SortaCrunchy

More Information on the H1N1 Vaccine

Almost every day, I get emails from friends or readers who are wondering what to do about the H1N1 vaccine.  I'm finding that those who are generally pro-vaccine feel absolutely comfortable with receiving the vaccine and having their children vaccinated with it.  Those who are generally anti-vaccine are more likely pass on the vaccine.

Those like myself who take a more selective approach to vaccines are amongst the parents who are having the hardest time deliberating about what to do about this flu pandemic and the vaccines being made available.

Shortly after I shared my post on 5 Things Parents Should Know About the H1N1 Vaccination, a friend of mine in the field working in immune systems and vaccines wrote me with some follow-up information.  He gave me permission to share this with you here:

1. Fear of the H1N1 vaccine over the seasonal vaccine is really unfounded.  The companies making the H1N1 inactivated vaccines (injectables) are not changing their formulations in anyway except changing the specific flu virions (a virion is just all the virus components which mostly contain the flu proteins but also their genetic material and structural components and are prepared from dead virus). 

This is why these companies are the ones making the swine flu vaccine as they already have seasonal flu vaccines from which they are building.  Other than the viral strain change, the basic formulations are exactly the same between the two.  So if you are one to get a yearly flu vaccine and have no problems then this will be no different. 

The perception that the H1N1 is "NEW" and has not been tested enough is also unfounded.  Why? Well for one, the seasonal flu vaccines are also new every year in the same manner.  This is why we have to get new ones every year.  The flu changes year to year, and the vaccine companies just change the new flu vaccines to contain the trivalent virions that represent that year's strains (or in the case of the H1N1, its monovalent or only one strain).  The proteins and other virus particles (mostly proteins) elicit an immune responses against the proteins that induce the immune system to remember the proteins (so called immune memory-one of the most fascinating parts of biology).  In this case, when the real flu rears its ugly head, then your body should have memory towards its particular proteins and the resulting hyper-activation of the immune system will clear infection in enough time that the flu does not have time to create a severe infection.  Forgive me, this is a general vaccinology lesson which I am sure you know.

Thus the take home is that if you get a seasonal flu shot, don't be scared by the swine vaccine shot.  If you have not had any reactivity or seen any side effects from a seasonal flu shot, then you won't see them here.  The same flu vaccine precautions should be noted here.  Flu virions are prepared in chicken eggs so please note this if have allergies to chicken products.

The inactivated vaccines do contain some preservatives such as Thimerosal (the nasal vaccines-mists-do not).  Adjuvants (which are particular agents that boost the immune system and sometimes make up the other parts of the formulation of a vaccine) to my knowledge are not used in flu vaccines in the US.  All these other components in the vaccine are the agents that have caused concerns over the years.  But again, the same agents that have been in all flu vaccines and have been used for several years now are no different in the swine vaccine thus, the notion that these have not been tested is not true.  However, you are correct to note (or as the vaccine information notes) that there still are tests being performed.  Reports have found that there have been no serious side effects to fetus from a mother receiving the inactivated flu shot.

The only other legitimate concern here with a vaccine would be possible autoimmunity induction.  BUT THIS IS A VERY RARE CHANCE in  flu vaccines and the same very rare chance can also occur if you are infected with flu itself.

2. Indeed a point of consideration would be which vaccine to get.  The mist is not inactivated virions, but attenuated (weakened) flu viruses, weakened to not cause disease but still alive.  It actually stimulates the immune system in a much more natural way and may confer a high protection rate, but since it is live virus that has been weakened, it can cause (in some people) a mild flu sickness and it can be shed.  But to my knowledge, pregnant woman and infants will not qualify for this vaccine and thus will only be given the injectable version as a functioning immune system is required; pregnant women and infants are more immunocompromised.

3.  Pregnant women are indeed a risk group for swine flu, and there are solid explanations to why this is.  The studies done (and reported in the Lancet, one of the top leading medical journals in our country) showed the statistics of a pregnant group infected with H1N1 (that was identified as H1N1), and indeed they have a higher incidence of serious disease and even death than the general population.  Now it's not a reason to get hysterical if you are pregnant, but it is something serious to consider.  The CDC doesn't indicate risk groups without serious study, and pregnant women top that list for swine flu.

