CA Vaccine Law - Pt 2 - Now W/arguments about everything!

[August]

You've only ever had sex with your husband, but he goes out and cheats on you with five different women. Suddenly your risk is much higher than you perceive. People's assessment of their risk level is not always accurate.

Yes, that's what I said. The risk assessment needs to be personal, and the default needs to be taking action.

Curious--do you think pregnant women should opt out of HIV testing if they perceive themselves at low risk? Same type of thing--huge consequences for the child if the mom is positive and doesn't know.

Testing and immunisation are very different things, not the same type of thing at all. One is virtually non-invasive, the other is invasive.

Unless you think I delayed the Hep B because needles are icky. Which doesn't make sense, because you're getting a blood test anyway for things which have a very very high risk for your baby, so adding HIV on is irrelevant in terms of risk, and enormous in terms of reward. And the needle goes to a different person.

MamaMia, they test for at least HIV, Hep B (and C maybe?), rubella ab, syphilis and blood type antibodies. HIV's the only one you have to give specific permission for, though.

[Petrel]

HIV testing is not without risks. Imagine getting a false positive.

[FundieFarmer]

I'd rather know than not, though. With a positive, they usually test twice...or at least that's what my GP said when they tested me after my assault. And I've heard you no longer have to sign anything about it, which would've been nice.

[Petrel]

Yes, that's what I said. The risk assessment needs to be personal, and the default needs to be taking action.

You seem to be saying people should be more inclined to refuse though. My opinion is people should be more inclined to get the vaccination or test because the risk is so low and benefits so great.

Testing and immunisation are very different things, not the same type of thing at all. One is virtually non-invasive, the other is invasive.

Unless you think I delayed the Hep B because needles are icky. Which doesn't make sense, because you're getting a blood test anyway for things which have a very very high risk for your baby, so adding HIV on is irrelevant in terms of risk, and enormous in terms of reward. And the needle goes to a different person.

Now that I think of it the HIV test was probably done with the draw for other tests, so opting out probably would have only saved a few milliliters of blood.

It is recommended as an opt-out test because if it's opt-in a lot of people will discount the idea that they might need it, similarly to the hepatitis B vaccination.

I'd rather know than not, though. With a positive, they usually test twice...or at least that's what my GP said when they tested me after my assault. And I've heard you no longer have to sign anything about it, which would've been nice.

I'm really sorry you had to go through that. They do run the test twice if it comes up positive. The first test is an ELISA test, which is fast and sensitive but produces some false positives. If that is positive they do a western blot to confirm, which is a more time consuming test but more conclusive.

We really need to reduce barriers to HIV testing since it is so beneficial to detect it early. With modern combination antiviral treatment a lot of people can reach almost undetectable viral counts, which means they are much less likely to pass it on and they are preserving their immune systems for much longer. Now people with HIV can expect basically a normal lifespan.

[FundieFarmer]

That's interesting, I really didn't know the two tests were different. Mine came back negative so I didn't have to do the second test. I do 100% agree the barriers need to be lower, and cheaper. I'm glad they removed the paper trail in my state...as shallow as it sounds, if I'd known before I walked in there, I would've been more hesitant. I hate to say I would've reconsidered it, but I probably would've. I couldn't risk my parents knowing, but I took the risk. I hope it didn't dissuade others in the past, but I'm glad it won't moving forward, especially knowing how it spreads and how much the stigma has gone down.

[August]

Stop equating tests and immunisations! They are two totally different things! If you want to discuss, say, mammograms for thirty year olds, annual pap smear or routine screeng PSAs, then let's. But HIV screening of a pregnant woman is very different from immunising a newborn.but don't get me started on syphilis!

HIV testing is not without risks. Imagine getting a false positive.

There are no false positives with HIV testing. As someone just explained, if the screening test is + they do the Western blot, which does not give a false positive.

[Petrel]

Ummm that was me. I'll be sure to get with myself and explain HIV testing to myself ASAP.

ELISA tests can and do come up with false positives.

Edit: HIV testing of pregnant women and hepatitis B vaccination of neonates seem very similar to me. They are both low-risk preventative care interventions that protect an infant against a disease with devastating consequences.

