So I'm getting tired of dealing with vaccine refusing/hesitant families. While watching the ags vs akry baseball I typed up a response to a F16 thread and figured I would post it here just for folks with questions and interested in discussion.

Anyway here is my 20+ years of frontline practice professional opinions on specific vaccines.

Hepatitis B- important if mom had Hep B but if they had normal prenatal care we know if they have it or not. Transmission from mom to a new baby is dangerous but otherwise this is only a risk for teens/adults so it could easily be delayed until teenage. The vaccine is very safe and effective though and included in most combo shots.

DTaP- diptheria- not a horrible disease outside of the first few months but no treatment.
Tetanus- this is a no brainer. You will never get rid of tetanus, there is no treatment and nearly 100% mortality. Foolish to not protect against it.
Pertussis/Whooping cough- horrible disease in kids under 6 months, treatment doesn't help the patient just prevents transmission.

PCV- Strep pneumonia - common cause of life threatening pneumonia, brain infections, blood infections. Another no brainer. Very safe and effective.

Hib- This one is very old so despite being in practice for two decades I've never seen it. It causes aggressive brain infection and epiglottic infections. Safe and effective again a no brainer

Polio- .a very contagious but mild infection but will occasionally leave long lasting paralysis. Why anyone would leave their kid open to this is mind blowing to me. Vaccine is proven safe and effective over several decades.

Rotavirus- newish (last 15 years) vaccine given by mouth. Rota causes severe vomiting and diarrhea. In the USA this resulted in a lot of hospital stays but very rare deaths. Vaccine was really made for the developing world since they die due to lack of access to IV fluids. It is safe overall so nice way to save some $$ from er visits/hospital stays. Decreased hospital stays for dehydration by 80% in the USA.

MMR- another no brainer IMO. Measles has no treatment, causes a pretty high rate of hospitalization for pneumonia and dehydration, has a small risk of subacute sclerosing panencephalitis which you don't want to know about. Mumps is a fairly miserable illness with no treatment. Causes very swollen lymph nodes and can infect the testicles and ovaries causing sterility. If you don't want grandkids I guess that is one way to do it. Rubella is no big deal unless you are pregnant and get it then it causes heart defects in your baby.

Chicken pox/Varicella- usually not dangerous unless your kid is on chemo. Can leave long term scars. Usually lasts about 2 weeks and they have to stay home the whole time. There is a risk of secondary bacterial infection that leads to necrotizing fasciitis which you don't want. Roughly 80% effective and the ones who still get natural infection get a very mild form with < 20 lesions and no fever. Both my kids had break through infections with this.

Hepatitis A- food born illness with no treatment. Causes vomiting and jaundice. Not terribly dangerous unless you are elderly. Vaccine is nearly 100% effective and very low rate of side effects.

---------------------that is it for infant vaccines until teen years----------------

Meningitis- Neisseria meningitis. When I was training at the turn of the century this was the bane of the hospital. Very rapid very bloody very nasty deaths in healthy kids. Just morally and spiritually devastating to treat these kids. Side effects are mild and worth it to prevent this now rare disease.

TdaP- see above- do you really want tetanus in your kid?

HPV- I reccommend this around 14ish or so. Data over the last 15 years is looking really good on effectiveness and safety. It is the one and only vaccine to prevent cancer. Sure if your kid is the unicorn that has one sexual partner and is not homosexual they don't have a risk of this but that is a big big gamble with humans.

----------Seasonal/situational----------------------
COVID- only for high risk patients - those with heart or lung disease of cerebral palsy. Right now only the mRNA vaccines are approved for under 12 and their efficacy drops off dramatically after 60 days so very dubious benefit. Novavax is a nice option for high risk 12+ as it seems to last longer and have fewer side effects.

Flu- Advised for kids under 1 and those with heart/lung disease of all ages. Efficacy is pretty bad around 35% annually. Main benefit is preventing hospital stays or death in high risk patients.

Pepper Brooks said:

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Have you read "The Vaccine Book" by Dr. Sears? If yes, how do you respond to parents who come in looking to delay/avoid/space out chicken pox/hep A/MMR and others?

He is also a pediatrician with 20+ years experience who claims to have done his research and came to different conclusions.

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Yes I have. There is no evidence delaying vaccine is safer or more effective. Babies' immune systems are more than capable of processing the current vaccine load.

That being said I'm happy to help with whatever vaccine schedule parents want.

I think what struck me most was seeing the rates of seizures and other severe reactions in the 1/100s and 1/1,000s vs much higher. The risk reward for things like hep A(unlikely to contract in modern homes/day cares with decent cleaning protocols), chickenpox, and MMR(treatable if caught and more or less isn't a concern given how few outbreaks in the US these days) doesn't seem to justify the vaccines at 1 yr if the rates are as high as he says.

Regressive autism is a touchy subject but the correlation before age 2 is hard to ignore from a parents standpoint, too.

Pepper Brooks said:

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I think what struck me most was seeing the rates of seizures and other severe reactions in the 1/100s and 1/1,000s vs much higher. The risk reward for things like hep A(unlikely to contract in modern homes/day cares with decent cleaning protocols), chickenpox, and MMR(treatable if caught and more or less isn't a concern given how few outbreaks in the US these days) doesn't seem to justify the vaccines at 1 yr if the rates are as high as he says.

Regressive autism is a touchy subject but the correlation before age 2 is hard to ignore from a parents standpoint, too.

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MMR is not treatable. No antivirals for any of them.

It is sad you even have to write something like this Doc. The problem is that many people have lost faith in the medical profession. COVID was a big blow to the credibility. There was a guy across from my church where I grew up that lived in an iron lung due to polio. I had a good friend of mine whose daughter almost died due to whooping cough. She was mis-diagnosed for a week before someone realized what was going on.

It would have to be extraordinary circumstances for me to ever take another vaccine or trust what the medical community is doing, and that is a sad thing. Quite frankly, I believe that the medical profession is being run by pharmacutical companies. You just have to turn on your television and see all the commercials for stuff you didn't even know existed.

Another example of a credibility issue is blood pressure. I'm old enough to remember when hypertension was considered 160/90. Why did it change? Could be for all the right reasons. Could be so it opens up the market to peddle more blood pressure drugs.

The medical profession has just gotten too dirty to trust.

And Doc - I hope you don't see this as a personal attack. The fact that you give your knowledge freely is VERY rare. I appreciate it - as jaded as I am.

Remember when not vaccinating your kids was a dumb super liberal hippie thing and now dumb conservatives have adopted it as well. COVID really brought us closer together as a country.

Hoosegow said:

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Quite frankly, I believe that the medical profession is being run by pharmacutical companies.

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Ya think? The US is rare in that it even allows DTC medical advertising. Talk about red flags.

This is not directed to anyone on this thread just something I've noticed. But it seems like we have a certain contingent of people in this country who consistently say we have the best health care system in the world (whenever there is a discussion about making drastic changes, i.e. single-payer, etc). But at the same time, a lot of these same people seem to have a huge amount of distrust in all things health care in the US. The same people that talk about the for profit system driving innovation, but then go on about how the medical / pharma community cannot be trusted, as they put profits over people.

I remember once posting on F16 about direct to consumer marketing of drugs, and how it's not good, and people lit me up because something about the free market and USA USA best healthcare in the world, etc.

Lots of cognitive dissonance.

Good informative thread. Child of a MD educated in the 70's so the "better living through chemistry" generation. Gimme all the vax you got. If I can avoid or minimize symptoms I'm all for it. Will be 49 this year and will be lining up at the doc's office for the shingles vax the day I turn 50.