4.  BOTTOM LINE:  BE EXTRA VIGILANT ABOUT YOUR SYMPTOMS AND YOUR HEALTH.  Moms, kids, dads, husbands, the guy that delivers pizzas, whoever you are.  If you feel different in any way, get to the doctor, and remove yourself.  Most of the time, anti-virals will work and will keep you from disease, but they only work in the first few hours of infection.  Four  days later and a fever of 103, and they wont do anything.    Don't abandon good hygiene (all those rules your mom taught you).  Wash your hands (warm water-soap-2mins-sing happy birthday twice), cover your mouth when you cough or sneeze (and cover it when someone is not doing so around you).  You know what to do, just be extra aware.

The swine flu is spreading like wildfire.  The docs don't even need to type it now as its become pandemic.  Its the only bug spreading so rapidly RIGHT NOW.  SO just be aware.  As always and in all things, keep an open dialogue and establish a great relationship with your doctors, your ob/gyns, your pediatricians, and consult them on the specific details of your health.  They of course are well-trained, but have also been well-versed in this flu pandemic and are intimately aware of which course of treatment is best for you, knowing your health the way they do.

So there's the perspective of someone working daily in this field.

I know the biggest concern for many families is what to do about the H1N1 if you are pregnant or have an infant at home.  I know if I were pregnant right now, I would feel very unsure of what to do.  On the one hand, it is risky to take chance catching it as it could be very serious, even fatal.  On the other hand, we know there are no established trials on the safety of these vaccines for unborn babies. 

On his most recent entry on The Vaccine Book blog, Dr. Bob Sears addresses this very legitimate concern:

What about pregnant and/or nursing mothers?

This is a little scary. The flu shots are ALREADY recommended for pregnant and nursing moms, BUT (and this is a really huge but) the vaccine product inserts make it very clear that the regular flu vaccines have never been tested on pregnant or nursing women to determine if there is any harm to fetuses or young babies (with one exception – the ­­­­Flumist nasal spray brand did have some testing in this area, BUT not enough, as is stated in the product insert).

Despite this complete lack of research, it is recommended for these moms anyway. Anyone see a problem with that?

If you do get a flu shot, at least make sure it is mercury-free (or at least only TRACE mercury).

Dr. Sears has received a lot of heat over his cautious stance for pregnant women, but he maintains his belief that pregnant women should not receive this vaccine (or any flu vaccine) unless, as the vaccine manufacturers suggest, it's clearly needed.  

To provide a little balance for those who generally do not vaccinate, here is the Mothering Magazine page of resources for the swine flu.

Many have asked what we are doing about the H1N1 vaccine, and I have been a little hesitant to answer because I so strongly, strongly believe each family (each individual, really) must decide what is best based on their own unique set of circumstances.  I do have to say that I really believe that we have already had swine flu.  Shortly after school started in August, H1N1 began going around in our community, and we had several verified cases within our church.  Dacey, Kyle, and I all got very sick with a list of symptoms that read like checklist for H1N1.  AJ had a touch of it, but nothing too bad.

Because of this and because we don't do the seasonal flu vaccine, we personally are opting not to get the H1N1 vaccine.  We have no pregnant mamas, no infants, no people with asthma, and no elderly people in our home.  So that is what we feel comfortable choosing for our family.  For now.

photo by NathanF

5 Things Parents Should Know About the H1N1 Vaccination

photo by stevendepolo

Tuesday morning, our local news aired a brief segment on the release of the H1N1 vaccine.  They quickly noted who should get the vaccine and who should not.  All-in-all, less than 30 seconds were taken to explain this week's release of the H1N1 vaccination.  I wanted to know more, and so I started to dig around. 

Here are 5 facts I discovered that I want to share with you:

1) The FluMist version of the H1N1 vaccine is what is known as a Live Attenuated Influenza Vaccine.  This means that it is made with live, weakened viruses.  Because of this, the FluMist version of the H1N1 and the seasonal flu vaccine is not recommended for:

• People less than 2 years of age
• People 50 years of age and over
• People with a medical condition that places them at high risk for complications from influenza, including those with chronic heart or lung disease, such as asthma or reactive airways disease; people with medical conditions such as diabetes or kidney failure; or people with illnesses that weaken the immune system, or who take medications that can weaken the immune system.
• Children less than 5 years old with a history of recurrent wheezing
• Children or adolescents receiving aspirin
• People with a history of Guillain–Barré Syndrome that occurred after receiving influenza vaccine
• Pregnant women
• People who have a severe allergy to chicken eggs or who are allergic to any of the nasal spray vaccine components.