[Mama Mia]

Ummm that was me. I'll be sure to get with myself and explain HIV testing to myself ASAP.

ELISA tests can and do come up with false positives.

Edit: HIV testing of pregnant women and hepatitis B vaccination of neonates seem very similar to me. They are both low-risk preventative care interventions that protect an infant against a disease with devastating consequences.

I really, really don't see how anyone could equate a test and an immunization. You might very well conclude that they both have relatively similar benefits, but even the safest immunization on the planet is going to carry some risk of a reaction, no matter how tiny. Where testing for something , particularly when they are drawing the blood anyway, has no inherent risk. They are just really different things.

[August]

But does the patient get told about an ELISA result? It seems like doing a Western Blot is automatic if the ELISA comes up positive. Do they need a fresh sample? And from what I've read, the problems with the Western blot are false negatives due to the window period.

You really cannot be seriously arguing that something going into the body to modify it is the same as getting information out about what's going on in the body.

And if you're going to be claiming HIV testing is dangerous because of false positives causing stress, how about hep B vax giving a false sense of security to a parent in a high risk situation? seroconversion can't be very good with a newborn.

[FundieFarmer]

I was told that if the ELISA came back positive, I'd be notified and we'd do another draw. They actually made me come in regardless of the result, because apparently legally they can't reveal it over the phone. I assume they'd do it at that appointment. Plus it's a clinical visit, so I paid just to be told I was fine, after paying huge lab fees.

I agree they're not quite the same in mechanics. My general feeling is better-safe-than-sorry, so I can see that application for both.

[August]

If you want to have another interesting discussion point about vaccines, I delayed my kids MMR a few months because it increases the effectiveness.

Now, this is way more risky, and needs a relatively sheltered child (IIRC, one got it overseas because that was when their first birthday was, and flying is the best way to catch something nasty), but as far as assessment of personal risk vs public health risk assessment goes, it's another good illustration. We do MMR in the US at 12 months even though it's less effective than at 15 months for compliance and for population-wide risk.

[PennySycamore]

I was just reading an article on a malaria vaccine to be released in Africa soon. It's already passed a European medical panel and only has to have WHO approval before it can be used. The anti-vaxx crowd had to show up. How could they say that shit about vaccines when malaria kills one African child every minute? Anti-vaxxers, BITE ME!

[3DMommy]

If you want to have another interesting discussion point about vaccines, I delayed my kids MMR a few months because it increases the effectiveness.

Now, this is way more risky, and needs a relatively sheltered child (IIRC, one got it overseas because that was when their first birthday was, and flying is the best way to catch something nasty), but as far as assessment of personal risk vs public health risk assessment goes, it's another good illustration. We do MMR in the US at 12 months even though it's less effective than at 15 months for compliance and for population-wide risk.

Why can't more people be like you? Research and make the best decision for their family? I know so many parents who can't even tell you what their kid is vaccinated for or what the letters mean. I'm not anti vaccination, but my almost 2 year old is currently unvaccinated.

[IronicallyMaeve]

A second dose of MMR is given at age 4-6 to ensure protection. One dose is 78-93% effective (depending on which virus) while two is 88-97% effective.

In any case, the recommendation is 12-15 months for the first MMR dose. Unless you live in a high risk area, it may make sense to wait until 15 months to vaccinate.

In regards to HIV testing, I had routine STI testing done through my school. They had my results posted to a secure website. They would have called me if anything came up positive, but it didn't so I just got my results a few days later.

[Petrel]

But does the patient get told about an ELISA result? It seems like doing a Western Blot is automatic if the ELISA comes up positive. Do they need a fresh sample? And from what I've read, the problems with the Western blot are false negatives due to the window period.

Answered above.

Western blot produces false negatives in people who have been infected but not yet seroconverted. This is an issue with someone who has a known potential exposure and is why testing at 3 and 6 months post-exposure is recommended to be certain. It would not be an issue with routine testing of pregnant women since most people are at low risk for HIV infection. I would hope any women who are at heightened risk and aware of it would discuss that with their doctor.

You really cannot be seriously arguing that something going into the body to modify it is the same as getting information out about what's going on in the body.

What I'm saying is the risks to both interventions are so low and the benefits so great that I see zero reason to decline either.

