliovirus (OPV) series, a fourth dose is not necessary if the third dose was administered at age 4 years or older."

for example.

but as far as the DTP is concerned, you still need to have 3 at one month intervals, up to the age of 6 according to that link.

Oh was it only the DTaP she was asking about? I thought it was late vaxing in general starting with an experience with the tetanus that her dd got.

ooh I don't know now you've said that - I thought it was just the tetanus (DTP)!
that link was very useful either way though.

Well it was just the tetanus that was necessary following an accident dd had ( involving dirt and cut to the bone).

however , tetanus can only be administered ( so i was told) as part of DTP hence she had first dose DTP. So my question was whether she needed further doses or whether one was enough. Seems she needs further doses as she is 5 yrs according to the link?

I didn't realize they had stopped the single tetanus!

btw, if you can only get the DTP vs the DTaP I would think long and hard about getting more. Might be best to wait a bit until DTaP is available.