(Source: CDC)

2. Because the FluMist version of the H1N1 and seasonal flu vaccination contains the live virus, it is possible for the virus to "shed" from the vaccinated person to those he encounters.  Please note this from the CDC (which speaks to general flu vaccinations, not just the H1N1 vaccination):

Because LAIV contains live influenza viruses, a potential exists for transmission of these viruses from vaccinees to other persons. Vaccinated immunocompetent children can shed vaccine viruses for <3 weeks (6). One unpublished study in a child care center setting assessed transmissibility of vaccine viruses from 98 vaccinated to 99 unvaccinated subjects, all aged 8--36 months. Eighty percent of vaccine recipients shed >1 virus strain, with a mean of 7.6 days duration (17). One influenza type B isolate was recovered from a placebo recipient and was confirmed to be vaccine-type virus. The estimated probability of acquiring vaccine virus after close contact with a single LAIV recipient was 0.58%--2.4%. The type B isolate retained the cold-adapted, temperature-sensitive, attenuated phenotype, and it possessed the same genetic sequence as a virus shed from a vaccine recipient in the same children's play group.

Should you choose the FluMist version of any flu vaccine, you may want to exercise care in thinking about whom you will come in contact with in the days (and possibly weeks?) following vaccination.

3. Speaking of shedding, it's important to remember that everyone infected with any kind of virus will shed that virus for 24 hours after fever subsides, but possibly longer.  There is some evidence that the H1N1 virus may shed longer than other influenza viruses:

A similar study of 70 patients by a team headed by Dr. David Chien Lye, of Tan Tock Seng Hospital in Singapore, showed that 80 percent were shedding virus after five days, 40 percent after seven days and 10 percent after 10 days. Both researchers agree that more study is needed to determine the period of time the disease can actually be transmitted, but that patients shouldn't rush to return to work or school.

Source: News-Medical.Net

4.  Because pregnant and nursing mothers and children under two are not supposed to receive the FluMist version of the H1N1 vaccine, some health care providers are encouraging these groups to get the injected vaccine.  Please note this information from the vaccine manufacturer's (Novartis) insert:

8.1 Pregnancy

Pregnancy Category C: Animal reproduction studies have not been conducted with Influenza A (H1N1) 2009 Monovalent Vaccine or FLUVIRIN. It is also not known whether Influenza A (H1N1) 2009 Monovalent Vaccine or FLUVIRIN can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Influenza A (H1N1) 2009 Monovalent Vaccine should be given to a pregnant woman only if clearly needed.

8.3 Nursing Mothers

It is not known whether FLUVIRIN or Influenza A (H1N1) 2009 Monovalent Vaccine is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Influenza A (H1N1) 2009 Monovalent Vaccine is administered to a nursing woman.

8.4 Pediatric Use
Safety and effectiveness in pediatric subjects below the age of 4 years have not been established. [see ADVERSE REACTIONS (6) and CLINICAL STUDIES (14)]

Essentially, the vaccine is safe for pregnant women, but it is unclear what effects it might have on the unborn baby.  It is also unclear what effect it will have on children under four.

This clearly creates quite a predicament for pregnant women.  There are some reports that H1N1 is more dangerous for pregnant women than the seasonal flu; however, in my county and in areas across the nation, health care providers are no longer screening for H1N1.  It seems to me, then, that this belief that pregnant women are more likely to die from H1N1 may not be entirely accurate because there is no longer an accurate number being reported on how many pregnant women are actually coming down with H1N1.

Again, I would just encourage women to exercise caution.

5. Finally, it is important to note that multi-dose vials of the injected H1N1 vaccine do contain thimerosal.  Thimerosal is a mercury-containing compound used as a preservative in some vaccinations.  I am not about to engage in the thimerosal-autism debate, and I actually don't want to address whether or not thimerosal is actually toxic in the amount it is found in vaccines.  What I do want to do is make you aware that of the nine different H1N1 vaccines (both injected and nasal mist) approved by the FDA, four do contain thimerosal:

• Novartis's single-dose syringe contains a trace of mercury
• Novartis's 10 dose bottle contains 25 mcg of mercury per dose
• CSL's 10 dose bottle contains 24.5 mcg of mercury per dose
• Sanofi Pasteur's 10 full-dose bottle or 20 1/2 dose bottles contain 25 mcg per dose
  

For a complete list of the nine vaccines and a breakdown of their ingredients, please see this article H1N1 Vaccines Approved: What's In It For You? at the AFA blog.

I hope this provides some helpful information for you in making a decision about whether or not to get the H1N1 vaccine.  Each family and individual must weigh the risks of the vaccine against the risks of this strain of influenza.  I have said before and I'll continue to say the only bad vaccination decision is an uninformed vaccination decision.