Seriously. What is it that worries you about the hepatitis B vaccine? The kid just was born and is suddenly being exposed to tens of thousands of new things for his or her immune system to react to, what is the significance to you of adding a couple more? It's like this unspecified vague horror that SOMETHING could happen, in spite of the fact that in the developed world most babies born are vaccinated with absolutely no ill effects!

And if you're going to be claiming HIV testing is dangerous because of false positives causing stress, how about hep B vax giving a false sense of security to a parent in a high risk situation? seroconversion can't be very good with a newborn.

So you suggest . . . doing nothing? Your recommendation would be the same as mine--test the mom, vaccinate the kid, administer immunoglobulin if indicated.

HIV testing is not dangerous, it is just not risk-free. No diagnostic test is risk-free. For some the actual test is dangerous (like biopsying a brain tumor), for others the danger is false positives and the time and money spent figuring out the patient is actually negative, plus the stress to the patient and possible relationship problems. A person with a strained relationship with their partner might react to a false positive HIV test by assuming the worst and result in the breakdown of the relationship before the confirmatory test comes back negative.

I feel like 70% of the reason you're debating this is because you personally did not vaccinate your child at birth, iirc, and are feeling judged. That's not the decision I made, and I think it is best if everyone adhere to CDC recommendations because that is the way to eradicate hepatitis B on a population level. But neonatal hepatitis B vaccination is just the tiniest facet of raising a kid. I'm not going to applaud a mom who gets her baby vaccinated and then leaves the newborn for hours to "cry it out", for instance.

[Petrel]

Why can't more people be like you? Research and make the best decision for their family? I know so many parents who can't even tell you what their kid is vaccinated for or what the letters mean. I'm not anti vaccination, but my almost 2 year old is currently unvaccinated.

:wtf: Why? Why would you do that? The entire global medical establishment has already done the research for you and found it's best to vaccinate, why would you let your kid go running around completely unvaccinated?? Why??? :lost: Do you live on a research base in Antarctica? A desert island?

[August]

3Dmommy, what's reasoning behind not getting them the DTaP?

[RosyDaisy]

Damn, nothing is going to kill this thread. smh

[3DMommy]

:wtf: Why? Why would you do that? The entire global medical establishment has already done the research for you and found it's best to vaccinate, why would you let your kid go running around completely unvaccinated?? Why??? :lost: Do you live on a research base in Antarctica? A desert island?

Nonot antartica, but up until 2 months ago we lived in the middle of nowhere and rarely left the house, and has never been to daycare. Baby was premature, and when they tried to vaccinate him for hep b in the hospital despite him not weighing enough (acxording to the manufacturer) I put my foot down.

Original plan was to wait 6 months then start vaccinating him, but my cheap soon to be ex husband refused to pay for health insurance (still does). Eventually baby WILL get all of the shots (including DTaP I'm not a fan of the pertussis portion of the vaccine simply because it is not effective). There is the added concern of a family member who can't be in close contact with people recently vaccinated with live virus vaccines.

Now that baby is almost 2 and closer to weaning (and we no longer live with the family member) I will start vaccinating, but like I said I am not anti vaccine, I also don't think they cause autisum, but I do know that they can cause side effects and sometimes be harmful to the people around you.

On a side note my older child is fully vaccinated for all required vaccines and I think the malaria vaccine is a great thing.

[Terrie]

I really, really don't see how anyone could equate a test and an immunization. You might very well conclude that they both have relatively similar benefits, but even the safest immunization on the planet is going to carry some risk of a reaction, no matter how tiny. Where testing for something , particularly when they are drawing the blood anyway, has no inherent risk. They are just really different things.

Well, there is always a small risk when when drawing blood. I recently had some tests done, and the informed consent form included the risk of infection from the needle stick.

[OkToBeTakei]

Nonot antartica, but up until 2 months ago we lived in the middle of nowhere and rarely left the house, and has never been to daycare. Baby was premature, and when they tried to vaccinate him for hep b in the hospital despite him not weighing enough (acxording to the manufacturer) I put my foot down.

