I wanted to do a separate thread from the one I saw on the first page because it addressed a specific vaccine (whooping cough) whereas mine addresses a specific question that Cecil answered.
Here is the part I have questions about:
My wife, who hates anti-vaxxers as much as I do (which is a lot) has a son who experienced an allergic reaction to one of the vaccinations he had when he was very tiny (before I came into the picture so I don’t know anything more specific) and said that the doctors admitted to her that there was no way to determine which vaccination caused the reaction because he had so many at once.
Fortunately is was not a major reaction so it didn’t mean any long-term harm or major discomfort at the time, but it made her leery of doctors who demanded that she subject her infant child to a dozen different vaccinations who then couldn’t let her know which one caused the reaction.
What I want to know is how common this is? Additionally, if a mother says to her child’s doctor that she wants her child to get vaccinations and doesn’t mind making numerous trips to get them all done, if it will ease her mind and also ensure that the child is vaccinated properly, is there a problem?
What exactly would be the point of knowing which vaccine caused the problem? Every single vaccine can cause an allergic reaction and the treatment is always exactly the same and depends entirely on the symptoms. The kid could have been allergic to two of the vaccines, or to an ingrediënt that’s present in every single vaccine. By giving him everything at once, he only experienced the allergic reaction once.
On the other hand spacing out the vaccines can quite easily lead to missed shots. As Cecil wrote and you quoted: A 1994 paper found an effort to administer MMR shots at the same time as other vaccinations would have spared a third of the unvaccinated preschoolers who got measles during an early-90s U.S. outbreak. Also, spacing out the shots means they get some shots later than they normally would have, giving an extra window of opportunity for every disease the kid would normally already be vaccinated for.
The standard treatment for a vaccine allergy is to to give that person any more of that vaccine. Like my wife who is allergic to the tetanus vaccine so they don’t give it to her. Unfortunately the whopping cough vaccine is now only available with with tetnus and so she can’t have that one which doctors recommends after each pregnancy because they can’t give the vaccine to a newborn. So I get it but my wife can’t.
Um, to determine what might have caused it? Vaccines have different ingredients in them, some of them inactive. Also, booster shots can be avoided down the road or modified if possible if we know what caused the reaction.
If the parent does not follow through on making and sticking to appointments. Which might be a problem with some parents but not others, including my wife.
My daughter had a bit of a reaction to one of her first batches of vaccines. Out of an abundance of caution, we did the “spread out” strategy after that for both kids. (Nothing was delayed more than a month, and yes there were a couple more “reactions” along the way).
The doctor had absolutely no problem with this, though she was our long-term family doctor who delivered our children so knew that we kept appointments. However, my doctor said that IN GENERAL, they go with the attitude “if I’ve got a kid here, there’s no guarantee he’ll see a doctor for years after this, so we try to get the parents to do everything.”
The problem with “spacing out” vaccinations in an attempt to avoid an allergic response goes beyond inadequate protection. It is also an ineffective strategy to identify and avoid a potentially serious allergic response.
“All suspected anaphylactic reactions to vaccines should ideally be evaluated in an attempt to determine the culprit allergen. It is disturbing that a patient who experiences an IgE-mediated reaction following immunization is often labeled as being “allergic” to the vaccine and is thus advised against receiving future doses without further investigation. This approach should be avoided as it may leave patients inadequately immunized if they unnecessarily avoid the vaccines to which they are not allergic to, or if the vaccine can be administered safely without causing an allergic reaction. In addition, not knowing the particular constituents of a vaccine to which the patient is allergic to may pose a risk to future doses of other vaccines that contain similar constituents.”
A physician who says it is impossible to know what vaccine constituent caused an allergic reaction is wrong. There are antibody and skin tests that can identify some of the most common allergens and help guide a safer immunization program (see linked article).
Note also that allergic reactions vary from relatively mild to rare but life-threatening situations.