"No Shots, No School!" - Not True! (On Vaccine Exemptions)

As Aliza Joy fast approaches two, I've been working on correcting and updating our delayed vaccination schedule.  I have to admit that as I have re-read Dr. Sears' The Vaccine Book and found new media stories and articles on the topic of vaccination, I've been getting a little worked up on the topic again.

As children across the country head back to school, many states are launching campaigns to remind parents, "No Shots, No School!"  That statement is simply not true.

Every single state offers an exemption policy for vaccinations.  In West Virginia and Mississippi, vaccinations can only be exempted for medical reasons; in the other 48 states, parents may obtain forms for vaccination exemptions due to medical, religious and/or philosophical reasons.

I want to share with you the most current, up-to-date, and easy to navigate source that I have discovered on vaccination exemptions in the U.S. - the National Vaccination Information Center (NVIC) has compiled a map which details state vaccine requirements.  Using this map, parents can quickly see which exemptions are allowed in their state.  Clicking on the state will provide links to further resources applicable to each state.  For years, state vaccine requirement information has been scattered and difficult to navigate.  I am so grateful the NVIC has created a resource for parents and care givers that is clear and concise.  

Parents who are choosing exemptions may also wish to read through Dr. Merola's article "How To Legally Avoid Unwanted Immunizations of All Kinds." 

Remember that the underlying public health philosophy on vaccinations is based on herd immunity.  From the viewpoint of schools and public health officials, it makes sense for each child to be fully immunized.  But parents must also remember that full, on-schedule vaccination is not necessarily the best choice for your child, for your family, for your religious views, for your beliefs.  Neither the CDC nor the AAP nor the State Department of Education holds the responsibility of making the best possible choices for your child - that responsibility belongs solely to each parent. 

Don't be bullied into believing otherwise.

photo by ZaldyImg

The Confessional: My Well Babies

When I first started cloth diapering, I immersed myself into the world of cloth diapering "hobbyist" message boards.  (Yes, such a thing exists.  We can talk more about it privately if you like.)  It wasn't long before I encountered some truly crunchy mamas whose approach to living looked far different from anything I had ever been exposed to.  I can remember the first time I read a post from a mama who chose not to vaccinate her children, and who, in fact, didn't take them in to see the doctor for scheduled well visits at all.

Hmph!  I remember thinking.  Well that's irresponsible.

I dutifully took Dacey in for each visit on the schedule and she received all of her immunizations at the prescribed time.

When I was pregnant with AJ, my best friend Kim and I started exploring the idea of delaying and selectively vaccinating.  As you know, I carefully created a schedule that I felt more comfortable with and stuck to it. 

And then we moved.

Today's confession:  AJ hasn't been in for a well visit (nor received a vaccination) since she was six months old.  One year ago this month.  I've become the mom that makes pediatricians not want to work with parents on vaccine schedules.  I made a schedule, and I have not followed through.

The thing is that the girls are just so well.  Healthy, I guess.  We did have to take AJ in to see someone last fall when a mystery virus caused her to run a high fever for days, but other than that - nothing.  Dacey starts pre-K in the fall (I like to phrase it that way because I have a hard time saying "She starts pre-K in five months" without choking back sobs), and she needs to complete her immunization schedule.  I just get overwhelmed thinking about reworking AJ's schedule.  I know I need to.  Anyone wanna hold my feet to the fire until I get it done?

Photo courtesy of Lee Nachtigal

Comments closed during Lent 09

A Word of Caution on Getting "Caught Up" on Vaccines

I find I am constantly humbled by the emails from parents who take the time to share their questions and experiences with vaccines with me. Obviously, I am far from being an expert of any kind of anything. I'm just a mom who feels passionately about vaccine information and choices.

Several times in the past month, I've heard from readers on the topic of getting their little ones "caught up" on their vaccine schedules. Upon discovering patients who are behind on their vaccination schedules, pediatricians will sometimes encourage parents to consent to getting their children caught up to the mandated schedule, even if that means a child receiving a large number of vaccines all in one office visit.

I want to emphasize that unless you have some extenuating circumstances (for example, an impending trip out of the country), there is probably no need for your child to get "caught up" all at once.

A reader emailed me her experience last week, and she has given me permission to share part of her family's story here:

I too am barefoot all the time. I was born in a lookout tower for firefighters, just my mom, dad and a friend were there to help. I was blessed to grow up and be a healthy woman. Somehow, I was fooled.