Original plan was to wait 6 months then start vaccinating him, but my cheap soon to be ex husband refused to pay for health insurance (still does). Eventually baby WILL get all of the shots (including DTaP I'm not a fan of the pertussis portion of the vaccine simply because it is not effective). There is the added concern of a family member who can't be in close contact with people recently vaccinated with live virus vaccines.

Now that baby is almost 2 and closer to weaning (and we no longer live with the family member) I will start vaccinating, but like I said I am not anti vaccine, I also don't think they cause autisum, but I do know that they can cause side effects and sometimes be harmful to the people around you.

On a side note my older child is fully vaccinated for all required vaccines and I think the malaria vaccine is a great thing.

Out of interest do you mean no vaccines at all?

Not any on the schedule at ALL?

[Snarkylark]

Well, there is always a small risk when when drawing blood. I recently had some tests done, and the informed consent form included the risk of infection from the needle stick.

Correct, there is a slight risk anytime anything breaks the skin.

[August]

Nonot antartica, but up until 2 months ago we lived in the middle of nowhere and rarely left the house, and has never been to daycare. Baby was premature, and when they tried to vaccinate him for hep b in the hospital despite him not weighing enough (acxording to the manufacturer) I put my foot down.

Original plan was to wait 6 months then start vaccinating him, but my cheap soon to be ex husband refused to pay for health insurance (still does). Eventually baby WILL get all of the shots (including DTaP I'm not a fan of the pertussis portion of the vaccine simply because it is not effective). There is the added concern of a family member who can't be in close contact with people recently vaccinated with live virus vaccines.

Now that baby is almost 2 and closer to weaning (and we no longer live with the family member) I will start vaccinating, but like I said I am not anti vaccine, I also don't think they cause autisum, but I do know that they can cause side effects and sometimes be harmful to the people around you.

On a side note my older child is fully vaccinated for all required vaccines and I think the malaria vaccine is a great thing.

Have you checked with the public health department to see if they'll provide free or low cost vaccines? We moved once and had a several month wait to see the new ped. The local public health gave the vax the child was due for for free and on the day I walked in.

The antibodies in your milk work great for things he encounters orally, like norovirus and e coli, but don't help for airborne things like measles. Your boost for his measles immunity was transferred in utero and has been gone for a long time now (they wane over the first year, and are mostly gone by the first birthday). In fact, if your baby is like most two year olds, he's nursing so infrequently and so lightly that he's not getting the continuous oral antibody boost a small baby gets anyway.

The oertussis vax is pretty crap, especially compared to one like diptheria, but it does help significantly reduce the severity, and believe me, that is something you want, especially the younger the child, and with susceptible lungs like preemies have. And the crapness of the vax means that you and the other vaxxed adults could bring it home from the supermarket or work for the baby, which you're less likely to with some other diseases. Older adults can have low/no immunity to measles if they only received one vaccine (I'd say people roughly around the ages of 20-40 fall in this group). If the adults haven't had a booster they could bring measles home from work to the baby.

The DTaP is very useful, even for isolated people, as tetanus is in the soil everywhere, and can infect them from a wound you don't even notice.

There are actually very few vaccines which shed and pose a danger to immunosupressed people. I know the old polio vaccine did, but the new one does not. edit: yep, per the CDC the injectible polio vaccine is fine for close contacts of severely immunosuppressed people, and so is MMR. There are two flu vaccines, you'd use the injectible one.

Do you have health insurance yet? If not, call up the local public health and ask what they suggest. If they don't offer any vaccines they might know of clinics where you can get them for free or low cost. I wonder if you called a peds office and explained if they'd help out? Maybe do them for cost only?

Do you have a plan for what to start with? HiB gives me the heebie jeebies, but with measles around that might be a better start. You might be able to get most of them started on the same visit, especially with combos.

[August]

VERY IMPORTANT INFORMATION

Yes, there's a federal program for uninsured or underinsured children to get free vaccines. Peds are even required to administer them for free if you can't pay the consult/injection fee.

You should contact your local public health (you could call your town or county office to start), and they will get you set up to start.

http://www.cdc.gov/vaccines/programs/vf ... ailed.html

[FundieFarmer]

Damn, nothing is going to kill this thread. smh

Maybe if we vaccinate it, it'll get complications and die, because that happens all the time, you know.