I vaccinated our first son, and he is completely fine. But our second son fell behind on his shots. He was given 7 at once to make up for this. The date was 12-21-05. On the way home from the doctor he became very sick. Within a few hours he had stopped breathing and was on a helicopter bound for children's hospital in Portland Oregon. He was sick for about a week and they let us go home. We noticed at the hospital that "C" was not speaking. After going from a fairly chatty one year old, he had become withdrawn.

I know that you know what I am going to say next. Yes. Six months later we were told that "C" was severely autistic. As I look back now, I realize that everything I was raised to believe by my parent hadn't saved my son. He spins, pokes his eyes until they are black and blue, he is bald in spots from pulling his hair out, he can't run, he can walk but with assistance, he is non-verbal, he hasn't smiled in 2 and a half years. My son is gone. In reality, I go through the motions, we make it through everyday with schedules, and appointments, kisses he doesn't want, and hugs he hates. But when the night comes, that is when the hard stuff happens. I watch him sleep and he looks normal, I see him smile in his sleep, and I wish I knew if he was dreaming of me. I cry, my husband and I hold each other and we wonder how we let this happen . . .

It may well be that there are some babies and toddlers who receive many vaccines in one office visit and their bodies are able to handle it. But experiences like this mother's compel me to encourage parents to allow no more than two vaccination doses to be administered in the span of one month's time. Your pediatrician/health care provider may cite CDC warnings like this one indicating your baby/toddler will be at risk as long as he/she is behind on the schedule. They are advocating what they sincerely believe to be a safe approach to your child's wellness and public health in general. Just remember you alone are able to advocate for your child's health and well-being!

Again, I must make it clear I am far from being a medical professional or expert of any kind. This is my opinion only, but I hope you will receive the word of caution in this mother's story.

(In a SortaCrunchy first, I am closing comments on this post. It is not my intention to debate the connection between vaccines and autism. Additionally, I feel a strong desire to protect this reader who was courageous in sharing her family's story and not open her up to any unnecessary and painful criticisms. Thanks for understanding!)

Soapbox Alert: On approaches to vaccinations

Last Friday, the New York Times published a little one page article titled "Public Health Risk Seen as Parents Reject Vaccines."  I read the article and wasn't really surprised by the way Ms. Steinhauer reported on this hot-button topic.  Typical mainstream coverage of those who are making alternative vaccine choices . . . implying that we "skeptics" are sending your babies to the hospitals with measles and selfishly taking advantage of personal-belief exemptions to protect our own children from the dangers of immunizations.  You know, just the usual mainstream party line.  Whatever. 

What I found much more disturbing than the article are the comments.  Those who choose not to vaccinate their children are accused of everything from being  hysterical kooks who base their parenting decisions on something they read on the internet (at best) to, far more frighteningly, child-abusing murderers whose children should be taken away from them.  These comments are quite chilling.

I learned a long time ago it's better not to make a habit of being defensive of parenting decisions.  In the realm of vaccine discussion and debate, however, I think it behooves those of us who make alternative decisions to prepare ourselves with the best research we can find just in case this backlash against non-vaccinators triggers an outcry towards revoking exemptions or, worse yet, a demand for forced vaccinations that reaches Orwellian proportions.

The thing is,  some of us have something far more telling than medical literature causing us to give great thought to vaccine choices.  In 1985, my youngest sister received the MMR shot at 15 months of age.  A week later, a series of grand mal seizures began that forever changed the course of my sister's life.  Although she eventually outgrew the epilepsy, she will forever be affected by Asperger Syndrome.  Acting on her behalf, my parents took part in a class-action lawsuit involving the National Childhood Vaccine Injury Act.  The federal government settled the claim out of court.  My sister (now nearly twenty-five) has a healthy trust operating on her behalf funded by that settlement.

What I find ironic is that many of those comments accuse those who make alternative vaccine choices as being uneducated on public health issues or of basing their parenting choices on a Google search.  In reality, most everyone I know (both online and offline) who has made choices that stray from the CDC mandated schedule are parents who have invested a great deal of time into research and reading real, documented, not magical, not made-up, published studies and perspectives.  I would go so far as to say that the average non-vax'ing-parent or delayed/selective-vax'ing parent knows more about the vaccine debate than the average vax-on-schedule parent.  And I say that speaking from my own experience with D.  I did absolutely zero reading or research on vaccine information with her.  It wasn't until she was nearly two years old that I began to do any research into the topic.  If it weren't for my unique family history, I cannot say that I would have ever given the subject a second thought.

Although I don't talk about it as often as I should, vaccine information advocacy is one of the topics I feel most strongly about.  If nothing else, I just desperately want every parent to know that just because the CDC and Big Pharm have a herd immunity plan in place doesn't mean you have to do what they tell you to do. 

And there's a sorta happy medium to be discovered in delayed vaccination scheduling. 

(Dare I ask?) 

Thoughts?

   

Our Delayed Vaccination Schedule

IMPORTANT UPDATE AS OF APRIL 20th, 2008

This month, I finally purchased Dr. Bob Sears' The Vaccine Book: Making the Right Decision for Your Child. I can say with absolute confidence this is a book every parent should have in their library. It is decidedly pro-vaccine, so if you tend to lean towards not vaccinating, it may cause you some concern. But if even you are not vaccinating your children, this book may give you some insights into the decision-making process of parents who do vaccinate. If you tend to lean towards vaccinating but have concerns over the CDC schedule and/or vaccine ingredients, I believe you will find this book to be immensely helpful.

Having said that, I am updating our original selective/delayed vaccine schedule below based on what I now know having read The Vaccine Book. For example, I did not realize that now (2008) all the major vaccines are now mercury-free. (There is still trace amounts of mercury in some brands of the flu shot.) Therefore, I have removed the "mercury-free" label that I had put in front of each of vaccine names. Additionally, I am switching the order of the measles and mumps vaccines. Originally, I had measles at 15 months and mumps at 39 months. Now, I will do mumps at 15 months and measles at 39 months. I still feel comfortable with delaying the Prevnar (Pc) vaccine, but please bear in mind that my babies are exclusively breastfed and not in group daycare situations. Dr. Sears feels that young babies should be receiving this vaccine, so please remember that your circumstances may warrant this one earlier than I have it scheduled.

I have received so many emails and comments from parents who are trying to make this hugely important decision for their children. I appreciate each email and comment and try to respond quickly and accurately as often as possible. I want to stress that this schedule is one that is best for our family, for my child. Every family has a unique set of circumstances that are made up of your family's medical history, your geographic location, and your access to doctors (and evidently, insurance coverages) that are open to alternate approaches to vaccines. All of that is to say that while my schedule may be a good starting point for you in creating your own schedule, please know that it is by no means a definitive selective/delayed schedule. You alone can make the best choice for your child.

************************************************************************************ 

This morning, I took AJ in for a well-baby check, and it reminded me that this might be a good time to share the delayed vaccination schedule we have come up with for her. This schedule is based on Dr. Stephanie Cave's What Your Doctor May Not Tell You About Children's Vaccinations (shout out to my friend KM for passing this on to me!!).

Here is our schedule:

Hep B
Delay until the year before starting school, although we may consider starting the series as early as two and half if we are considering preschool at the time.

Hib
4 mo, 6 mo, 8 mo, 17 mo

IPV
4 mo, 6 mo, 8 mo, 17 mo (booster at 4 years)

DtaP
5 mo, 7 mo, 9 mo, 15 or 18 mo (booster at 4 years)

Pneumococcal (PREVNAR)one dose at age 2

Varicela (Varivax)
Age four, if at all

MMR
Mumps – 15 mo
Rubella – 27 mo
Measles – 39 mo
Booster – age 5

Now, some physicians will tell you that you cannot get the MMR separated. This was a huge area of concern for me as my youngest sister had a reaction to the MMR vaccine that resulted in her having both epilepsy (now outgrown) and Asperger Syndrome. I did just a little digging in the Delayed Vaccinations forum at MDC, and found this information:

Dr. Stephanie Cave is an advocate for children being immunized with three separate doses instead of the MMR combined. Reportedly, she asked for American Medicine (wholesale pharmaceutical company) to carry these immunizations. The owners of American Medicine are Mark and Bridgette Schexnayder who are also pharmacists.

The pharmaceutical company of these three separate immunizations is Merck.

American Medicine will need the following from your doctor:
Doctor’s prescription with the child’s name
Copy of Doctor’s license
Have your doctor fax this to 225-924-0249.

You will then pay American Medicine (225-924-0247) and they will overnight the immunizations to your doctor. You will have to pay the overnight shipping fee due to the medicine needing to be refrigerated.

Make sure you ask for the expiration dates so that you will know ahead of time and for your records.

September 2007- Cost is appx. $119 (for all 3) plus shipping/handling (+-$20.)

I called the company and talked to Bridgette Schexnayder today. She said the $119 is for all three vaccinations which they overnight to your doctor's office at one time. She said the vaccines are currently on backorder, but they should be receiving a new shipment next month (Dec 07). She also said the vaccines will have about eighteen months until they expire. If that is the case, we will have to reevaluate and adjust when AJ gets each of these three vaccines as I currently have them spaced over a longer time period than eighteen months.

Another MDC member posted that Johnson Drug will also send you the separate vaccines. I have not personally contacted them to verify this information, but I wanted to share it as well. This MDC member stated that to order from Johnson Drug, you need a prescription from your pediatrician and to expect to pay about $40 per vaccine.

Anyone else have a delayed vaccination schedule you want to share? I would love to read what other people are choosing. Post in the comments or share it on your blog and let me know so I can check it out!

READ THIS POST IN ITS ORIGINAL FORM ON MY OLD BLOGGER SITE - COMPLETE WITH ALL COMMENTS!

And so she made some lists . . .

Seth Godin recently wrote that "the mistake most blogs and books make: they are about the writer, not the reader."

Last month, I shared with you that I try to keep my audience in mind as I write and post here at SortaCrunchy.

But today I am going to be selfish and post some totally me-centered stuff just because I big fat want to. So feel free to skim on by if you feel so led, but I do want to say I am posting this publicly because I welcome advice and feedback and suggestions!

We are now staring down the barrel of less than one month until Little Sister's delivery. (Scheduled c-section date is September 5th.) As I panicked mulled this over yesterday, I found it very theraputic to make some lists. Helps me feel a little more, oh I don't know, centered? In control? It at leasts organizes my thoughts and helps me break free of this pervasive sense of denial which hounds me . . . denial that in less than one short calendar month, the SortaCrunchy family will be a Party of Four.

Humor me.

TO DO:

* wash and sort all of Little Sister's diapers
* figure out some kind of organizing solution for the cloth diapers that are slowly taking over the nursery (D's and LS's combined)
* find all the parts to my trusty hand pump and figure out what parts need to be replaced
* make appointment with our pediatrician to go over delayed vax schedule
* go over birth plan choices with my OB and clarify what hospital procedures will allow for (Can I have one arm unstrapped to hold her for a minute after she is delivered? Can she be with me in recovery? these kinds of things . . .)
* write thank you notes from LS's shower
* wash newborn clothes
* get a haircut
* pack hospital bag

TO BUY:

* more infant prefolds and small covers
* button-front pj's for Mama for the hospital and home
* at least one more decent nursing bra
* Lansinoh
* breast pads - cloth or disposable? Would love to hear feedback on what worked for you!
* more post-partum pads
* snacks for the hospital bag
* Mei Tai? Which one? I am to the point of having anxiety dreams over this one. Of course, I want an uber-cool, uber-chic BabyHawk, but the Budget Mistress within is balking at the price tag. But a Mei Tai will definitely take us through toddlerhood, isn't it worth the investment? But couldn't I find a fully functional Mei Tai for less somewhere? And so goes the circles of debate in my mind. DEFINITELY open to feedback on this one, mamas!

And so that's that. For now. Thanks for bearing with my all about Megan indulgence.

Labels: baby

SortaWhat? Part Two

Wow, I will tell you what . . . There is nothing like being out of town for the better part of a week to allow a mama to see how much she does around the house on a daily basis! D and I got home Friday night and I am just now climbing out from under the piles of laundry and dust bunnies.

(And on that note, I am so terribly, TERRIBLY behind on my blog reading. Reading the blogs of both my friends and the amazing women whom I have "met" in the blogosphere is such an important part of my day. I am suffering from tremendous blogger guilt and frustration in not being able to read and comment as much as I would like to, and Google Reader is just taunting me by reminding me I have 100+ posts to peruse! Anyway, soon and very soon I will be back in the swing of things.)

So to continue the conversation on why I choose to identify myself as "sort of" crunchy (yep, Katherine, as in granola-y . . . mmmmmmm, granola . . .), I am just going to outline the natural family living (NFL for short, but not the kind of NFL your man wants you to appreciate) practices that are an important part of my life.

Natural Family Living Philosophies/Beliefs I practice:

* child-led weaning
I used to say "extended breastfeeding," but I have taken a step away from that term for now. Breastfeeding advocacy is very important to me, but at the same time, I want to emphasize that I believe in a mutual weaning process. I have friends online and in my community whose babies simply would have nothing more to do with the breast after nine months or six months or some age earlier than a year old. In these cases, the breastfeeding mother would have loved to have practiced "extended breastfeeding" (general term for breastfeeding past a year), but saw the need to balance her desire to breastfeed with her desire to respect and follow her baby's desires.

I found that Kellymom was a great place to start in researching common questions and concerns regarding breastfeeding past infancy.

* cloth diapering
I have a ton of posts about cloth diapering which you could easily access through my Blogger tags. When it comes down to it, I love cloth diapering because I think it is best for the environment, best for baby's skin, and definitely best in overall cuteness. :)

* babywearing
Although that particular "label" may be new to some, the art of wearing a baby is as old as time. You've no doubt seen mainstream versions of babywearing in the form of Baby Bjorn and New Native carriers, but those carriers are just the very tippy-top of the babywearing iceberg.

I had toyed with idea of buying a carrier before D was born; I had no idea the high-needs baby about to be delivered to me would make it a necessity rather than luxury to have some kind of device by which to keep her on me for the majority of the day. I have worn D in ring slings, pouch slings, Mei Teis (Asian Baby Carriers), and my personal favorite for toddlerhood - the Ergo.

TheBabywearer.Com offers a vast array of babywearing information. These articles say it all much better than I ever could!

* emphasis on whole foods (organic when possible)
I feel guilty even mentioning this because pregnancy triggers within me non-stop cravings for junk! and sugar! and junk! and comfort foods! and junk!

But in my normal, non-pregnant life, I try to make the healthiest cooking and eating choices available to me and my family. Last summer, The Coach and I went vegetarian for a while and really enjoyed the change. D is a born vegetarian (seriously, the only meat the child will eat is turkey lunch meat and corn dogs from Sonic *red-face*). We love to shop the local farmers' market and are thankful we don't live near enough to a Whole Foods Market to shop there because we manage to spend astronomical amounts of money on each visit to that holy mecca.

* shared sleep (co-sleeping)
EDITED - It wasn't until I went upstairs to lay down with D for a nap that I remembered that we also practice shared sleep!
We never intended to be co-sleepers, but again, it was one of those things that just sort of happened. Now I cannot wait for Little Sister to be here so we can snuggle a wee one between us in bed again. Big Sister sleeps in her crib full-time now (well, with the rare exception - like last night when a bad dream awakened her and her daddy said, "Just let her sleep with us . . ."), so I miss that snuggle time at night.

The Sears site has some great information (including VERY important safety tips) on co-sleeping.

* Attachment Parenting
One need not practice NFL in order to practice Attachment Parenting, but by and large, the same parents who are drawn to natural living also find they connect with the Attachment Parenting philosophy. I will not try to reinvent the wheel here on what AP is. A great deal of information is available at askdrsears.com including What Attachment Parenting Is and What It Is Not. Some time ago, I also shared how it came to be that Attachment Parenting chose me.

Natural Family Living Philosophies/Beliefs I Do Not Practice (or Why I Am Not One Hundred Percent Crunchy)

At this point in time, we believe we are led to send our children to public schools. There are many in the NFL community who choose to homeschool for a variety of reasons. The Coach and I feel a special call to have our children in public schools, but we are open to whatever God leads us to do at any given time for any of our children.

Also at this time, if we are blessed with a son, we will choose to have him circumcised. This is very unusual in the NFL community as a whole, but it is an issue about which The Coach holds strong feelings and I am at peace in following his leadership in this area.

D has been vaccinated on schedule. You will find many families who practice natural living choose not to vaccinate their children. After much discussion and thoughtful consideration, we feel vaccinating is a good choice for us at this time. The two of us are currently in negotiations over whether or not Little Sister will be vaxed on schedule. I would like to follow a delayed vax schedule, but that is not set in stone yet.

Finally, as I have recently talked about, I am choosing an elective repeat c-section for Little Sister's delivery. As much as I fully support and strongly believe in the beauty and power of a natural vaginal delivery, there are factors that complicate and muddy my situation that have turned what could be a black-and-white issue into a big gray area for me.

So there ya have it! A fairly concise picture of me straddling the fence between crunchy and mainstream. Thankfully I am not posting an actual picture of me straddling anything! My big ol' pregnant self does not need to be shown straddling anything at this moment in time.

That reminds me, I think I owe ya'll a belly shot . . . no fences. I promise.

Labels: babywearing, breastfeeding, cloth diapering, food, general natural family living